Americans are getting older, and heavier—and both trends are trouble for the country's knees.
The rate of total knee replacements almost doubled between 2000 and 2010 for Americans over 45, according to new data from the Centers for Disease Control, while the average age of patients decreased by more than two years, to 66.2. The elective surgeries, which replace worn-out cartilage and bone with metal and plastic mechanical joints, became the most common inpatient hospital procedure for people over 45 in 2008. Almost 700,000 were performed in 2010.
The annual market for knee implants is roughly $4 billion in the U.S., according to estimates compiled by Bloomberg Intelligence analyst Jason McGorman. The cost of the surgery can vary wildly depending on the region or hospital. On average, it's increased to about $16,600 in 2012, from $13,900 in 2000, in inflation-adjusted dollars, according to CDC data. Though there are risks with any surgery, including possible infections or implant failures, knee replacements are considered a highly cost-effective intervention, McGorman says, because they can allow people to continue to work and avoid disability or other expensive care.
The force on the knee when going up stairs can be three to five times body weight, says David Teuscher, president of the American Academy of Orthopaedic Surgeons. Not everyone who suffers from obesity gets knee pain, but the extra weight can aggravate arthritic knees. The relationship may run both ways, as joint pain deters people from work or exercise. "We counsel our patients for weight reduction, but more and more we’re realizing that they’re never going to be able to lose the weight unless we replace the knee and put them into an exercise program," Teuscher says.
Knee Replacement Surgery
Needing a surgically replaced knee
can be a consequence of obesity
and the vicissitudes of age
which have brought joints to a painful stage.
And it appears that climbing stairs increases stress
and all this can make one's life a mess
so, in order to replace a groan with a smile,
in two thirds of patients the procedure's worthwhile.
But how is it that so few can achieve a lean ideal
and learn to control both exercise and meal?
And this is probably also true
of all our other attempts at virtue!
Therefore, it may be fortunate for us all,
whether short, medium or tall,
that they can't daily weigh our merit on a scale
and then know how often so many of fail!
HZL
9/2/15
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