Written by Senior Communications Editor Kim Savage
Improvements in implants and surgical techniques are prompting more people to choose joint replacement surgery at increasingly younger ages.
More than a million hip and knee replacement surgeries are performed each year in the US, and patients over age 45 account for 95% of those procedures. The number of joint replacements for middle-age patients (ages 45 to 64) increased 205% over a 10-year period, compared to a 92% increase among ages 75-plus, studies show.
This pronounced spike in younger patients having joint-replacement surgeries presents a growing dilemma for orthopedic surgeons.
“It really brings into question how young is too young,” said surgeon Edward Stolarksi, MD medical director of Sarasota Memorial’s orthopedic services. “There was a time when we would send patients home and say ‘Come back when you can’t stand the pain anymore.’ But with today’s personalized implants and advanced surgical techniques, that’s not the case anymore. We are operating on people in their 20s, 30s and 40s, with exceptional results.”
There is a clear benefit to performing surgery on younger patients whose chronic pain has not responded to more conservative treatments. Not only do younger patients heal faster, their joints function better, allowing people to quickly return to the workforce and an active lifestyle. That reduces the financial drain on a family’s income and improves their quality of life.
But because younger patients live longer and play harder after joint replacement, patients and their surgical team must weigh the benefits with the risk that they may need a revision surgery 20 to 30 years down the road, explained orthopedic surgeon Sean Dingle, MD.
Dr. Stolarski and Dr. Dingle, who are in practice together at Kennedy-White Orthopaedic Center, are the two top-volume orthopedic surgeons in the community, and are among the highest volume surgeons performing hip and knee replacement and revision surgeries in the nation.
Done well, they noted, hip and knee replacements can last for 30 years or more. Studies presented at the American Academy of Orthopaedic Surgeons found that many joint replacements implanted in adults younger than age 50 are still performing well 35 years later.
However, the decision to do a total hip or knee replacement on a young person cannot be made lightly. The patient’s age is taken into consideration, but their functional limitations and discomfort are essential factors in making the decision to move ahead with a joint replacement. When possible, surgeons will opt for procedures that preserve the joint instead.
“Everyone is different, and as surgeons, we have to base our recommendations on each patient’s history and needs,” Dr. Dingle said. “Generally speaking, if it hurts to walk, climb stairs, or do other routine things, and that pain persists after trying more conservative treatments for several months, that’s a sign you might need a new joint.”
Learn more about joint repair and replacement options at smh.com/ortho.
Kim Savage is the public information officer for Sarasota Memorial Health Care System, overseeing media relations and external communications since 1999.
* Updated from an article pusblished in SMH Today, Spring 2019.