Knee replacement surgery numbers soar, according to a new study published by the Journal of the American Medical Association. According to the study, from 1991 to 2010, the incidence of knee replacement surgery increased 161 percent. This increase seems to be driven by the increase in Medicare patients, which makes sense as the population is aging and seniors are living longer. Also a factor is a higher usage rate by the general population driven by the exercise industry - more on that below. More worrisome to me is the re-admittance rates to hospitals has increased while the recovery time in hospitals has declined. Are we sending people home too soon only to have to re-admit them when the complications show up?
Knee replacement surgery, known in the medical field as a total knee arthroplasty or TKA, involves removing the existing weight bearing surfaces of the knee joint to relieve the pain from osteoarthritis in our older population. In the general population, knee replacement surgery may be performed in response to meniscus tears, cartilage defects, and ligament tears that may cause enough pain to necessitate the surgery.
This is important. In a time where every element of health care is under debate, a surgery that costs $10,000 to $45,000 whose growth is exploding makes it more likely that the procedure will face limitations not due to its effectiveness but for financial reasons.
One quibble that I have with the Yahoo! News article on the knee replacement surgery study is their statement "Knee joints wear out over time and use; the more physically active a person is -- depending on the type of activity -- the more chances are that one or both knees will develop problems." While this is part of the conventional wisdom, a study from the J.B. Snow Biomechanics Laboratory at Wake Forest University in November 2008 states "Epidemiologic studies indicate that running reduces the threat of some chronic diseases, decreases disability and pain, and lowers healthcare costs." The problem is not the exercise. The problem more often is total body weight, a sedentary lifestyle to allows the musculoskeletal system to weaken and poor technique during activities.
Tomorrow I'll put together a post on some things that you can do to avoid knee replacement surgery.