The days when getting older meant losing the desire to be active are a thing of the past. In the minds of baby boomers, whose youngest members are reaching their early 50s, life is full of possibilities that should not be overlooked due to the limitations of a body that is entering years.
An aging and overweight population
And as the general U.S. population declines. UU As it continues to age until 2050, the prevalence of arthritis will continue to increase. That combined with the growing prevalence of overweight or obese Americans of all ages, it’s not surprising to see that orthopedic surgeons like Carlos Alvarado, M.D., of Miami Orthopedics & Sports Medicine Institute, are so busy operating on damaged knees.
“The knee is exposed to a great deal of stress on a daily basis,” Dr. Alvarado said. “Between 2.5 and 7 times the weight of our bodies is absorbed through the knee joint with each step. That means that even the smallest changes in our weight can have a drastic effect on the function of our knees.”
In fact, a recent study published in the Journal of Bone and Joint Surgery suggested that the epidemic of overweight and obesity was influencing the need for total knee replacements at a rate that exceeds the need for hip replacements.
Alexander van der Ven, M.D., who is also an orthopedic surgeon at Miami Orthopedics & Sports Medicine Institute, agrees with the study’s findings. He has seen an increase in the need for knee replacement surgeries in people with a Body Mass Index (BMI) of 25 or higher. But he also attributes the sheer volume of knee replacement surgeries to better technology and surgeons’ understanding of how knee replacements can benefit younger patients.
“Younger patients have better satisfaction with knee replacements than younger patients because they have many more years of activity to lose at a younger age,” he said. “Whereas we used to operate on people in their 80s and 90s, we’ve learned that intervening earlier – when patients are in their 50s and 60s – brings better outcomes and improves overall quality of life in their 80s and 90s.”
Custom knee replacements
In 2010, just as orthopedic surgeons were beginning to perform traditional knee replacement surgeries — which had been practiced for more than 30 years — on younger patients, three-dimensional printer technology made custom knee implants a reality.
To produce a prosthesis tailored to a knee, a CT scan of the patient’s knee anatomy is sent to the manufacturer, where a three-dimensional printer creates a metal knee implant, designed with the patient’s exact measurements and shape.
Instead of using prefabricated knee implants, and manipulating them so that they can be molded to patients, surgeons receive custom knee implants that are ready to be implanted in each specific patient.
“With custom knee replacement, we mold the knee to serve you, rather than molding you to serve the prosthesis,” Dr. van der Ven said. He describes the difference as something akin to having yourself make a suit or a tailored dress, rather than making alterations to a suit to serve you. “If we can make the knee look better, it will work better and feel more like your natural knee.” In addition, Dr. van der Ven says that a better fit leads to faster surgery, less bleeding, and fewer adjustments to the muscles and tendons around you, leading to a faster recovery.
Dr. van der Ven says recovering from a custom knee replacement still requires intensive physical therapy for about six weeks and patients should actively collaborate in their rehabilitation after surgery. But he says once patients recover, they say their knees feel like new.
Age as a factor in recovery
He debunks common myths that custom knees will wear out after 10 to 15 years so patients shouldn’t wear them in their 50s or 60s. “That’s not based on any evidence,” he said. “It’s not like tires that wear out after 20,000 miles. There’s really no reason why these knee implants shouldn’t last up to 30 years.”
That’s why Dr. van der Ven recommends talking to an orthopedic surgeon about knee replacement surgery sooner rather than later. “If you have knee pain and haven’t sought medical attention until the damage is too much, your recovery time will be less than optimal,” he said.
Dr. Alvarado, who like Dr. van der Ven also performs traditional and custom knee replacements, says that rather than age, patients’ overall health is a better measure of whether they are candidates for knee replacement.
Both doctors agree that the most successful knee replacement surgeries occur in patients who are eager to regain their lifestyle and are willing to work hard during their recovery and rehabilitation – no matter how old they are.
“Attitude is key,” Dr. Alvarado said. “If patients approach postoperative physical therapy with vigor and a positive attitude, it’s amazing to see them improve.”
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