Wednesday, May 11, 2011

Original Equipment or Rebuild?

http://online.wsj.com/article/SB10001424052748704004004576270844211718806.html?mod=WSJ_article_RecentColumns_HealthJournal
I get excited reading these kinds of articles.  I hope it'll be another 15 years until I "have" to get something done for my knee, but fortunately for me, there are enough folks out there with wrecked knees and insurance (or cash) that the market for rebuilding joints is driving innovation and better solutions seemingly by the year.

One thing all these folks would benefit from both before and after surgery is to work on functional movements, learning and re-learning how to feel and utilize their musculature in ways they may not have since their injury.  Runners in particular are notoriously deficient in range of motion and hip/hamstring/glute development - this is not a good thing.  One friend I know who trains in a unique but intense and functional ways commented on finding his hamstrings after years of atrophe.  After a knee replacement surgery, this former D1 football player said "I felt my hamstrings firing for the first time in years!"  I think that bodes well for his future.


Joint-replacement patients these days are younger and more active than ever before. More than half of all hip-replacement surgeries performed this year are expected to be on people under 65, with the same percentage projected for knee replacements by 2016. The fastest-growing group is patients 46 to 64, according to the American Academy of Orthopaedic Surgery.
Many active middle-agers are wearing out their joints with marathons, triathlons, basketball and tennis and suffering osteoarthritis years earlier than previous generations. They're also determined to stay active for many more years and not let pain or disability make them sedentary.
To accommodate them, implant makers are working to build joints with longer-wearing materials, and surgeons are offering more options like partial knee replacements, hip resurfacing and minimally invasive procedures.
More younger people also need joint-replacement surgery due to obesity, and some orthopedists refer them for weight-loss surgery first to reduce complications later.
Even the most fit patients face a long period of rehabilitation after surgery and may not be able to resume high-impact activities.
"There is, to be honest, some irrational exuberance out there," says Daniel Berry, chief of orthopedic surgery at the Mayo Clinic in Rochester, Minn., and president of the American Academy of Orthopedic Surgeons. "People may be overly optimistic about what joint replacement can do for them."


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