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Hip and Knee Replacements on the Rise

More women and men are turning to artificial joints for a second lease on an active life.
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WebMD Feature

Thinking about getting a new knee or a new hip next year? You're not alone. For baby boomers, it seems that joint replacements are as prevalent as iPods are for teenagers.

About 500,000 knee replacements and more than 175,000 hip replacements are performed annually, and those numbers are on the rise. In fact, hip replacements are expected to increase 174% in the next 20 years, and knee replacements will rise even more -- 673%, according to a study presented at the American Academy of Orthopaedic Surgeons' 2006 annual meeting.

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What's behind the growing demand for new joints?

Blame it on the lifestyle of the baby boom generation, says Mathias Bostrom, MD, an orthopedic surgeon at New York's Hospital for Special Surgery, where total knee replacements were pioneered.

"They're not willing to be sedentary or change their lifestyle," Bostrom tells WebMD. "Their joints are beat up and they're living longer, and they want joints that let them do the things they're used to doing."

This also means that younger people, in their 50s and even 40s, are demanding joint replacements, increasing the market for the surgery. It's a trend that Bostrom sees mirrored at his hospital, as well as throughout the U.S. and in Europe.

Are joint replacements inevitable as we live longer?

"A hundred years ago, maybe we did more manual labor and worked our joints more, but we also didn't live nearly as long," Bostrom says. As our life expectancies increase, we're putting more demands on our joints -- and perhaps, hitting their sell-by dates. "Maybe our joints weren't designed to last as long as we're living these days."

A couple of decades ago, the majority of people needing joint replacement surgery had rheumatoid arthritis, a disease for which treatment has markedly improved. Now, osteoarthritis -- caused largely by trauma and wear and tear on the body -- is the leading reason for joint replacements.

Another reason behind the growing demand: joint replacements are getting better. "It's still major surgery and not as good as a native joint," says Bostrom. "But people do very well with joint replacements, and they last a long time, so many people are less anxious about getting them because they're more comfortable with the longevity of the joints."

Why is the demand for knee replacements so much higher than for hips?

We're harder on our knees, Bostrom says, while at the same time doctors have learned to take better care of hips. "A lot of the pathology we used to see in hips was due to not recognizing early hip disease in infancy," he explains. "Now that we've gotten better at screening for hip dysplasia, those indications for hip replacement have declined markedly.

"Meanwhile," he notes, "we're beating up our knees more. There are a whole group of people who've had meniscal tears and ligament tears due to athletic activities. Even if that damage has been treated, it may still cause a problem long-term."

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