Major surgery may be a last resort for most people but for those who suffer from joint pain, cartilage loss, and limited mobility, a replacement surgery may be exactly what they are looking for. Knee, hip, and shoulder replacements are the most popular in the United State but the question of how long these artificial joints last still remains.
Joining us today is Dr. Richard Iorio, an orthopedic surgeon and the chief of adult reconstruction at New York University Langone Hospital for Joint Diseases to discuss the longevity of joint replacements and the risks that may come with them.
There is no cure for arthritis and while there are treatments like medication, physical therapy, and surgeries to preserve the joint from additional damage, these only stall the deterioration. Many arthritis patients turn to joint replacement to regain the quality of life they had before they developed arthritis problems.
Conservative treatments for arthritis are limited, according to Iorio.
“We have pills, we have injections, we have some conservative surgeries which try and preserve the joint. They are not terribly successful we have not been able to replace native articular cartilage,” Iorio said.
As new materials have been developed, joint replacement surgery has become more reliable. The lifespan of the artificial joints has increased from ten years to between twenty and thirty years. This means patients don't have to wait as long to get the replacement surgeries they need.
“The average age of joint replacement now is probably around sixty four [or] sixty five,” Iorio says. “That means half the patients that get joint replacement are below that age, and we begin to do joint replacement now in younger and younger, more active patients."
Even though the surgery has gotten more reliable over time, there are still risks of the joint failing. Instability or dislocation and infection are the top reasons an artificial joint would fail. While joint infection is uncommon, it is still a concern because it is hard to fight off.
"There are many reasons a patient can get a joint infection but this joint replacement is artificial, there is no immune system to fight for it. Bacteria are attracted to foreign bodies in one’s own body and it’s difficult to fight those off," said Iorio.
Even though these are artificial joints, active people can resume almost normal activity. Iorio recommends that patients avoid strenuous physical activity that would put the joint at risk for dislocation.
“So the reason we limit patients activities is to stop the possibility of the joint dislocating, so occasionally we will limit their activities. But basically we tell people now they can do anything they want as long as it doesn’t hurt. We prefer they didn’t run and jump and do high impact activities like that,” said Iorio.
The development of new and better artificial joints is stunted though. Joint replacement surgery remains the largest cost for Medicare. With Medicare looking for ways to reduce the cost of joint replacement surgery, new materials and the research that goes into developing them are a cost they don’t want to shoulder.
“The whole health care reform movement and restrictions on industry and the way they innovate have retarded some of that innovation and those prosthesis will be quite expensive," said Iorio. "So cost is a major issue with innovation in healthcare today."