Knee Surgeries Double Upwards: New Research Reveals

600,000 Knees Are Replaced Each Year Nationwide

By Judy Feldman on September 26, 2012 12:43 PM EDT

Knee Operation
Knee Replacement-Rates Doubling UP Nationwide (Photo: Wiki Commons)

Research recently published in the Journal of the American Medical Association has revealed that Americans are getting more and more initial knee-replacement surgeries. The rate has doubled over the last twenty years, which is an increase of 162 percent from 1991 to 2010. This is most prevalent amongst seniors. (The findings come from a study that involved some 3.6 million Medicare patients aged 65 and older and covered by Medicare benefits, between 1991 through 2010. On average, the patients in the study were actually in their mid-70s, and during the almost twenty years of the study, the average age went up slightly.)

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Almost 10 percent of the operations were "Revisions, or redo's", which means some kind of repair procedures to replace worn-out artificial joints. (Not an entirely first-time new knee.) Revisions have increased 106 percent.

In total, approximately 600,000 total knees are replaced, now, annually, to adults of ages - costing a total of $9 billion, as reported at Salon.com. And this frenzy of knee replacement and repair is mostly to ease the pain of severe arthritis.

Success rates have remained consistent over the period, the study found. But people needing to go back to the hospital soon after the surgery has gone up. Hospital readmissions within one month have increased from 4.2 to 5 percent in initial knee replacement patients and from about 6 percent to almost 9 percent among revision patients. That rise in readmissions is largely related to shorter initial hospital stays these days, the author study said, as reported by ConsumerHealth.com. 

Cost effectiveness in action?  Now, if you get an initial knee replacement, you are likely to leave the hospital in 3.5 days. In the mid-1990's you'd spend about 8 days in the hospital. But now, you're more likely to need a subsequent hospital readmission. 

Knee surgeries had slowed down in America for a while. Experts guess that perhaps was because younger adults were also getting artificial knees, and typically do not need their second knee replacements as soon. Knee replacements have typically lasted 15-20 years. (Note: the newer knees now being used as initial replacements, doctors hope, will last longer.)  Plus, the  difficulties in the economy may also have slowed the demand for an operation that is not cheap.  A new knee costs about $15,000.

Reasons? The boomers and the elderly who want and do stay active fuel part of this increase in knee replacement surgery. Another factor is the increasing problem of obesity in our country. Obese older patients getting first knee-replacement operations were up almost 12 percent, from 4 percent two decades ago. as reported by the PhillyNews.  

And the cost? The cost is estimated at currently costing about $9 billion annually, for all knee surgeries in the United States. Some 60 percent of this cost is covered by Medicare, the federal government health program for the elderly and disabled, said Mr. Peter Cram, an associate professor of internal medicine at the University of Iowa and the lead author of the study, as reported by The Associated Press.

The country needs to implement measures to control costs of these operations, reported one editorial in the journal, saying that demand has been projected to rise to as many as almost 4 million knee operations annually by 2030.

The public-health issue, Cram said, according to Business Week, Is that "a procedure that is great in small numbers is financially devastating to the Medicare program and the federal government in the long term. As a patient you want that knee replacement, but from a budgetary standpoint this starts to add up to real dollars."

Another view?  Knee replacement is cost-effective, said Dr. Matthew Hepinstall to Consumer.healthday.com. Hepinstall is an orthopedic surgeon at Lenox Hill Hospital in New York City. and not involved in the recent study.  "This is surgery that can actually pay for itself in the increased productivity of the person who goes from disability to return to work," said Hepinstall. "There are also current savings in disability payments and the costs of ongoing care available today," he reportedly said.

Of course, recovery rates can vary from patient to patient, depending on many variables including age, and willingness on the part of the patient to work on their own therapy and recuperation. "Recover from a knee replacement takes about three months and requires patients to undergo physical therapy," added Hepinstall.

For more information on knee replacement, visit the American Academy of Orthopaedic Surgeons

And, (for interesting viewing), to watch an arthroscopic knee surgery, see here.

© 2012 iScience Times All rights reserved. Do not reproduce without permission.

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