|Total Joint Replacement: Staying Young Longer by Allen Weiss, MD, CEO & President|
by Allen Weiss, MD, MBA, FACP, FACR
President & CEO, NCH Healthcare System
December 15, 2006 - There is a revolution in healthcare in the United States today. It started in the late 1970s when hip joints were replaced, as they wore out, with artificial plastic and metal parts. English surgeon John Charnley applied engineering principles to orthopedics when he devised a low-friction joint that was held in place by methyl methacrylate cement, a compound developed for bonding metal to human bone. Subsequently, these same principles were adopted for other joints including knee and shoulder. Dr. Charnley won great recognition for this application, and changed millions of lives.
In 2003 there were 800,000 hip and knee replacements performed in the U. S. The usual cause for joints wearing out is osteoarthritis that is also known as the “wear and tear” arthritis. Half of the 66 million people in the country who have arthritis are under age 65. Medicines are helpful to control inflammation but for long term care there is no medicine currently available that can replace the surface of the joint responsible for it’s effortless motion. Once it wears out, the joint becomes stiff and loses function. Until joint replacements became routinely available, patients suffered in wheelchairs or spent the remainder of their lives on stretchers with all the discomfort, humiliation and complications that limited life created. Commonly, patients in a rheumatologist office before 1980 came in on stretchers and wheelchairs. Now they walk in with no one even knowing they have had multiple joint replacements.
Baby boomers are getting older, but their desire to maintain an athletic lifestyle has lead to a remarkable increase in joint replacements in younger and younger people. Initially the life span of artificial joints was thought to be 10 to 15 years. Now, however, with better materials and implanting techniques, over 90% of them will never have to be replaced. People with artificial joints need to follow their physicians’ instructions but most can resume full activities. Obviously, swimming or biking would be better than singles tennis or running, but most recipients of total joint replacement can do all four of these activities.
At NCH our orthopedic surgeons perform more than 1500 joint replacements each year, about the third highest number in Florida and in the top 25 nationwide. More patients are coming to NCH for this elective surgery than are going elsewhere in our community. We also are blessed with a wonderful rehabilitation facility within the downtown campus, and the new Garden of Hope and Courage, adjacent to the hospital, enables patients to spend pleasant time outdoors while recovering from surgery.
We all want to stay young and active. Total joint replacements are just one of many wonderful contributions from modern medicine that encourage full participation in all that life offers.
Dr. Allen Weiss is CEO & President of the NCH Healthcare System. He is board certified in Internal Medicine, Rheumatology and Geriatrics, and was in private practice in Naples, Florida from 1977 - 2000. Dr. Weiss is active in a variety of professional organizations and boards, and has been published in numerous medical journals, including the American Journal of Medicine and the Journal of Clinical Investigation.