Do you have a creak in the knees when you walk up the stairs? Or maybe an ache in your hips that makes it a chore to hop out of bed? You might have the occasional flare-up of pain that reminds you of an old sports injury.
You are not alone in your pain. Arthritis, injuries and other conditions can cause serious joint damage at any age. If the damage is bad enough, the pain can interfere with your daily activities.
Nonsurgical treatments like modified behavior, medicine and physical therapy are good first steps. But if they don’t provide enough relief, surgery may be an option. In a knee or hip replacement, surgeons replace damaged bone and cartilage with sturdy artificial parts.
In fact, a growing number of Americans are having hip and knee replacement surgery. From 2000 to 2010, there was a 205 percent increase in the number of patients ages 45 to 54 who had hip replacement surgery, compared to the previous decade.
What Can Lead to a Joint Replacement?
Why are so many younger patients having these surgeries? Dr. Arnie Herbstman, an orthopedic surgeon and Plan medical director for Blue Cross and Blue Shield, says many doctors believe there are two major reasons for the increase.
“Years ago, my patients were almost always at least 60 or 65 and older, even 90,” Herbstman says, “but the obesity epidemic and the increase in people playing sports or exercising have led to more replacements.”
Going up and down stairs can add the stress of more than double a person’s body weight against a hip or knee joint. Some injuries can add the stress of five times a person’s body weight. When people are overweight, they magnify the stress on their joints even more.
On the opposite side of the scale, some “weekend warriors” may be wearing out their joints. Overdoing it or cramming a lot of physical activity into one or two days may put them at an increased risk for injuries.
How Do You Know if You Need a Joint Replacement?
Replacement surgery isn’t the first step when a person has pain. Many doctors encourage their patients to lose weight or make other changes to see if the pain lessens before moving forward with surgery.
According to Dr. Herbstman, a patient may be a candidate for knee or hip replacement if the pain limits their daily activities. In addition, “there should be X-ray evidence that the surface cartilage is worn out — there is no space at all between the two bones — that’s a good indicator that it is time to have a joint replaced,” he says.
The good news is that today’s artificial hips can handle more strain than older models. The improved technology in the plastics used for replacement helps reduce wear.
Knee and hip replacements also last longer. “We used to tell people it could last 15 to 20 years,” Dr. Herbstman says. “Now they can last 30 plus years.”
Dr. Herbstman says recovery times have also improved. “Ten years ago, patients would be in the hospital four to five days. Now they have outpatient surgery or are only in the hospital for a day or two. This is really better for the patient. The faster you get them out, the less chance they have of getting an infection.”
Patients can recover at home with a home nurse and a visiting physical therapist. They begin walking the day of their surgery and often resume normal activity in two to three months. A doctor may need to check your replacement if an infection occurs.
Compared to older people, young hip replacement patients are often in better health. That improves the chances of a good outcome. Still, having the surgery when you are young means living longer with the replacement joint.
Hip and knee replacement surgery may help reduce your pain, but it isn’t for everyone. And not everyone is a good candidate for surgery, including people with certain health conditions, like diabetes.
If you’re considering it, weigh the pros and cons with your surgeon, and learn more about changes you could make to reduce the need for surgery.
Want to make sure you never need a joint replacement?
Getting the right kind of exercise and keeping your weight in check are important ways to help prevent joint damage. Not sure if you’re carrying extra weight that could be hurting your joints? Check your BMI with this tool from the National Heart, Lung and Blood Institute’s Aim for a Healthy Weight campaign. If you have a high BMI, it could be time to shed some pounds.
Sources: The Role of Overweight and Obesity in Relation to the More Rapid Growth of Total Knee Arthroplasty Volume Compared with Total Hip Arthroplasty Volume, Journal of Bone and Joint Surgery, 2014; Knee Replacements, Obesity and Weight Loss, U.S. News & World Report, April 15, 2015; Weight Loss Reduces Knee-joint Loads in Overweight and Obese Older Adults with Knee Osteoarthritis, Arthritis & Rheumatology, 2005; Is Being a ‘Weekend Warrior’ Actually Good For You? Men’s Health, Jan. 9, 2017