Health Essentials from Cleveland Clinic

Contributor: Brett William McCoy

It’s a great time to be a baby boomer. Arthritic joints no longer mean you have to stop being active. Even though arthritis is the leading cause of disability in this country — affecting more than half of all 60-year-olds — today’s artificial joints are meeting and exceeding people’s expectations for a full return to regular activities.

This is good news for an active generation that has no intention of slowing down – especially because by 2030, Americans 65 and older will make up 20 percent of the population.

Replacing hips, knees

When patients with arthritic hips and knees no longer respond to conservative care such as medications and physical therapy, orthopaedic surgeons can replace these joints.

Hip and knee replacements, in particular, are among the most successful and satisfying surgical procedures for patients. We can often relieve pain and restore function, with great attention to safely and accuracy so we can minimize complications.

Advances in joint replacement

There have been many advances in joint replacement since the 1960s, when these procedures were first performed. They include:

• Computer “navigation” during surgery — This allows surgeons to be more precise in placing implants, which can be turned and flexed in various ways. The more precisely placed an implant is, the better it fits and works. Think of the spinning of a car’s tire, which is greatly improved with better alignment.
• Improved post-operative pain control — Spinal anesthetics, long-acting local anesthetics and regional blocks help pinpoint and control pain. With this approach of what we call “multimodal anesthesia,” we try to hit the pain from different angles — and by doing this, we can also avoid using narcotics, which have more side effects.
• Patient-specific instrumentation — We can use CT or MRI scans of the knee and get 3-D images that let a surgeon know exactly where to make a cut. A 3-D mold can be dropped right onto the patient’s own knee to guide the surgeon.
• Robotic-assisted surgery — Uses preoperative imaging and intra-operative navigation with robotic assistance to improve the accuracy of implant placement and preserves soft tissue.
• Improvements in the quality of joints — Advances in prosthetic design and biomaterials are improving motion as well as the length of the life of these joints. This means they are lighter and stronger and last longer than joints of the past.

What to expect

It’s important to think of surgery as the last resort once all other rehabilitative options are exhausted. However, if you do need joint replacement, the good news is that the innovations have made these procedures safer and the rehabilitation time quicker than ever before — often allowing people to return to high levels of activity.