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Replacements for knees, hips expected to increase

December 13, 2009
Salem News

Joint replacement is becoming more common with about 773,000 Americans having a hip or knee replaced each year. This number is expected to skyrocket in the next few years due to an increase in arthritis and obesity, combined with a growing elderly population.

"Joints can be damaged by arthritis, disease, injury or simply years of use that may cause the joint to wear away," explained Orthopaedic Surgeon J. Cletus Paumier, M.D. "Each of these problems results in damage to the cartilage which normally covers the ends of the bones and allows the joints to move smoothly and without pain. With about one-third of Americans being obese and over 46 million having arthritis, the need for joint replacements will increase.

"Joint replacement surgery is an important treatment option for those individuals who have constant pain that limits their daily activities. This pain may be so severe that a person will avoid using the joint, which weakens the surrounding muscles and makes it even more difficult to move. Replacing the joint can relieve pain, swelling and stiffness, and help the person move and feel better. Hip and knee joints are replaced most often, but other joints can be replaced like the shoulder."

Joint Replacement Surgery

The Surgery Center at Salem Community Hospital offers a specialized Orthopaedic Surgery suite that accommodates several types of joint replacement procedures. "The goal of joint replacement surgery is to relieve the pain in the joint caused by damage done to the cartilage," Dr. Paumier added.

"This surgical procedure involves removal of the worn cartilage and the damaged joint, followed by re-surfacing of the bone. The damaged joint is then replaced with a new artificial joint, called a prosthesis, which can be made of plastic or metal. This artificial joint looks and functions much like the person's normal joint.

Fact Box

On the rise

From 2000 to 2004, the number of hip replacements increased by 37 percent and knee replacements by 53 percent. At this rate, it is predicted that 600,000 hip replacements and 1.4 million knee replacements could be performed in the year 2015, if the current trends continue.

A joint replacement

may help if you:

- Have pain that limits daily activities such as walking, climbing stairs and getting in and out of chairs, or you experience moderate or severe pain at rest.

- Have limited function or mobility, such as chronic stiffness and swelling that prevents you from bending and straightening your joint.

- Have tried other methods to improve your symptoms without relief, such as weight loss, physical therapy, a cane or other walking aid, medications, etc.

- Have a joint deformity, such as a joint that bows in or out.

- Are generally healthy. Good candidates for joint replacement are typically healthy, without conditions such as diabetes, or infections that can complicate their recovery. Obesity alone won't disqualify a person from surgery, but it may slow the healing process.

"A joint replacement surgery usually takes about two hours to complete," Dr. Paumier advised. "The length of the surgery depends on how badly the joint is damaged and the type of surgical procedure that is performed. Although many different joints in the body can be replaced, most replacement surgeries involve the hip or knee.

"Over the last 30 years, improved surgical techniques and new implant materials have been developed, making total joint replacement one of the most reliable and durable procedures in medicine. Most patients who undergo joint replacement are between the ages of 60 and 80; however, this procedure has been performed successfully on people of all ages."

After Surgery

Following a recovery period in the hospital of three to five days, most people continue their rehabilitation in a skilled nursing facility for several days before returning home. "After a hip or knee replacement, a patient will often stand or begin walking with assistance soon after surgery," Dr. Paumier concluded. "Physical therapy can begin as soon as possible to help strengthen the muscles around the new joint and regain motion. Daily activities can be resumed after three to six weeks, and outpatient physical therapy may be needed during this time.

"Joint replacement is usually successful in more than 90 percent of people who have this procedure performed. However, the success of the surgery and speed of recovery depends a great deal on what patients do when they return home as well as their level of activity before surgery, their general health, the degree and duration of physical impairment before surgery, and the type of surgery performed."

J. Cletus Paumier, M.D., is a board certified orthopaedic surgeon affiliated with Salem Community Hospital's active medical staff. Dr. Paumier received his fellowship training in arthritis and reconstructive surgery from the Hospital for Joint Diseases in New York City. His advanced training there was directed toward simple and complex hip and knee replacements, as well as shoulder surgery. His office is located at 2376 Southeast Boulevard in Salem; 330-337-7255.



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