Recon

Knee and hip replacements part of boomers’ active life

Robin Erb, Detroit Free Press Staff Writer

Orthopedic implants — once the dreaded inevitability of our final, fragile years — are now part of the lives of the nation’s active baby boomers and their adult children.

Sure, we’re living longer and parts wear out. And collectively, we’re carrying around more pounds these days — an increased pounds-per-square-inch grinding down on knees and hips.

But then there’s this, too: Few of us — to borrow from poet Dylan Thomas — will go gently into retirement.

Instead, we’re zig-zagging across tennis courts and knocking out laps at the local pool …

Twisting and wrenching on hockey rinks and chasing glory on the softball diamond …

Pounding out 5Ks and marathons trying to squeeze extra mileage out of joints pounded during the era of high impact, no-pain no-gain racquetball and home video aerobics.

All of this means millions of Americans are in line for replacement parts in the coming few years. In the meantime, they turn to everything from physical therapy to pain pills to chicken shots made from the combs of roosters.

An estimated 45 million have some level of joint pain, according to the Minnesota-based Mayo Clinic, which has published two consumer-oriented books on managing arthritis pain.

Less than a decade ago 792,449 new hips and knees were put into Americans; by the year 2020, that number is expected to jump to nearly 2.1 million, according to a study published this year in the Journal of Bone and Joint Surgery.

Even in the depth of the bum economy between 2009 and 2010, business in the orthopedic operating room was booming, with some major joint replacements showing double-digit growth.

“People anticipate being active in retirement,” said Dr. James Carpenter, who heads the University of Michigan’s new Comprehensive Musculoskeletal Center, where 250 doctors from nearly a dozen specialties are focused on the complex interplay of muscle and tendon and cartilage.

Among baby boomers, he said, “there’s an expectation and a demand that they function longer and function without pain.”

Finally, today’s technology, including fine-detail imaging equipment and robotic arms, have made orthopedic surgery almost routine in recent years. There’s less scarring and quicker recovery time.

At the Detroit Medical Center, Dr. Roland Brandt uses MAKOplasty, a robotic arm that helps doctors resurface only the parts of the knee damaged by osteoarthritis. In December, DMC doctors used the machine for the first time in hip surgery, said the longtime orthopedic surgeon.

“The kind of procedure that used to keep someone in the hospital for two or three days with swelling and discomfort is now an outpatient procedure with an hour and a half of recovery time and you go home,” Brandt said.

Patients worry about months of painful recovery, but he said: “I can tell them they’ll be back on the golf course in two weeks if things go well.”

Bone on bone

Joint pain is often the result of a lifetime of wear-and-tear of cartilage, the tissue that allows for frictionless, painless motion.

Orthopedic surgeon Dr. James Eberhardt sees it when he pulls out an arthritic hip — the loss of cartilage, the inflammation and then bony spurs that build up painfully as bone grinds bone.

Imagine a chicken bone with that white, shiny stuff at the end, he tells patients.

If you scrape that white stuff off with a knife, the Oakwood Healthcare doctor said, “you’ve given it arthritis.”

Such wear-and-tear can be made worse by decades-old, minor damage — the kind of thing that Rebecca Bartek imagines she sees, as if in slow-motion, each time a girl’s elbow slams onto the floor of a volleyball court or a knee twists out of whack on a lacrosse field.

For half her work week, Bartek is an athletic trainer at Academy of the Sacred Heart in Bloomfield Hills. The other half, she’s at Henry Ford Health System’s Detroit campus teaching “joint preservation” classes to those in their 30s, 40s and 50s seeking relief from joint pain has grown intolerable.

“I tell the girls: ‘I know you want to get back as soon as you can to playing. But you have to take the time, re-educate the muscles, or I’m going to see you when you’re 35,’ ” she said.

Athletes of any age — both competitive and casual — worry about the right foods to eat before the big game and the best workouts for the gym. They ignore those nagging little pains, often the body’s message that worse is to come.

The key is listening to your body’s pain now — not tomorrow or next week, she and others said.

“Bigger, faster, stronger — everyone wants that. But you have to protect those joints, too.”

Kyle Stack, the mayor of Trenton, knows.

“I was really involved in sports all my life, and I think it’s come to bite me in the butt,” she said, chuckling.

Tough to exercise

After a lifetime of tennis and ice skating and dancing and softball — a catcher, she’s had both hips replaced and her knee is giving her trouble these days.

Pain — occasional at first and then ever-present — made it tougher to exercise. She gained weight, putting more pressure on the joints, a vicious cycle.

In fact, a single pound is equivalent to four pounds on your knee, according to a 2005 study published by the journal Arthritis & Rheumatism. Controlling factors like footwear and gait, researchers concluded that shedding just 10 pounds reduces the “compressive load” on the the knees by 48,000 pounds each mile.

“I was getting kind of depressed — ‘God, am I ever going to get better?’ ” she said.

That’s when officials from Oakwood Healthcare approached her. Oakwood doctors wanted to partner with the city to step up health screenings and health programming — an effort unveiled Thursday to shrink the city’s collective waistline, address chronic health problems and focus residents on healthy living.

Stack was daunted. But — typical of an athlete perhaps, she also was all in.

Amid the clink of weight machines last week, Stack and Roy Vreeland, her personal trainer at the Trenton Athletic Club, reviewed the progress she’s made in a few weeks: lifting more weight, more reps, fewer inches and, most importantly, a general return of her energy and confidence.

“I decided, you know, how can I lead a city to be healthier if I’m not willing to do the work myself?”

On a personal level, she’s hoping to delay, even avoid, knee surgery altogether.

In fact, studies have found that remaining physically active in our later years significantly improves musculoskeletal and overall health — even minimizing the overall effects of aging.

Vreeland, counting Stack’s reps and with a post-workout tuna fish sandwich and a health drink awaiting, says tracking your progress is as simple or as complicated as you want to make it. Done correctly, though, the results are the same.

“It’s the muscular system that supports and stabilizes the skeletal system, including the joints,” he said. “When you lose the muscle, you lose the structural support around hips, around the knees, around the back, around the neck, around the shoulders.

“It only gets worse as you continue to lose muscle tissue.”

Contact Robin Erb: rerb@freepress.com or at 313-222-2708. Follow her on Twitter @Freephealth.

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Josh Sandberg

Josh Sandberg is the President of Ortho Sales Partners and Partner for The De Angelis Group. He also serves as Co-Founder and Editor of OrthoSpineNews.

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