More New Knees for Baby Boomers

Knee replacement surgery for osteoarthritis is on the rise among younger patients

(RxWiki News) When traditional treatments do not work, many osteoarthritis patients turn to joint replacement surgery. Even though this surgery is common, there is little information on how many younger patients go through with it.

The rates of partial and total knee replacement surgery for those under 60 years of age has increased over the past few decades, according to a recent Finnish study. Throughout the study, women had higher rates of knee replacement than men.

"Ask your doctor about joint replacement surgery."

The risk of osteoarthritis increases with age, says Jarkko Leskinen, M.D., of Helsinki University Central Hospital and lead author of the study. Knee replacement surgery - or knee arthroplasty - is a commonly used treatment for severe cases of arthritis.

"Despite the more frequent use of replacement surgery, very few data are published on knee arthroplasty incidence and its effects in younger populations," explains Dr. Leskinen.

Motivated by this lack of information, Dr. Leskinen and colleagues set out to determine the rates of partial and total knee replacement surgery among osteoarthritis patients in Finland.

According to a 2002 report by the World Health Organization, osteoarthritis is the fourth major cause of disability in the world. In the United States, an estimated 10 million adults suffer from the pain and stiffness of osteoarthritis.

For some patients, joint replacement surgery may be the only way to improve their quality of life. In 2009, more than 600,000 total knee replacements were performed in the United States. By 2030, that number is expected to grow to 3.48 million.

Knee replacements may be more likely to fail in younger patients, meaning these patients may have to undergo a second replacement surgery.

For this reason, it is important to understand the effects of knee replacement on people under the age of 60. First, however, one must have an idea of how many of these surgeries are being performed.

For their study, Dr. Leskinen and colleagues looked at data of all the partial and total knee replacement surgeries performed in Finland between 1980 and 2006.

The study's findings show that there was a 130-fold increase in the rates of total knee replacement surgery among Finnish arthritis patients under 60 years of age.

During the entire study period, rates rose from 0.5 to 65 operations per 100,000 individuals. The biggest increase happened between 2001 and 2006 when rates rose from 18 operations per 100,000 individuals to 65 operations per 100,000.

Looking at the last decade of the study, the researchers also found that women were 1.6 to 2.4 times more likely than men to undergo total knee replacement surgery.

The findings also show that the oldest patients in the study (50 to 59 year-olds) were more likely than younger patients to undergo partial and total knee replacement surgery.

According to Dr. Leskinen, "Given that younger patients may be at higher risk of artificial knee joint failure and thus in need of a second replacement surgery, long-term data are needed before widespread use of total knee arthroplasty is recommended for this patient population."

Elena Losina, Ph.D., M.Sc., of Brigham and Women's Hospital in Boston and who was not involved in the study, wrote in an editorial that total knee replacement is an effective treatment for osteoarthritis patients in their 60s, 70s, and 80s.

However, she notes, with an increasing number of knee replacement recipients under the age of 60, more research is needed on the outcomes of knee replacement for younger patients.

The results of the Finnish study are published in the journal Arthritis & Rheumatism.

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Review Date: 
January 17, 2012