In the United States, joint replacement surgeries are some of the most common elective procedures. According to a recent study conducted by the American Academy of Orthopaedic Surgeons, the average age of joint replacement patients is decreasing and becoming more common among men today. This study was highlighted at a recent meeting with surgeons from around the world. Dr. Ira Kirschenbaum, Director of Orthopaedics at Bronxcare Health System regularly performs these surgeries on patients and works with other orthopedic surgeons who specialize in this area.
As an expert in the field, Dr. Kirschenbaum studied at Brown University and earned his medical degree from Albert Einstein College of Medicine. He earned credentials at Philadelphia’s Rothman Institute. Dr. Kirschenbaum received special training for joint replacement surgeries and is a member of multiple associations. In addition to clinical topics, Dr. Ira Kirschenbaum lectures and writes about information technology, process management and process re-engineering in the medical field.
What Is the Average Age of Joint Replacement Surgery?
According to the study, “Changing Demographics in Primary and Revision Total Joint
Arthroplasty, 2000-2014,” by Dr. Matthew Sloan and Neil P Sheth, the average age of joint replacement patients is now 65. This represents a significant lowering of the average age in just one year, as the average age had been a full year older. Dr. Kirschenbaum points out that the study also included more detailed statistics about different types of joint replacement surgeries. For example, the average age for knee replacements decreased from 68 to 66, a very significant three-year differential.
While this one to three-year decreases in the average age of joint replacement surgery may seem small to the casual observer, they are actually quite significant when considering that the health of different people varies a lot in their sixties. Sixty is the new forty as some say and while some Americans are winding down and taking it easier, others actually enjoy a new lease
on life in their sixties and become more active. The decrease in average age for joint replacement surgery is also indicative of a rapid escalation in health issues the developed world is experiencing and in the rapidly changing lifestyles that contribute to joint damage.
Obesity Is A Major Factor in lowering the Age of Joint Replacement Surgery Patients
When Dr. Ira Kirschenbaum is evaluating a patient as a candidate for knee replacement surgery or hip replacement surgery, he must determine the first steps in whether or not the surgery will offer a substantial improvement to the patient’s quality of life. In some cases, Dr. Ira Kirschenbaum may recommend other interventions to help his patients such as diet, exercising more, exercising differently, and in some cases, changing work habits or other activities.
Sometimes these interventions can help prevent a patient from having to undergo joint replacement surgery, but in most cases, these changes work to help patients prepare for and recover after their surgeries. For example, strengthening the muscles around the knee can improve recovery after knee replacement surgery. The health issues that contribute the most over time to the necessity of earlier joint replacement surgery, obesity and being overweight are certainly among the most significant. According to Harvard Medical School, for each extra pound a person carries, there are four extra pounds of pressure placed on each of their knee joints. This means that with every step an overweight person takes, their joints are
compressed more than they should be and this has the effect of wearing away the cartilage and other soft tissues that provide cushioning to the joint. The more compression on a joint, the faster the cartilage disappears.
Let’s look at a concrete example of how much extra pressure that extra weight can put on an individual’s knee joints. A person who is five feet seven inches tall, and weighs one hundred seventy pounds, is considered to be about ten to eleven pounds overweight, based on a typical body mass index (BMI) chart. While being ten pounds overweight may not sound like
a huge health crisis, you must ask yourself, “How much extra pressure does that put on each of her knee joints?” Here’s the answer: 10 pounds x 4 extra pounds of pressure on each knee = 40 extra pounds of pressure on each knee! That’s a lot of extra pressure on each knee with every single step, especially if this occurs over a period of several years.
You’ve probably heard people say, “I feel so light on my feet,” after they lose even a modest amount of weight. The reason they say this is because it’s actually true! As an experiment, try carrying around ten extra pounds, even a short distance and pay attention to how much extra pressure this puts on your joints. The extra pressure that even a few extra pounds adds to your joints is why it is so common for doctors like Dr. Ira Kirschenbaum to urge their patients to lose weight, even if they are just a “little overweight.” Now consider this: if the same five foot seven inches tall person was just barely into the obese category, about thirty-two pounds overweight, she would have 128 extra pounds of weight on each knee just by standing up and walking across the room.
The Arthritis Foundation and other non-profits do an excellent job at spreading the word about the direct relationship between obesity and joint damage. They point out nationwide statistics compiled by the U.S. Centers For Disease Control and Prevention (CDC) which prove this direct relationship.
Among the general population, one in five Americans are diagnosed with osteoarthritis. However, the percentage of osteoarthritis jumps to one in THREE Americans among those who are obese. There is no doubt that the growth rates of obesity and being overweight in the United States are significant contributors to the earlier need for knee replacement surgeries and hip replacement surgeries. Obesity, and just being overweight, can have a profound effect on the health of your joints and on the age at which your joints may deteriorate to the point of needing surgery to restore function and reduce pain.
On the other side of that coin, there is good news. Losing weight at any age, even a modest amount of weight can substantially decrease your risk of needing joint replacement surgery and or delay the age at which it may become necessary. It’s important to listen to the advice of Dr. Ira Kirschenbaum and other orthopedic surgeons. They know what they’re talking about because it’s not only backed up by their own observations with their own patients but by broader statistics and science.
Autoimmune Diseases Are All On the Rise
Autoimmune diseases that affect cartilage, connective tissues, muscles, nerves, blood vessels, and bone are on the rise in the United States. These autoimmune diseases are known to contribute to a rapid decline in joint health, even if a person is not overweight or obese. In fact, it is a common misconception that only overweight and obese people have joint damage to the point they need joint replacement surgery. While joint damage is more common in overweight people, it can and does occur in underweight people and people of average weight. This may be why an orthopedic surgeon, like Dr. Ira Kirschenbaum, may send you to a different type of medical specialist when putting together a medical profile to determine what’s contributing to your joint decline.
Autoimmune diseases occur when a person’s own immune system attacks their own normal body parts as if they were a foreign entity. The U.S. Department of Health and Human Services reports that approximately seven percent of the total American population is affected by one or more of at least eighty known autoimmune diseases. Further, the occurrence rate of these diseases is increasing rapidly, especially among women.
Many scientists believe that the degradation of the environments the top reason why autoimmune diseases are so rapidly increasing. Negative environmental factors include air pollution, microscopic bits of plastics in water and food, and pesticides and herbicides contaminating food.
People Want To Be More Active To Enjoy Retirement More
Older Americans today are less likely than previous generations to be content with sitting in a rocking chair or spending so much of their time doing other sedentary activities after they retire. They want to take advantage of the fact they no longer have to work and really live life to the fullest. However, knee and hip joint deterioration can cause severe pain and reduced physical ability and this can put a real damper on a person’s ability to enjoy his or her retirement years. Therefore, many Americans are now electing to have joint replacement surgery earlier so they can more thoroughly enjoy their retirement years.
According to the 18th Annual Transamerica Retirement Survey of Workers, the most common dream that people have for their retirement years is to travel more. In fact, seventy percent of those surveyed said that travel was their number one priority after retirement. Lending even more support for this, the Motley Fool reports that Americans spend on average $11,077 per year on vacations after they retire! Therefore, it makes sense that Americans would want to get joint replacement surgeries out of the way at a younger age so they can feel healthy enough to gallivant around the world and enjoy every minute of their retirement.
Dr. Ira Kirschenbaum and other orthopedists see lots of patients who want to continue to enjoy their favorite hobbies into their later years. For example, many Americans who enjoy playing golf during their early and mid years may elect to have knee and or hip replacement surgery earlier so they can play even more golf when they retire. Erin Hurley-Booker, a physical
therapist writing for Golf Fitness Magazine, reports that more than ninety percent of patients are able to play golf after a knee or hip replacement surgery.
In fact, Dr. Ira Kirschenbaum and other orthopedic surgeons encourage their patients to return to their physical activities as soon as they possibly can, within reason of course and taking into account cues from their own body. Joint replacement surgeries, particularly knee replacements and hip replacements, have vastly improved the quality of life for retirees and many others.
Shifts In Joint Replacement Surgeries
Dr. Ira Kirschenbaum recently shared some information about the history of orthopedics. The history of total joint replacement dates back to the 1890s. At that time, surgeons replaced the ball of a hip joint. Sir John Charnley developed the modern technique for total hip replacement surgery in England in the 1960s. While surgeons in the 1900s dabbled with knee replacements, those procedures did not gain popularity until the 1970s.
With total joint replacement, the parts of a joint with arthritis are removed. Those parts are replaced by plastic, ceramic or metal implants. The replacement parts replicate the size, shape and movement abilities of the natural joint components. Shoulders, knees, and hips are the most common joints that require replacements. However, ankles, wrists, and elbows can be replaced as well. There are about 700,000 knee replacement surgeries in the United States every year,
and hip replacement operations total about 400,000 annually.
In the past, joint replacement surgeries were riskier and came with longer recovery periods. Today, some of these surgeries are performed as outpatient procedures. However, joint replacements are not designed to last forever. They must be replaced or revised over time. Revision surgeries are more complex and often require the rebuilding of bone in addition
to removing or replacing an implant. Since these surgeries require precision and are more involved, they do not have as high of success rates as original surgeries. As a rule, modern joint replacement implants are supposed to last about 20 years. In some cases, they may last longer.
Vitality After Joint Replacement Surgery
Dr. Ira Kirschenbaum encourages his patients to live healthier after joint replacement surgery.
One of the biggest contributors to joint damage and pain is obesity. According to the study, people with end-stage arthritis were commonly referred for joint replacement surgery. The statistics in the study showed that women had higher rates of arthritis than men. This may be due to anatomical differences. However, the number of men who required first and revision knee replacement surgeries rose significantly during the past several years. The study also
showed that 54 percent of patients who had total hip replacements were obese, and nearly 80 percent of patients who required total knee replacements were obese. These statistics included people who were moderately obese or morbidly obese.
Injuries also contribute to the rising number of joint replacement surgeries. Some patients have sports injuries that lead to severe joint damage. Many younger people are active in high school, college and recreational sports leagues now. With people maintaining active lifestyles throughout adulthood, the number of activity related injuries is rising. Also, many sports injuries cause arthritis, which develops over the span of several years or decades.
In the past, most people were not as active during their retirement years. Today, many younger people expect to be able to maintain an active lifestyle through 70 years of age. Since joint replacement surgical techniques have improved, doctors have gained more confidence in performing operations. Implants have also become more durable over time with new and improved designs. In addition to performing thousands of successful joint replacement surgeries, Dr. Ira Kirschenbaum was instrumental in developing some well-known joint replacement systems. His innovation has made him a trusted name in the world of orthopedic surgery.
Modern doctors see joint replacements differently than doctors of the past saw them. In the past, people were often told that replacements were unnecessary if they could still walk. However, doctors today who see problems that will worsen in the future may tell a patient to have surgery soon. If a patient waits until the future, the individual may have other problems that will complicate or hinder an elective surgery.
The only downside to the increase in joint replacement surgeries is their costs. However, the good news is that regulators are looking for ways to reduce these procedure costs, which are some of the most expensive elective surgeries. The regulators are trying to ensure that costs are not so low that they hurt facilities and not so high that they bankrupt patients.
About Dr. Ira Kirschenbaum
Dr. Ira Kirschenbaum is a proponent of more affordable costs for joint replacements. He had his own solo practice for joint replacement surgeries, where he averaged about 500 operations annually. Dr. Kirschenbaum also worked for several other notable organizations and held distinguished leadership roles. As the orthopedic department’s chairman at BronxCare Health System, Dr. Kirschenbaum ensures that the facility’s surgeons uphold the highest standards.
He specializes in shoulder, knee and hip replacements. He has also spread valuable medical information electronically. Dr. Ira Kirschenbaum was one of several medical professionals Who collaboratively founded the Medscape website, and the group later sold it to WebMD. He also served as a community health editor for WebMD. In addition, Dr. Kirshenbaum serves as the Chief Medical Officer for DTC Healthcom and as a Managing Partner for Sprocket Health.
He has been a member of the American Academy of Orthopaedic Surgeon since 1991 and has been on the Board of Directors for the EHR Project Team since 2010. With changes occurring every day in the medical field, the role of dedicated medical professionals is crucial. Dr. Ira Kirschenbaum is one among many focused surgeons that care about the future of innovative technological developments in this field.