Can Joint Replacements Keep The Elderly Active For Longer?
Joint replacement, though starting early, became available more generally in the 1960s with hip replacements followed by knee replacements. Ankle and shoulder replacements are now available. Due to increases in the elderly population and improvements in surgical procedures the number of joint replacements has been increasing massively and is set to carry on increasing. It is predicted in the USA that between 2005 and 2030 hip replacements will grow by 174% to 572,000 and for knee replacements to grow by 673% to 3.48 million.
Data from 2011, in the UK, shows 80,314 hip replacements, 84,653 knee replacements and 492 ankle replacements, data on shoulder replacements was not collected in 2011. The data shows that most replacements occur due to osteoarthritis and the average age at replacement is around 68 years.
As we get older it is common for our posture and walking pattern to change. This is because many changes occur in the body as we age. For example bone density as lost during the ageing process, particularly in women after experiencing the menopause. During the age process joints may also get stiffer and less flexible. This is because the fluid in the joints can decrease and this means that the cartilage may begin to rub together and erode. Calcification (deposit of minerals around the joints) can occur particularly in the shoulder joint. The hip and knee joints are common areas for cartilage to be lost.
Effects age related changes can have on the body
Almost all elderly individuals are effected by joint changes in some way, and this can vary from stiffness to Arthritis. There are a number of effects that ageing can have on the body, for example bones can become brittle, and these means that they can become more prone to breaks. The most common effects that can occur include: inflammation, stiffness, pain and deformity as a result of a breakdown of the joints structure.
As a result of these changes within the body individual’s are more likely to become unsteady on their feet, and this can result in falls. This can have a major impact on an individual’s health and well-being, as falls can result in serious breakages, such as a hip fracture.
What can be done to help?
In serious cases joint replacements would be a viable option, as it can relieve pain and disability. It is common as people age for them to need knee or hip replacements. This is because these are joints that see a considerable amount of wear and tear throughout individual’s lives, though statistics show that many replacements are due to the pain from osteoarthritis which there is no current cure for.
The procedure for a joint replacement involves removing the damaged joint and then an artificial joint (either made of a metal alloy or ceramic) is put in place. This can either be cemented or non-cemented. Cemented means that the artificial joint has been fixed to the remaining bone with cement, and this is quite often used in older individuals as their ability to heal is more limited. Non-cemented joint replacements allow the bones to naturally grow around the replacement to fix it into place. This is generally used in cases where younger individuals or more active individual’s need joint replacements. This is because it can provide more flexibility and movement in the long term. However with this method of joint replacement healing time may take considerably longer than a cemented joint replacement as the bones need the opportunity to grow.
Recovery time following a joint replacement can be particularly long, and an individual may require countless hours of physiotherapy and support in order to regain movement and flexibility. Generally individuals manage to regain a normal level of activity within two to three months of having the replacement, but it can take up to a year to make a full recovery and full benefits of the new joint. Following the surgery you would be enrolled into an exercise programme that is designed to help to gain strength and improve mobility of the new joint.
Home care and joint replacements
As a result of the surgery it is likely that you will be off of your feet for a while, and recovery may be slow, some extra help may be needed. It may be beneficial to implement a home care package in order to provide some additional support. A care worker would be able to visit to help with daily living tasks such as washing, dressing and preparation of meals. Care workers can also provide some support with some exercises in order to help build up strength in the new joint. The Care Worker can focus on getting you back to doing what would have normally been doing before the surgery.
In the UK history is showing that replacements are lasting 8 years without problems in many cases therefore people are prolonging their active lives. Having to redo work on joints is occurring in around 10% of cases and as more data is collected and shared with surgeons around the world the life of replacements is increasing and the level of issues is reducing.