A total knee replacement is usually performed to relieve symptoms of severe knee arthritis. According to new data from Medicare records, total knee replacement procedures for seniors over 65 rose 162 percent from 1991 to 2010 and the number of revision procedures, a surgery to repair a previously implanted artificial knee joint, jumped 106 percent. The statistics are part of research released in the Journal of the American Medical Association. The research includes only Medicare patients and data for those younger than 65 who may have had the surgery is not included. According to the study, about 600,000 total knee replacement procedures are performed each year in the U.S. and about 60 percent of those are paid by Medicare.
My Uncle George is one of the millions of older Americans contributing to those statistics. He is a tough old bird. As part of the 90th infantry he landed on Omaha Beach during the D-Day offensive. A self-described “foot soldier” he carried the 45-pound baseplate of the 81mm mortar from the shores of Normandy to Pilsen Czechoslovakia. After the war, he became a commercial plumber and spent years on his knees on cold concrete floors running copper pipe and fittings. His knees gave out long before he was ready to slow down so, twenty years ago at the age of 66, he underwent knee replacement surgery. His wasn’t the first; according to the American Academy of Orthopaedic Surgeons, the first knee replacement surgery was performed in 1968.
Howard County General Hospital, Johns Hopkins Medicine has been performing joint replacement procedures since the hospital’s earliest days, but in May of 2008 the hospital decided to focus and specialize in these procedures and opened the Joint Academy. “Although joint replacement surgery has been offered for many years at HCGH, the establishment of the Joint Academy in May 2008 took the service to a whole new level,” said Richard Kinnard, M.D., medical director of the Joint Academy. Last year the Academy performed 195 joint replacements and 158 of those were knee replacements. As with all joint replacements, the knee replacement has evolved as improvements in the artificial implants and surgical techniques have made the surgery more effective. Post-operative rehabilitation has come a long way as well. The study indicates that the average post-surgery stay in the hospital dropped to 3.5 days from 7.9 days. (At the HCGH’s Joint Academy most patients come in on Monday for surgery and go home on Thursday.)
Toni Keller, coordinator of the Joint Academy believes that the pre-op process helps improve the post- op experience. “When patients come in before their surgery and are educated on what to expect, it makes them much better prepared as a patient,” Keller says. “We also teach the family what to expect and how to prepare the home to make recovery easier.” Keller points out that improvements in care continue to evolve. “Currently Howard County General Hospital’s Joint Academy is one of only 300 hospitals nationwide participating with IHI (Institute for Healthcare Improvement) in phase 2 of ‘Project Joints.’” The project involves a rigorous protocol to prevent Surgical Site Infections (SSI). Steps include specialized pre-operative bathing, selective choice of antibiotics, and pre-operative evaluation for staph infections. Keller notes that the hospital’s focus on joint replacement received recognition. “In 2012, the Joint Academy earned the designation of a Blue Distinction Center for knee and hip replacement by CareFirst BlueCross BlueShield.”
Howard County General Hospital has several upcoming seminars about joint replacement that you can attend to learn more about the procedures. It’s Hip to Be Pain Free is presented by Dr. Charles Mess on October 16, Considering Joint Replacement Surgery presented by Dr. Mark Bullock and Toni Keller is October 25th and Knee Deep in Pain will be presented by Dr. Daniel Tang on October 30th.
And, if you are still curious about George…on his old knees, he earned the Purple Heart after he was wounded in the Battle of Chambois and a Bronze Star for his bravery while helping others cross the Moselle River. In 2007, standing tall on new, pain-free knees, he was awarded the French Legion Medal of Honor by French President Nicolas Sarkozy for his service during the liberation of France.