Knee Replacement XRay. Photo by Scott Thieman
By Yasmin Noone
A rapidly increasing number of Australians are taking to hip or knee replacement surgery to fix their arthritic pain and injury woes, with nationwide data recording a 60 per cent rise in surgery figures over the last 10 years.
According to the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) 2011/12 annual report, more than 85,000 Australians underwent hip or knee surgery last year, marking an additional 4.3 four per cent of cases in one year.
President of the Australian Orthopaedic Association (AOA), Dr Graham Mercer, said the marked increase in hip and knee replacements in Australia is a good news story, highlighting surgery success rates over time.
He said the survival rate for most hip and knee replacement devices has grown to 90 per cent over the last 10 years.
“[It’s a] remarkable achievement by world standards,” Mr Mercer said, commenting on a decade of surgical success.”
Physiotherapist, Jeremy Kestenberg, said the newly released figures are as expected.
“We know the procedures have improved remarkably – the quality of the procedures have improved and the rehabilitation protocols have improved,” Mr Kestenberg, the director of Revita Health for Seniors, said.
“When you have all those improvements in one and have better anecdotal evidence for the people who have had the procedures, then you encourage more people to have these procedures.”
Mr Kestenberg believes knee or hip replacement surgery is often a lifeline for those older people suffering from severe arthritis or other pain, recovering from a fall, or having a hard time coping with their medications. But then again, he adds, so too is rehabilitation which aims to get the patient back to living their life, post-surgery.
“I guess overall, we want to look at outcomes. People are not going to look at surgery if they don’t need it.
“[We’ve found] that people who have been suffering from arthritis and severe pain for long periods of time often comment ‘it’s the best thing I’ve ever done’ after surgery. That’s a positive thing.”
Detailing all hip and knee replacements performed in Australia over the last 12 years, the annual report is thought to be one of the most comprehensive registries of its kind in the world.
It analysed 713,077 hip and knee replacement procedures in Australia since September 1999 – more than 332,350 hip and over 380,720 knee procedures.
It estimated that the median age of hip replacement for women is 73 years, and 68 years for men. Knee replacement figures also recognised that the median male age was 68 compared with 69 years for women.
“…People who have been suffering from arthritis and severe pain for long periods of time, often comment ‘it’s the best thing I’ve ever done’ after surgery. That’s a positive thing.” Jeremy Kestenberg
Australian women have had more hip replacements than men with 188,145 procedures for women and 144,206 for men. Equally women have had more knee replacements with 213,092 compared to 167,634 for men.
“With 12 years of data, trends can be seen with some significant patterns emerging,” Dr Mercer added.
“For example, more women are having replacement surgery, however men are having replacements earlier.”
The difference between male and female knee and hip replacement trends, according to Mr Kestenberg, may be due to physical work performed by men in what used to be known as ‘traditionally male roles’.
“Anecdotally, it can just be due to high physical workloads putting pressure on the joints in early life.”
Another trend to come out of last year is the increase in revision hip procedures, which increased from 4,013 or 11.3 per cent in 2010 to 4,646 or 12.5 per cent of all hip replacements during the reporting period.
PREVENTION OVER REPLACEMENT
Although Mr Kestenberg sees the great value that improved knee and hip replacement surgeries have on the quality of life of an older person, as a physiotherapist, he still recommends prevention rather than reactive solutions.
“We say that older people should really partner up with a physiotherapist for life,” he said.
“Overall good physical health, regular exercise, falls prevention programs and pain management programs can reduce the need to have surgery.
“So avoiding surgery is really about partnering up with a physio or health professional to help create a goal-driven preventive approach to [your health].
“It’s never too late to start. If you can delay or prevent that fall then why not?”