Health Care

October 18, 2012

Total joint replacement surgeries on the rise, say Wichita surgeons

Area surgeons say they are seeing an increase in the number of total joint replacement surgeries, and they attribute the rise mostly to demographic shifts.

Area surgeons say they are seeing an increase in the number of total joint replacement surgeries, and they attribute the rise mostly to demographic shifts.

Nationwide, knee replacement surgeries have more than doubled in the last 20 years, and studies indicate that trend will continue.

“People are not very tolerant of sitting on the sidelines,” said John Schurman, an orthopedic surgeon with Advanced Orthopedic Associates and physician leader with Via Christi’s total joint team. “If you have something like that to offer them that dramatically changes their quality of life, that’s pretty attractive.”

Schurman said there’s a significant need for knee and hip replacements and that his practice has grown 10 to 15 percent every year for the last several years.

Last year, he completed about 800 operations, with about 65 percent of those knee replacements, he said.

Wesley Medical Center has seen a 26 percent increase in total joint replacements since 2010, said Paula Hopkins, advanced practice registered nurse and coordinator for the total joint replacement program at Wesley Medical Center.

Wesley now performs about 50 total joint surgeries for knees and hips per month, Hopkins said. Surgeons at Wesley generally perform more knee replacements than hip, but it varies.

Wesley’s total joint replacement program was established in 2009, and Hopkins said she thinks more hospitals will look at the need for more resources in the area of orthopedic surgery and related fields as the population continues to age.

“It’s a well-known fact people are living longer, and we have higher percentage of population that are older,” Hopkins said. “We have patients in their 80s and early 90s that still want to golf, go fishing with grandchildren. They do want to stay active and (the surgery) helps them do that.”

But, Schurman said, the increases in joint replacements come at a time when insurers, especially Medicare, are developing more stringent rules about paying for the procedures.

“I think that unless you’ve been asleep, you know health policy is changing in our world,” Schurman said. “I think hip and knee replacements are two things that are very visible as health costs. With the uptick in the volume, we’ve seen payers begin to try to validate from the record that the patient actually needs an operation.”

The most common reason people come in for the joint replacement surgeries are osteoarthritis, rheumatoid arthritis of the hip and knee, and avascular necrosis of the hip, Hopkins said.

Both Hopkins and Schurman said that another factor is obesity because of the extra strain the weight puts on a person’s joints.

In addition to more elderly patients, hospitals have also seen an increase in younger patients for knee surgeries. Patients at Wesley range in age from their 40s to their 90s, Hopkins said.

“Expectations in the baby boomer population are that ‘We’re not going to compromise. We want it all. We want good quality of life and we’re not willing to sit in a chair,’ ” Hopkins said.

For the most part, patients can generally expect joint replacements to last several decades, whereas before they might have lasted about 10 years, Schurman said.

The change comes from improved plastics and shapes of prosthetics as well as the methods used by surgeons, he said.

“The technology is very good,” Schurman said, “but what can make all the difference is the skill of surgeon putting it in.”

Contributing: Associated Press

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