The most common reason for knee replacement in the United States is severe osteoarthritis.
According to a report from Center for Disease Control published at the end of last year, in 2010, total knee replacement was the most frequently performed inpatient procedure on adults aged 45 and over in the U.S., with an estimated 5.2 million total knee replacements performed in the 11-year period from 2000 through 2010.
There were an estimated 693,400 total knee replacements performed among inpatients aged 45 and over in 2010 alone.
The rate of total knee replacement for men and women almost doubled from 2000 through 2010, while the mean age at which inpatients aged 45 and over had total knee replacement decreased significantly.
Money magazine in September 2015 estimated the market for knee replacements in the U.S. to be worth $4 billion.
Giving an aging population staying in the workforce longer, and rising obesity rates, a paper in the Journal Of Joint And Bone Surgery predicts that the demand for total knee replacement surgery is expected to exceed 3 million per year by the year 2030.
What’s behind the growing demand for new knees, with the rate of replacements doubling and the mean age of those receiving knee replacements decreasing?
A Bloomberg report identifies the knee replacement boom as being driven by two major demographic shifts.
Though there are risks with any surgery, including possible infections or implant failures, knee replacements are considered a highly cost-effective intervention because they can allow people to continue to work and avoid disability or other expensive care.
On the down side, some patients who get knee replacements don’t get the benefits, particularly if their pain or impairment was mild to begin with.
“The actual eligibility criteria for total knee replacement is by definition vague,” says Daniel Riddle, a physical therapist and professor at Virginia Commonwealth University.
He led an analysis of 205 knee replacements that judged almost one-third of them to be inappropriate.
Therein lies the rub and the prospective knee replacement patient’s dilemma: what to do in a situation where one is having issues with one’s knees but one’s alternatives are so limited?
For someone suffering from knee pain and loss of mobility caused either by injury, osteoarthritis, or both, the treatment choice continuum involves treatment for symptoms, lifestyle changes, physiotherapy, hyaluronic acid injections or stem cell therapy on one end, and either partial or total knee replacement surgery on the other, with little or nothing in between.
Two months into 2016 and two new technologies have been added to the continuum of alternatives to traditional knee replacement surgery.