Orthopaedic Surgeons Tell Boomers to Change Lifestyle
AgeVenture News Service
Baby Boomers whose knees are giving way to arthritis, can best manage their condition by giving up jogging and weekend basketball, explained Arlen D. Hanssen, MD, today at a media briefing at the 69th Annual Meeting of the American Academy of Orthopaedic Surgeons. "They should choose different types of exercise to avoid heading into surgery," says Dr. Hanssen.
"A conservative approach based on lifestyle alterations, with surgery used only as a last resort, provides the most realistic answer for
arthritis patients in their forties and fifties," said Dr. Hanssen, an orthopaedic surgeon at Mayo Clinic.
"Middle-aged patients who've had knee surgery recommended to them should try less aggressive alternatives first," advised Dr. Hanssen, who also moderated an instructional course entitled Surgical Options in the Middle Aged Arthritic Knee. "The current thinking combines changes in lifestyle to include different types of exercise, for example, a combination of medication, physical therapy, and surgery, only if all else fails."
As clinical experience mounts, a growing number of orthopaedic surgeons are advocating for this cautious approach. The surgical treatments that benefit a younger person may be sub-optimal in 40 to 50 year olds. The primary concern is the longevity of a prosthetic replacement in an active middle-aged individual.
"The middle-aged are a distinct group wedged between two sets of surgeries, and in many cases, neither group of procedures adequately meets their needs," explained Dr. Hanssen. The ligament repairs that would effectively reduce pain and restore function in the active, resilient 25-year-old, for example, would not yield the same favorable results in an individual with 20 additional years under his or her belt. Twenty-five-year-olds are flexible enough to actually benefit from ligament reconstruction surgery designed to restore a higher level of activity.
Many 65-year-olds, on the other hand, have already adjusted to life in the slow lane. This decelerated routine makes those with severe arthritis better candidates for knee replacement surgery, because the surgery requires a decrease in physical activity. "A middle-aged person who loves singles tennis potentially risks repeat surgeries by putting their artificial knee through premature wear and tear," said Dr. Hanssen.
For this population, he recommends delaying surgery as long as possible by switching from high impact aerobics and demanding sports to activities that are easier on the joints, such as swimming, walking on a treadmill and biking. "Keep exercising, but change the form of exercise," explained Dr. Hanssen.
The fact that many people today remain active as they age complicates the scenario for the middle-aged patient. The tendency to stay "on the go" longer has raised the demand for surgery, including surgery for the "uni-knee," a procedure that replaces only a single portion of the knee with a prosthesis. "Orthopaedic surgeons must exercise great care in selecting patients from the middle-aged population for this and other knee surgeries," said Dr. Hanssen.
The 25,500 member American Academy of Orthopaedic Surgeons (www.aaos.org) or (orthoinfo.aaos.org), is a not-for-profit organization that provides education programs for orthopaedic surgeons, allied health professionals and the public.
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David Demko reports on lifestyle issues and trends in Aging.
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