Joint Replacement Younger More Active Patients Find Relief With New Options

April 06, 2011

Once reserved for the 65 and over set, candidates for joint replacement are now often younger, more active and have a whole new attitude toward this highly evolved procedure.

"Advances in the implants themselves, as well as surgical and pain management techniques have made joint replacement acceptable and accessible to many more patients who will benefit from it. The artificial joints last longer and the recovery can be quicker," notes orthopedic surgeon Eddie El-Yussif, DO.

Treatment plans are tailored for each patient depending on their age, physical condition and goals after surgery.

The majority of patients seeking replacement of the knee or hip joint suffer from severe osteoarthritis. The cartilage helping the joint move smoothly has worn away and the resulting "bone on bone" condition is extremely painful.

When it begins to interfere with day-to-day activities and cannot be managed with physical therapy, medications or injections, joint replacement surgery is often the answer, notes Dr. El-Yussif.

"We are seeing younger patients and by younger we are talking about patients 60 and under or whose ‘physiological' age is 60 or under," Dr. El-Yussif says. "We have had patients in their 30s who need joint replacement because of trauma or a congenital condition."

Physical condition, mindset play roles in recovery

For the typical "younger" patient who is in good health and motivated to succeed, the hospital stay and even the pain associated with joint replacement can be dramatically reduced. The average hospital stay is about three days but in January, Dr. El-Yussif performed hip replacement on 57-year-old Wade Bliss, who went home the next day. Wade had been trying to manage his arthritis pain with over-the-counter medications and it just wasn't working. A pipe fitter and plumber, Wade's strenuous job was getting more and more difficult as his hip further deteriorated.

"When I went in to the hospital, I thought I would work hard," Wade said. "The nurses were all real professional, asking me how I was, asking if I was in pain. I was sitting in the chair the night of the surgery."

Controlling pain is key to allowing patients to graduate to more and more demanding physical therapy both while in the hospital and after returning home, Dr. El-Yussif added.

"Physical therapy came and I was doing all they were asking of me," Wade said. "The pain was controlled and everything was easy. I picked the walker up and walked with it. They all looked at me like I was crazy!"

Wade continued physical and occupational therapy at home and was back to work within six weeks.

Back on their feet

The Warren hospital program is experiencing similar success stories with a wide range of patients. For mother and daughter Juanita Hall and Judy DeFazio, hip replacement surgery has given them back their mobility. Orthopedic surgeon Fremont Scott, DO, performed their surgeries back to back in August.

For 54-year-old Judy, the trouble was osteoarthritis. She had already had her right hip replaced and knew what to expect. When her mom, 76-year-old Juanita, needed surgery, they decided it might work out best if they had it at the same time. Judy and Juanita could recover together at Judy's home, assisted by her grown children.

"The arthritis focused on my hip and I waited (for surgery) until I couldn't walk," Judy said. "I couldn't do anything. It was all I could do to make it to work."

While Judy's issues were pretty straightforward, her mom's problem was a little more elusive. Juanita had spine surgery in 2007 and had broken her hip in 2009. Both had healed, but she was having pain.

"Nothing showed up on tests," she said. "It was very discouraging. I was wondering if it was all in my mind and if I would be able to walk anymore. I finally went to Dr. Scott and he wanted to find the answer."

"It was very difficult to determine whether the pain was from her back or the hip," Dr. Scott said. "For me it was a diagnostic challenge."

Finally, the pain was pinpointed to her hip. Dr. Scott suspects when the hip was broken and healed, the mechanical alignment of the hip was affected. That changes the gait, which helped cause the joint to deteriorate.

He said Juanita's case was a little mysterious, while Judy had some plain bad luck being prone to osteoarthritis. The good news is that there is relief via joint replacement for younger patients.

"Sometimes in women's anatomy the bones don't line up correctly, causing pain and restricting activity like running or biking. Now we don't dismiss that pain and say ‘just don't run.' We can offer several alternatives, including joint replacement, which relieves their pain and ensures their mobility," Dr. Scott said.

A top program for patient satisfaction

The Henry Ford Macomb Center for Joint Replacement at Clinton Township and Warren focuses on healing body, mind and spirit as patients move from preparation, surgery and hospital stay to recovery and rehabilitation at home.

Patients receive an individual plan of care that includes advanced pain management, physical and occupational therapy. Private rooms are designed especially for the needs of patients getting a hip or knee joint replaced. Individual and group therapy maximizes the time spent in the hospital. The camaraderie experienced at the group sessions goes a long way to encourage recovery and build confidence.

The Center also offers a menu of complementary medicine services for patients to choose from, including therapeutic massage, Reiki, aromatherapy and music. The Center provides a unique staffing model that provides patients with care from a team of dedicated registered nurses and certified therapists who have been specially selected for the Center.

All of these special touches have helped put the Center in top 1 percent of hospitals nationally for patient satisfaction.