Grandma isn't the only one getting a new hip.
Newly released information shows that nearly one-third of hip and knee replacements in Canada are now performed on people under the age of 65. Once a telltale sign of frail old age, joint replacements are increasing most rapidly among active people in the 45-54 age group.
The number of total knee replacements performed on people under the age of 55 rose 90 per cent and total hip replacements increased 30 per cent, said a report released by the Canadian Institute for Health Information.
The trend reflects the fact that jogging, tennis-playing boomers are wearing down their joints like never before. Health consumers are also more demanding than ever and unwilling to live with pain for prolonged periods.
But because many of the recipients of artificial hips and knees will outlive their prostheses -- they last about 10 to 15 years -- it will also create new demands on the health system in future.
"This trend is important to monitor because many of these younger patients will likely outlive their first implants and, therefore, require a subsequent joint-replacement surgery later in life," said Greg Webster, manager of clinical registries at CIHI.
In Canada, 42,917 total hip and total knee replacements were performed in 2001, up from 32,147 in 1994. That is a 33-per-cent increase over seven years. The figures help explain lengthy waiting lists for orthopedic surgery.
According to the Arthritis Society of Canada, more than 20,000 Canadians are waiting for knee and hip replacements. The wait stretches to 64 weeks in some provinces and averages more than six months nationwide.
Osteoarthritis, the condition that prompts the need for joint replacements, is characterized by the degeneration of joint cartilage and adjacent bone. Surgery is elective because the condition is not life-threatening.
Robert Bourne, an orthopedic surgeon at the London Health Sciences Centre in London, Ont., said the majority of patients getting hip or knee replacements, regardless of their age, experience dramatic improvements in their quality of life. But they are frustrated by the long waits.
"Patients often wait several months for surgery and, as a result, often live in pain, some require assistance or a wheelchair and others are immobile while they wait for their surgery," Dr. Bourne said.
The new CIHI data also reveal broad variations between provinces in hip and knee surgery rates. For example, the hip-replacement rate in Alberta -- 73.5 per 100,000 -- is almost twice Newfoundland's rate of 37.6 per 100,000. And the knee-replacement rate in Nova Scotia -- 100.6 per 100,000 -- is almost triple Quebec's rate of 37 per 100,000.
Replacement surgery
A recent study shows an alarming number of young Canadians are needing hip or knee replacement surgery. The study compares numbers and percentage change for 1994-95 to 2000-2001.
Hip replacements
Age groups.... 1994-95... 2000-2001... % change
Under 45.........964......1,089......+13.0%
45-54..........1,346......1,924......+42.9
55-64..........3,268......3,621......+10.8
65-74..........6,221......6,641.......+6.8
75-84..........4,268......5,447......+27.6
85+..............720......1,065......+47.9
TOTAL.........16,787.....19,787......+17.9
Knee replacements
Age groups.... 1994-95... 2000-2001... % change
Under 45.........259........335......+29.3%
45-54............679......1,444......+113
55-64..........2,976......4,658......+56.5
65-74..........6,924......9,380......+35.5
75-84..........4,161......6,660......+60.1
85+..............361........653......+80.9
TOTAL.........15,360.....23,130......+50.6
SOURCE: CANADIAN INSTITUTE FOR HEALTH INFORMATION
André Picard