By Karim Elsharkawy M.D.

One of the most often asked questions I get about joint replacement is “when is the right time to have this procedure.”

A few years ago, the age of the patient was one important consideration, due to the relatively short life of the implants. New evidence has shown that artificial joint replacements are now lasting longer than the earlier prototypes and the joint replacement surgeons on the referral line of Texas Health Spine & Orthopedic Center along with the patients they treat are enthusiastic about the news.

According to a research report released in February 2019, researchers conducted an exhaustive review of several hundred thousand joint replacements in Australia, Denmark, Finland, Norway, Sweden, and New Zealand.

The researchers followed nearly 216,000 hip replacement patients for 15 years. “They also tracked 74,000 for 20 years and more than 51,000 patients for 25 years. Overall, 89 percent of hip replacements lasted 15 years, and 70 percent lasted 20 years. Nearly six in 10 lasted 25 years.

In addition, the researchers looked at knee replacement patients, including nearly 300,000 patients who were tracked for 15 years; 92,000 who were followed for 20 years; and about 80,000 who were tracked for 25 years.

Of those who had a total knee replacement, 93 percent lasted 15 years. The same was true for about 77 percent of patients who had a partial knee replacement, the investigators found.

Why Are Joint Replacements Lasting Longer?

Joints have not always lasted this long. Surgeons used to tell patients that the joint would most likely last for 15 or maybe 20 years.

The ‘weak link’ in the system back then was the plastic (polyethylene) from which the joints were made. What has changed over the past few years is that a better manufacturing process of the polyethylene material has been developed. Plus, where we once used metal and plastic in the past for the joints, we are now using ceramic materials (for total hip replacement) and better polyethylene materials, which are much more durable.

There have also been other improvements in hip and knee implants. We are now using press-fit’ or ‘cementless’ implants. There was a time when we relied on cement heavily, but now we use the press-fit technology, especially for hip replacements, and it allows the bone to grow onto the prosthesis and this is a much better fixation than cement. This is especially effective for hips. For knee implants, cement is still more often used. However, the press-fit technology has been introduced over the last few years with promising results thus far.

Have Surgical Advances Improved Joint Longevity?

As with all medical procedures, joint replacement surgery continues to evolve for better patient outcomes. Do these advances account for greater longevity of artificial joints? Yes. They do.

“We are using better technology – such as advanced imaging and robotics – to measure all of the replacement components. The capability to check the measurements of these components is especially advantageous for hip replacements. If components are in an awkward position, that does affect the longevity of the implant. Placing the implants in a more accurate, reproducible and balanced position does affect the durability of the replacements.

Post – Operative Effects on the Life of Joints

We tell our patients to avoid high-impact, repetitive activities immediately after surgery. This doesn’t mean that the recovering patient can’t play sports or run. It just means that they probably don’t want to run a marathon right away, especially if they are 50+ years old.

For the most part, I tell joint replacement patients that they can do pretty much whatever they want to do. We just suggest that they are careful with repetitive, high impact activities.

Better component technology and state-of-the-art medical technology are two reasons why joint replacement surgery is one of the most popular procedures in the history of medicine. The human touch from caring surgeons and patient navigators from Texas Health Spine & Orthopedic Center completes the experience.

Dr. Elsharkawy is an orthopedic surgeon who specializes in joint replacement surgery. He is on the referral line of Texas Health Spine & Orthopedic Center

Physicians who are members of the referral line practice independently and are not employees or agents of Texas Health Spine & Orthopedic Center.

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