CHICAGO, March 24 /PRNewswire/ -- The demand for total joint replacement is expected to increase so dramatically in the next 25 years that there may not be enough orthopaedic surgeons to perform the surgeries, as indicated by results from recent research on the topic. As presented at the 73rd Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS), the study projects the number of hip and knee replacement procedures that will be performed in the United States through the year 2030. Lead author Steven M. Kurtz, PhD, director of the Philadelphia office of Exponent Inc., an engineering and scientific consulting firm, and his research team projected that the number of procedures for primary (first-time) total knee replacement would jump by 673 percent - to 3.48 million - in 2030. The number of primary total hip replacements, the authors estimate, will increase by 174 percent - to 572,000 - in 2030. Partial joint replacements were projected to increase by only 54 percent. The research team based its projections on historical procedure rates from 1990 to 2003, combined with population projections from the U.S. Census Bureau. Also expected to become more prevalent is the repair or replacement of the artificial joint, called revision joint replacement. The number of revision surgeries likely will double by 2015 for total knee replacement and by 2026 for total hip replacement, according to the authors. Currently, hip revisions outnumber knee revisions, but knee revisions should surpass hip revisions after 2007, Kurtz stated. "There's definitely going to be a huge need for more orthopaedic surgeons," explained Kurtz, who is also research associate professor at Drexel University's School of Biomedical Engineering in Philadelphia. "If the massive expected demand for total joint replacement is not planned for before 2030, patients may end up waiting a long time for a new hip or knee." The growing need for joint replacement must be met not only with more surgeons, according to Kurtz, but also by increasing economic resources and longevity of the artificial joint. Among the reasons for the expected increased demand is that total joint replacement is gaining in acceptance. "There are few procedures that return as much quality of life as joint replacement," he explained. Other reasons include an aging population with arthritis requiring joint replacement; the increasing prevalence of obesity, which puts undue stress on the knee and hip joints; and the trend toward baby boomers remaining physically active later in life, which also places demands on the joints. Given these trends and the scientific methods that Kurtz' team used, their estimates are realistic, said Joshua J. Jacobs, MD, associate chairman and professor of orthopaedic surgery at Rush University Medical Center in Chicago and chair of the AAOS Council on Research, Quality Assessment and Technology, who was not affiliated with the study. However, future scientific advances could change their projections, he added. If joint replacement surgeries increase as the authors projected, it will burden an already financially challenged health care system, according to Dr. Jacobs. "We're on a collision course between the demands placed by the Medicare population for services - joint replacement being a major one - and the ability of our society to pay for them," he explained. Costs of revision joint replacement are particularly great and must be reduced, Dr. Jacobs stressed. The best way is to make the original joint implant last longer. For that to happen, there is a need for more research to improve surgical materials and technologies, continuing education on best practices for surgeons performing the procedures and new medical approaches to prevent loosening of the implant. Also, the AAOS has called for a national joint-replacement registry. Such a registry could help decrease the need for revision surgery, as it did in Sweden, Dr. Jacobs said, by identifying best surgical practices and the best- performing implants in primary joint replacement. No external funding was received for this study. An orthopaedic surgeon is a physician with extensive training in the diagnosis and non-surgical as well as surgical treatment of the musculoskeletal system, including bones, joints, ligaments, tendons, muscles and nerves. With more than 29,000 members, the American Academy of Orthopaedic Surgeons (www.aaos.org) or (www.orthoinfo.org) is the premier not-for-profit organization that provides education programs for orthopaedic surgeons and allied health professionals, champions the interests of patients and advances the highest quality musculoskeletal health. Orthopaedic surgeons and the Academy are the authoritative sources of information for patients and the general public on musculoskeletal conditions, treatments and related issues. An advocate for improved patient care, the Academy is participating in the Bone and Joint Decade (www.usbjd.org) - the global initiative in the years 2002-2011 - to raise awareness of musculoskeletal health, stimulate research and improve people's quality of life. The Academy's Annual Meeting is being held March 22-26, 2006 at McCormick Place in Chicago.
SOURCE American Academy of Orthopaedic Surgeons