Never Too Old for New Knees?

BALTIMORE, Md. (Ivanhoe Newswire) – About 600,000 Americans got their knees replaced the year before the pandemic and experts say that number is expected to swell by 110 percent in 2025 to 1.2 million. In the past, experts have cautioned patients not to get their knees done too young because parts can wear out. But how old is too old for new knees? The answer might surprise you. Ivanhoe has more.

Seventy-three-year-old Marnie Masotti and Skyler love their walks together, something that caused Masotti pain in the past.

“When you’re walking along and your like, you hear this crunch, crunch, crunch … you know something’s wrong there,” shared Masotti.

Masotti’s cartilage had worn down, and her legs began to bow out.

“Most patients become bow-legged because it’s more common for the cartilage to wear out on the inside of the knee than the outside,” explained Joseph Ciotola, MD, an orthopedic surgeon with Mercy Medical Center.

Dr. Ciotola replaced Masotti’s right knee six years ago, removing the damaged joint and replacing it with an artificial one. For her left knee, last year the doctor had a new robotic system called the Mako. Experts say with Mako, and other recent advances, there’s more precision, a shorter hospital stay, and less pain. Important for all patients, but especially those at a later stage in life.

“I’ve done surgery on a patient that was 100 years old, and I saw him on his 102nd birthday, you know, still enjoying it,” stated Dr. Ciotola.

Experts also say despite the old conventional wisdom to wait as long as possible, 85 percent of all replacements now last 20 years or more, making it a viable option for younger patients. Dr. Ciotola said pain, not age, is often the determining factor. Masotti feels good and is moving better than ever after her knee replacement.

“It just worked; I mean worked out perfectly,” smiled Masotti.

Doctors also say having a chronic condition, like diabetes or heart disease, won’t exclude you from total joint replacement. You may need to ensure your blood sugar is under control, and your orthopedic surgeon may work with a cardiologist during your surgery and recovery.

Contributors to this news report include: Cyndy McGrath, Producer; Roque Correa, Editor; and Kirk Manson, Videographer.

BACKGROUND: Having sore knees is common and is usually not a sign of anything serious. Some possible causes can range from a simple muscle strain or tendonitis to arthritis. The pain can develop gradually, may come on suddenly, or repeatedly come and go. As you age, getting knee pain may become more common. Osteoarthritis is the most common type of arthritis and can affect anyone at any age, but it is most common in people over 50. If you have osteoarthritis of the knee, you might feel that your knee is painful and stiff at times, and it might affect one knee or both. A doctor will often be able to diagnose a knee problem from symptoms along with a physical examination of the knee. Occasionally, they may suggest tests or a scan to help confirm a diagnosis, especially if further treatment is needed.

(Source: https://www.versusarthritis.org/about-arthritis/conditions/knee-pain/)

RELIEF OPTIONS FOR KNEE PAIN: Acetaminophen, an over-the-counter pain medication, can be used for osteoarthritis. It is a pain reliever but not an anti-inflammatory. NSAIDs can be more effective because they relieve pain and reduce inflammation. However, they come with side effects and risks as they can irritate the lining of the stomach, which may lead to an ulcer or other stomach problems and impair kidney function. Some NSAIDs can increase blood pressure and have been linked to an increased risk for heart disease. For people with milder pain, supplements such as the combination of glucosamine and chondroitin or the spice turmeric can be helpful. Turmeric has anti-inflammatory properties, and there is some evidence for its usefulness for painful knee arthritis. If other strategies don’t provide enough relief, injection therapy is an option with low risk. A corticosteroid injection involves delivering this anti-inflammatory drug directly to the knee. The benefits are typically short lived, but it varies from person to person.

(Source: https://health.clevelandclinic.org/whats-the-best-way-to-find-relief-from-your-knee-arthritis-pain/)

DEVELOPMENT IN JOINT ARTHROPLASTY TECHNOLOGY: A recent development in joint arthroplasty is the use of robotic assisted hip and knee arthroplasty. It is an evolution of navigated joint replacement surgery where computer assistance helps to guide the positioning of instruments and implants. Robotic surgery takes this a step further with the robot helping to position instruments or controlling the function of tools to ensure that bone resection matches the planned operation. The surgical plan is based on the patient’s own anatomy derived from a CT scan used to map a series of anatomical landmarks from the patient peri-operatively to a stored catalogue that are used to plan the procedure. It’s been reported there is lower blood loss and superior functional outcome scores with this surgery. In total knee arthroplasty, robotic assistance has been shown to protect soft tissues in comparison to manual techniques. Further studies are still needed to determine if this procedure should be considered the gold standard for hip and knee arthroplasty.

(Source: https://journals.sagepub.com/doi/full/10.1177/2055668320952043)