UAE knee replacement patients getting younger
Dubai- Knee replacement is no longer a surgery option meant for a geriatric population and is now a common phenomenon among patients as young as 50 in the UAE, point out orthopaedic surgeons.
Obesity appears to be a common factor in a growing prevalence rate of the health problem among younger patients.
Dr Suad Trebinjac, Consultant in physical medicine and rehabilitation at the Rashid Hospital, said that on an average he saw about four to five patients every six months below the age of 65 for knee replacements in the UAE.
“Compared to Europe where people opt for knee replacement only when confined to wheelchair, here younger people opt for knee replacements to have better standard of living when they cannot manage the pain. However, this needs investigation as to why the average age for knee replacement is going down. There are at least two or three clear reasons for this.”
Dr Trebinjac attributed it to the obesity epidemic which was causing earlier degeneration of the leg muscles and the onset of osteoarthritis. “The sedentary lifestyles and limited physical movements cause weakening of the leg muscles putting the load and pressure on the knees. Besides that, people in this region have more foot deformities such as flat foot where the arches are not well formed, once again stressing the joints of the ankle and the knee and causing degenerative changes.”
According to Dr Kutaiba Salman, specialist orthopaedic surgeon at Cocoona Centre for Aesthetic Transformation and Day Surgical Centre, Dubai, the incidence of Total Knee Arthoplasty (TKA) and of Total Knee Replacement (TKR) has risen worldwide: “The volume of TKA or TKR has increased dramatically over the last two decades worldwide. The percentage of the relatively young patients who have undergone TKA has increased substantially. Most of the knee registry systems which are used worldwide confirm the above statement. According to our clinical experience we can see that there is high volume of osteoarthritis patients who are candidate for TKA,” he said
This is a trend that is confirmed by the American Association of Orthopaedic Surgeons (AAOS) which states that the average age for knee replacement is getting younger than 65 worldwide. In the US every year 1 million Total Knee Arthoplastys are conducted, while in the UK the number stands at 600,000.
Who should consider surgery?
According to Dr Salman, patients need knee replacement when the articular cartilage of the knee gets damaged or the patient finds it extremely hard to move as the bones rub and crush together causing pain and that is when the patient needs to be fitted with an artificial prosthesis to alleviate pain.
“A patient should consider surgery when there is intolerable pain in spite of painkillers, We should consider surgery when there is radiological signs of arthritis and when the lifestyle is affected,” he added.
With improved technologies and better quality of prosthesis it is important for patients to resume their regular lifestyle after surgery. Dr Salman explained: “Knee replacement surgeries continue to improve. One of the new techniques which is now used in some centres is called minimally invasive knee arthroplasty. The other new technique is called CT or MRI navigated TKA. Some prosthesis companies has designed what is called high flex-prosthesis, which allows more range of flexion.”
Flexion of the artificial prosthesis is an important factor taken in to consideration by orthopaedic surgeons as people in the Gulf region require maximum flexion when they offer prayers, he said.
The average lifespan of the artificial knee is about 20 years although there could be complications in one in 50 cases such as nerve damage, early degeneration of the artificial prosthesis requiring a repeat replacement in less than 20 years. On a precautionary note Dr Salman added: “In general the studies show that the survival rate is still getting longer and the survival rate is shorter in the young patients because of their high level of activity. Sitting on the knee, sports with running, sports with risk of twisting are not recommended. Cycling and swimming are highly recommended.”
Source: Gulf News
Published: 05 Jan 2015
