“When I started practice 30 years ago, if someone had hip pain, we’d take an X-ray and even if they had arthritis, and were in their 40s, we’d tell them to modify their activity and wait,” said Dr. William Maloney, professor of orthopedic surgery at Stanford University.
No longer. “The technology caught up with our patients’ desire to stay active,” he said.
One of the biggest innovations came in the late 1990s and early 2000s — just in time for the marathon-running, tennis-playing boomers to start showing signs of wear and tear.
“The industry figured out a way to make the implants better,” said Robert Cohen, president of digital, robotics and enabling technologies for Stryker’s Orthopedic joint replacement division in Mahwah, N.J. “We used the exact same plastic — relatively soft, but durable — and put it through a post process, of heat and radiation, that made it even stronger.”
The “highly cross-linked polyethylene” implants significantly reduced the need for revision surgery. “One of the main reasons for revision was the polyethylene breaking down in the replacement joint,” he said.
Thanks to the advent of the stronger, more durable material, he says, “we’ve pretty much eliminated that.”
The new implants also helped lead to faster recovery times.
“When I was a resident, people were admitted to the hospital for 10 days after a total hip or knee,” said Dr. Dorothy Scarpinato, in Melville, N.Y. “Now they get them out after a day or two.” As a result, she added, “people aren’t as afraid of this surgery as they used to be.”
The factors contributing to the shorter hospital stays, Dr. Maloney said, include less invasive surgery, accelerated rehabilitation protocols, better pain management methods and the use of regional as opposed to general anesthesia.