An Ageing Population Means More Work for Joint Specialists
While statistics vary between countries and there are many regions plagued by famine and drought that have high rates of infant mortality, as a general rule, successive generations of humans have shown a consistent tendency to live longer than their predecessors. Compared with the Middle Ages, when 35 was considered to be a ripe old age, on average, those born in the developed countries today are now living to more than twice that age and centenarians have ceased to be the rare novelty they once were. Longevity, however, has a downside. There is now more time for the symptoms of ageing to manifest. While this may not affect dentists and barbers, joint specialists and audiologists could soon find themselves with more work.
Our ankles, knees, and hips and, to a lesser extent, wrists, elbows, and shoulders absorb a lot of punishment over the course of six decades. Today, with life expectancies extending into the 80s, in many countries, longevity has to be weighed against the quality of life. In an increasing number of cases, the latter would be sadly lacking if it were not for the intervention of skilled and experienced joint specialists.
Left untreated, many of those aged 60 and over could look forward to a life of constant pain in a knee, hip, or shoulder joint that, in time, could no longer be curbed by the use of prescription painkillers or steroid injections. At this point, a gradual loss of mobility is inevitable. Longevity alone, however, does not explain the greater incidence of osteoarthritis, which is the most common cause of these symptoms. A more sedentary lifestyle involving less physical activity appears to be reducing the strength of those muscles and ligaments that serve to stabilise our joints and, combined with a spike in average body weight, the result is increased wear and tear on the cartilage protecting the articulating surfaces of the bones in the hips and knees. Consequently, many joint specialists are reporting that a growing number of their hip and knee replacement patients are now in their 50s, while some are even younger.
The job of these healthcare professionals is a varied one that combines both medical and surgical treatments. In addition, they must be competent diagnosticians and to assist them in this area, there are a number of tools that both simplify the process and provide more reliable results. Where, once, an X-ray of the affected joint, the physical examination, and the patient history would have been all they had to go on, today’s joint specialists enjoy the benefits of the arthroscope, an instrument which, when inserted into a hip, knee, or similar joint, enables a surgeon to view every detail of its internal structure in full colour and real time.
Not only has arthroscopy proved to be a valuable diagnostic aid, but it has also since enabled surgeons to adopt less invasive techniques for many of the procedures that they are commonly called upon to perform. By leaving the arthroscope in place and making additional small incisions through which to insert the necessary instruments, today’s joint specialists are able to monitor their actions without any need to expose the entire joint. Irrigation of a joint to remove detached particles of bone and cartilage, and repairs to the meniscus or anterior cruciate ligament are just some of their routine tasks now performed using “keyhole” surgery. In practice, some of the more experienced surgeons are now using the arthroscopic technique to perform joint replacements.
Known as arthroplasty, joint replacements are cited as the most successful of all orthopaedic interventions. With an average lifespan of 20 years, the sole limitation is the durability of materials used in artificial joints. With patients living longer, but requiring arthroplasty sooner, joint specialists may soon be in need of a new miracle material for their prostheses.