Monday, November 23, 2009

Health

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To Build a Knee

Done right, it's fast, safe, and effective

By Michelle Andrews
Posted 7/15/07

These days, people in their 50s and even younger are discovering that the athletic sins of their youth have made them candidates for knee replacement. Not long ago considered a remedy mainly for old people whose elderly joints are crippled by arthritis, new knees increasingly are finding their way into aging baby boomers. After jogging, skiing, and hitting the tennis courts for decades, many find that knee injuries they sustained in their 20s and 30s—remember that torn anterior cruciate ligament?—may have damaged the cartilage that protects their bones from rubbing against each other, setting the stage for early arthritis.

Analyzing a patient's gait
(JIM LO SCALZO FOR USN&WR)

About half a million knees a year are being replaced, far more than any other joint. The procedure is straightforward. The orthopedic surgeon removes up to half an inch from the bottom end of the femur (thighbone) and top end of the tibia (shinbone), fits them with sturdy metal or ceramic caps, and snaps a high-density plastic cushion between the two as substitute cartilage. Some patients are back on the golf course within two months. Doctors discourage joint-jarring activities like jogging, volleyball, or singles tennis for patients with artificial knees, but many people can and do safely return to favorite activities like hiking, biking, and even doubles tennis.

The operation should be carried out only at a facility where it has become routine. The Hospital for Special Surgery in New York City performed some 2,500 knee replacements in 2006. Steven Haas, chief of the knee service, needs a little more than an hour for a minimally invasive version done through a small incision. Knee replacement can bring an end to years of crippling pain. "Ninety-five percent of the people I treat feel much better after having surgery," he says. "How great is that?"

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