An aging US population, plus minimal non-invasive alternative options, determine the rate and scope of work an orthopedic surgeon sees today.
A Manhattan-based patient population is already likely to present a diverse array of makeup and characteristics. Add in the symptom variety that presents in patients with hip and knee surgery needs, and Claudette Lajam, MD, can say she has seen a bit of everything.
In an interview with MD Magazine, Lajam, an orthopedic surgeon with a focus in hip and knee reconstruction at New York University Langone, described how patients commonly present in her practice, and how an aging US population has influenced her rate of work.
MD Mag: What is the average patient for hip and knee surgery?
Lajam: Well, this is New York City, so we have people of all cultures, shapes, sizes, ages, races, and many different languages in my office. We have a little language translator, and that thing is
plugged in and used a lot, because we have a lot of folks who speak different languages.
Most people who come to me have some form of arthritis. So, there are many types of arthritis, but the most common is osteoarthritis, which is just a wear-and-tear of the joints. People who have worn and torn their joints tend to be a little bit older. My patient population tends to be on the older side. But we have folks who have had problems—trauma or something—and they come to me much younger with arthritis.
Are you seeing greater rates of hip and knee procedures due to the aging US population?
Well yes, certainly, when you have a group of people in a large group, like the Baby Boomers, who have exercised their whole lives. So, there are 2 components to arthritis: as a genetic component, and then there's a youth component. Regardless of the genetics of someone, if they've been exercising their entire life, their joints are going to wear a little faster.
We do see quite a few folks in that age range who are now coming to me with pain from arthritis, who are noticing that their function is decreasing. So yes, that population is expanding, and we continue to see more and more folks like that.
What sort of care are patients receiving before they end up being referred for an invasive procedure?
Well that's a very good question. Non-surgical treatment for arthritis can last for a few weeks or it can last for years. Some people who come to my office have been taking anti-inflammatory medicines, doing physical therapy, working on weight loss, modifying their activities, getting injections into their joints for years prior to having a replacement surgery.
And we really try to optimize non-surgical treatment before we move ahead to surgical treatment because what I do is not subtle. We do take out a joint, we take out the surfaces of the joint, and put something in so you can't go back from that.
Some folks have even had other surgeries on the joints in question. Arthroscopy has done in a lot of folks who then move on to have joint replacement. Some people had these surgeries many, many, years ago, but now come to us because they have arthritis.