Increase in number of total knee replacement surgeries, especially in younger adults, linked to obesity

The number of total knee replacement (TKR) surgeries more than tripled between 1993 and 2009, while the number of total hip replacements (THR) doubled during the same time period. A study appearing in the June Journal of Bone and Joint Surgery (JBJS) found that an increase in the prevalence of ovrweight and obesity in the U.S. accounted for 95 percent of the higher demand for knee replacements, with younger patients affected to a greater degree.

“We observed that growth of knee replacement volumes was far outpacing that of hip replacements and were curious as to the origins of this trend,” said lead study author Peter B. Derman, MD, MBA, an orthopaedic surgery resident at the Hospital for Special Surgery in New York, N.Y.

Previous studies have found a strong link between a higher body mass index (BMI) and knee osteoarthritis. The effects of weight on hip osteoarthritis were less clear. In this study, researchers reviewed at least 10 years of national data (through 2009) on TKR and THR volume, length of hospital stay, in-hospital mortality, and orthopaedic workforce trends.

Among the study findings:

  • TKR volume has far outpaced that of THR for patients with a body mass index (BMI) of ≥25 kg/m² (persons with a BMI of ≥25 kg/m² and <30 kg/m² are considered overweight; patients with a BMI of ≥30 kg/m², obese), but not for patients with a BMI of <25 kg/m²
  • In 1993, surgeons performed 1.16 TKRs for every THR, but this ratio grew to 1.60 by 2009.
  • Patients ages 18 to 64 experienced a more rapid rise in overweight and obesity, compared to patients over age 65.
  • From 1997 to 2009, the share of patients ages 18 to 64 undergoing TKR rose 56 percent, compared with only 35 percent for THR.
  • Surgeon per-case reimbursement for TKR fell from approximately $ 3,000 in 1995 to $ 1,560 in 2009, and surgeon fees for THR from $ 2,840 to $ 1,460. As the data represents an approximate 48 percent drop in fees for both procedures, surgeons do not appear to be performing more TKRs over THRs because of higher reimbursement.
  • Hospital reimbursement, length of hospital stay and in-hospital mortality pertaining to TKR and THR also comparably declined between 1995 and 2009.

“We found that this differential growth rate in total knee replacement procedures could not be attributed to changes in physician or hospital payments, length of hospital stays, in-hospital death rates, or surgical work force characteristics,” said Dr. Derman. “Because excess body weight appears to be more damaging to the knee than to the hip, the increasing prevalence of overweight and obesity may explain the growing demand for knee replacements over hip replacements.

“If rates of overweight and obesity continue to climb, we should expect further acceleration in the number of knee replacements performed annually in the U.S. with a more modest increase in hip replacement volumes,” said Dr. Derman. “This knowledge can inform future policy decisions regarding health care funding and surgical

… Continue reading here.
Diet And Weight Loss News — Sciencedaily
— Courtesy “Science News Daily” (ScienceNewsDaily.com) <p>

Calorie burn + all other info about this Fitness Blender Pilates Abs Workout Video @ http://bit.ly/14dvZMk Lose 16-24 lbs in 8 weeks with our free workout vi…


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    • Traci Johnson
    • June 5, 2014

    I combined this with the Upper Body Tabata Workout and I feel good. 

    • Purple Pear
    • June 5, 2014

    my abs were hurting baaad during this one. thanks!

    • moop383
    • June 5, 2014

    I am really hoping this girl in the video see’s this comment. she is so so
    so so so beautiful…

    • lala lili
    • June 5, 2014

    I just love ur exercise it’s amazing cardio Pilates squats every thing but
    it’s not easy and ur adorable. 

    • hospitalcakewalk
    • June 5, 2014

    Omg, my abs burn so bad! I love this workout!

    • cluckyclucky
    • June 5, 2014

    Not sure if I completely understand the question but Pilates frequently
    coordinates exercises with inhale and exhale patterns, and use the breath
    to initiate and support movement. The whole point of breathing throughout
    Pilates exercises is to draw in lots of fresh air, get rid of every bit of
    stale air, and to train your abs. It’s difficult to do at first but you get
    used to it.

    • Roman Rebecca
    • June 5, 2014

    This think works… ? I means is that doing anything ? like a “real”
    workout.. I wanto try it but I don’t know it seems to easy to build muscles
    or burn anything ?

    • postedbynorico
    • June 6, 2014

    This is just great! Thank you!

    • jessica quansah
    • June 6, 2014

    I want to loose weight but i want it to be a gradual procees, not ant fast
    fix. Ive started changing my diet gradually as i want this to be a
    lifestyle. Wil i achieve my goal if i do an hour of pilates morning and
    evening with about 30mins walk a day.I hate the gym and also i have
    athritis in my hand so its not fun exercising there

    • SparklewishMakeup80
    • June 6, 2014

    great workout!!

    • smc05812
    • June 6, 2014

    Love your videos!!!

    • TheMowlee
    • June 6, 2014

    Kelli & Daniel – my virtual fitness trainers!!!

    • Vicky Thompson
    • June 6, 2014

    Good job Daniel! I like your positive attitude throughout the workout. I
    must admit I was encouraged to see you struggling. Sometimes you make it
    look so easy that I think something must be wrong with me!

    • beneenqasim
    • June 6, 2014

    I like when you pulled her shirt down when was rolling on her stomach!!
    That was really cute.

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