“Adults today are more active than their parents were”

When it comes to exercise, we believe more is better and moderation is rarely mentioned in the same breath. We are told that exercise is a win-win situation and that getting everyone to exercise 60 to 90 minutes a day will guarantee better health and reduce healthcare costs. This belief forgets the other side of the calculation: the growing costs resulting from overuse injuries and joint damage sustained during high-impact activities.

It’s been called ‘little league-itis’ in kids and ‘boomeritis’ in young adults. Earlier this year, an orthopedic specialist estimated 90% of the annual 30,000 joint replacements in Australia were due to osteoarthritis and the biggest increase is among people under age 50 engaging in more competitive sports and high-impact activities. The American Academy of Orthopedic Surgeons has reported that total knee replacements among patients aged 38 to 56 has doubled in the past ten years. Many of these younger patients are athletic types who sustained injuries in their 20s, or are people who continue to indulge in high impact sports. While physical activity is certainly a natural, healthful part of life, we rarely hear in the news that more of us are more active today than previous generations or of the benefits of moderation.

The trend of soaring hip and knee replacements among young boomers has also been reported in Canada. The Canadian Institute for Health Information released the most recent data on hip and knee replacements last fall. It reported that over the past decade among adults aged 45-54, the rates (per 100,000 people) of knee replacements had increased 174% for women and 125% for men; and hip replacements were up 41% and 53%, respectively.

As the Vancouver Sun reported this week:

A hip surgery for young boomers

It wasn't his intention, but Dale Saip is something of a trendsetter these days. Two years ago, at the age of 46, Saip underwent surgery on his left hip to treat crippling osteoarthritis — a degenerative disease caused by the breakdown and loss of the cushioning cartilage in the joint. In Saip's case, the arthritis was likely the result of an old sports injury.... Increasingly, younger and younger patients across the country are seeking surgical repairs to, and replacements of, their damaged and worn-out hip and knee joints - surgeries that were, not so long ago, considered the strict domain of patients 65 and older. No more....

[A] recent report by the Canadian Institute for Health Information found the number of patients heading into operating rooms across the country for a total replacement of either a hip or knee has leapt an incredible 87 per cent from an estimated 31,500 patients in 1994-95 to more than 58,000 in 2004-05, with the number of procedures increasing at a faster rate than the population is aging.

The report also found that while Canadians 65 years and older continue to make up the majority of joint replacement patients (representing about 66 per cent of total surgeries performed), the largest rate of increase recorded over the decade is for patients between the ages of 45 and 54 years. Hip replacements doubled in this age group over 10 years - from 1,313 in 1994-95 to 2,664 in 2004-05, while knee replacements nearly quadrupled, from 655 in 1994-95 to 2,529 in 2004-05. [figures are total numbers]

The costs just for the hospitalization and physician (not including physical therapy, lost time from work, medications, etc.) for each hip and knee replacement, according to their Ministry of Health, was reported as about $13,100 and $14,500, respectively. Intense exercise can exacerbate joint damage for heavier people who make up the largest portion of those getting joint replacements. The increases in joint replacements exceed increases in the average weights of the population.

But health care professionals are also seeing a dramatic rise in the number of patients like Saip, who have spent much of their lives involved in sports of one kind or another..."I did pretty much everything," he said. By the time he was in his early 30s, Saip began to feel the brunt of those years of chronic-impact athletics...A portion of that trend, he said, has to do with the general mentality and activity levels of the so-called baby boomer generation, now between 41 and 61 years old. “They are more active than their parents were," [Dr. Paul Sabiston, a North Vancouver orthopedic surgeon who specializes in knees] said... Other factors also play a critical role in the patient increase - namely advancements in surgical procedures, as well as faster discharge and recovery rates.

In B.C., the total number of surgeries is expected to reach about 14,400 by 2010, up another 25 per cent over current annual figures of 11,135. Adding to the pressure, surgical patients now in their 40s and 50s, will likely be facing revision surgery in the next 10 to 15 years to correct or replace failing artificial joints....