American servicemen and women are getting new hips ad knees at an increasing rate. Over an 11-year surveillance period, researchers discovered that service members in their 30s and early 40s were having the joint replacement procedure done more often. They were also remaining in the military for a longer period following rehabilitation.
Rates of Joint Replacement Among Veterans Increasing
1 min read Premium comments
Secondary
Service members who were 40 years old or older were at greater risk for both hip and knee replacements. During the period of 2009 to 2013, incidence rates also increased in the following age groups 30–34 years (45%); 35–39 years (10.7%); 40–44 years (13.0%); and 45 years and older (3.8%)
In 2014 the rates of knee and hip replacements were identical—1.6 per 10, 000 person years. It appears in the report, published by the Armed Services Surveillance Center, that service members may be electing to have joint replacements at earlier ages due to improvements in surgical techniques and the increased durability and longevity of prosthetic joints.
The report documents a total of 3, 905 joint replacements among 3, 805 active members of the Army, Navy, Air Force, Marine Corps, and Coast Guard Among the cohort of service members who had a joint replaced during 2004–2012, 18.2% had retired; 5.2% had been medically disqualified from service; 6.3% had otherwise left service; and 70.3% were still in service one year after their joint replacement.
Of the services, the Army and Coast Guard had the highest overall rates of joint replacement (2.89 and 2.88 per 10, 000 person-years, ) The Coast Guard had the highest rate of hip replacement (1.54 per 10, 000 person-years) and the Army had the highest rate of knee replacement (1.46 per 10, 000 person-years).
The Army and Coast Guard had the highest rates of shoulder replacement
The report concluded, “It takes years of training and experience to produce a seasoned NCO or Officer. If joint replacement allows servicemen and women to remain on duty longer and continue being valuable contributors to the military, then it will be a good thing for the U.S. Armed Forces.”
React:
Discussion
This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
Join the conversation
Orthopedic professionals are discussing this. Sign in and upgrade to read every comment and add your voice.