How advancements in joint replacement therapy are helping patients stay active longer

It’s often the first signs of aging. Our knees start creaking, back pain intensifies, hands lose their flexibility and hips hurt. Weekend warriors, middle-aged marathoners and even younger fitness zealots that may overdo physical activity are joining older adults in experiencing chronic orthopedic problems.

Diseases, disorders and injuries to the musculoskeletal system eventually affect more than 80 percent of Americans.

To learn more, Smart Business turned to Douglas Garland, M.D., orthopedic surgeon and the medical director of MemorialCare Joint Replacement Center at Long Beach Memorial, which has received many accolades for its achievements, including being listed among America’s Best Orthopedics Programs in U.S. News & World Report.

What’s new in the fields of orthopedics and joint replacement??
Some of the greatest advancements that have taken place in orthopedic medicine have occurred in joint replacement procedures, particularly for the hips, knees and shoulders. The strides in replacing these joints are restoring individuals to greater mobility — with little to no pain. Surgeries are less invasive, and advanced prostheses more durable and longer lasting.

We have also identified some preventive measures to avoid orthopedic problems. They include maintaining a healthy weight, properly warming up prior to any physical activity, performing weight-bearing exercises, increasing exercise intensity slowly, wearing sensible shoes that fit, conducting a home safety check to prevent falls and balancing your routine to build strength, flexibility, muscle tone and cardiovascular health.

When is surgery needed?
Joints damaged by arthritis and other diseases, injuries or simply years of use may cause the joint to wear away and produce severe pain, stiffness and swelling. Joints are alive; and they require joint fluid to be healthy, grow and repair themselves, especially since the diseases and damage inside a joint can limit the fluid required to reduce friction between the cartilage and particular joints during movement. Joint replacements can be appropriate for patients who are no longer getting relief from pain and swelling with medicine or injections.

In addition to seniors, who for decades represented the majority of joint replacement surgeries, there is a growing number of people in their 40s and 50s who are now candidates for these procedures. In the past, younger individuals were often forced to wait until their mid-60s. Older joint replacement materials were not expected to last more than a decade or two, and many surgeons were reluctant to perform a second replacement when the first wore out. Today’s wear-resistant materials are lasting longer, allowing hip and knee replacements among the 45- to 64-year-old group, with surgeries tripling in numbers compared to the last decade.

What are the characteristics of an outstanding program?
The MemorialCare Joint Replacement Center at Long Beach Memorial guides those requiring hip and knee replacements through surgery and rehabilitation, while promoting wellness and an active hospital stay. Individuals are often able to walk, with assistance, the same day of surgery, move independently in a day or two and leave the hospital in two to three days. They lead active lifestyles within two to three months.

Our goal is to fully engage patients and their loved ones — from the moment the surgical decision is made to the transition home. We stress to patients that ‘you are well,’ better preparing them for the surgery and best possible outcome. The Center features private rooms and a large, well equipped center for physical and occupational therapy, education and group lunches — all in one area exclusively for joint replacement patients. Individuals, their families, volunteers and a dedicated staff of joint replacement specialists work together following surgery as the patient starts ‘Cruising to Recovery’ at the cruise ship-themed Joint Replacement Center.

Education plays an important role in achieving successful outcomes by reducing fear regarding the surgery, recovery and transition home. The individuals and their families will attend comprehensive educational classes prior to surgery to help understand what to expect, which emphasizes the importance of beginning therapy immediately after surgery. A family member or friend participates in the program, acting as the individual’s coach. Together they attend ongoing therapy and educational sessions to learn what it takes to recover as quickly as possible and how they can assist the individual’s return to daily activities. An actual car in the center helps with training on how to get in and out of an automobile safely.

Group settings differentiate the Joint Replacement Center from typical hospital stays. Group therapy builds camaraderie and even competition among the patients who attend classes and have lunch with fellow patients, coaches and staff. And the cruise ship-themed ‘Walking Board’ tracks the number of steps an individual takes each day. The more steps taken, the further patients venture on their journey to recovery.

Douglas Garland, M.D., is an orthopedic surgeon and the medical director of MemorialCare Joint Replacement Center at Long Beach Memorial Medical Center. The not-for-profit MemorialCare Health System includes Long Beach Memorial Medical Center, Miller Children’s Hospital Long Beach, Community Hospital Long Beach, Orange Coast Memorial Medical Center in Fountain Valley and Saddleback Memorial Medical Center in Laguna Hills and San Clemente. For additional information on excellence in health care, please visit memorialcare.org.