Joint Reconstruction

with Bruce Fauré, M.D., Orthopaedics, Advanced Healthcare

Posted: April 1, 2004

The science of joint reconstruction has come a long way in the last five years. The traditional way of looking at who needs reconstruction or replacement has changed dramatically. “It used to be for people 65 and older, people living a sedentary lifestyle,” said Bruce Fauré, M.D., an Advanced Healthcare physician specializing in joint reconstruction and arthroplasty. With the improvements in materials and patients’ willingness, 55 and older has become a norm.

Bruce Fauré, M.D., Surgery/Joint Reconstruction and Arthroplasty, Orthopaedics, Advanced Healthcare "There are 600,000 hip and knee replacements every year in the United States."

Although still a factor, age is now less important when it comes to who needs joint reconstruction. The average age may be 55, but anyone aged 30 to 90 can easily be a candidate.

One’s activity level plays a large role as well. “Someone in their 40s doing manual labor will face different decisions than a librarian in his 50s,” Dr. Fauré said. The amount of stress and pressure joints experience in everyday life directly reflect upon the decision-making process.

Surgery today
The hip and knee are the most common joints facing reconstruction. “There are 600,000 hip and knee replacements every year in the United States,” Dr. Fauré stated. “And they occur at nearly a one-to-one ration; meaning there are nearly 300,000 hip and 300,000 knee replacements.”

He noted that this constitutes a large increase from just five years ago. The increase has occurred partly because younger people are now candidates for the procedure.

The hip and knee joints are most prevalent because “they are high-weight bearing joints,” Dr. Fauré said. Joints like the shoulder bear no real weight, and therefore have fewer problems.

“There are three factors in the process of evolution in joint replacement in surgeries today,” Dr. Fauré said. The first is alternative and improved materials. Current and future technologies have allowed for all-around better materials, reducing particle wear, loose particles and rubbing within the reconstructed joint.

The second is the use of limited-invasive procedures. Patients face a more limited exposure to surgical trauma now than five years ago. “This has led to a reduction in pain, recovery time and hospital time,” Dr. Fauré said.

The final factor is an improved accuracy in alignment. “Tools of navigation allow surgeons to better determine where cuts and joints need to be placed,” he explained. Using computer technology, doctors can see inside the human body, which allows precise positioning of a joint.

After the surgery
Currently, reconstructed joints can last ten to fifteen years. However, “it is expected that the new bearings and materials currently being developed will last significantly longer,” Dr. Fauré said.

A person’s activity level often dictates how long a new joint will last too. The less activity, stress and pressure, the longer the procedure will last.

Sensitivity to particle wear within the joint matters as well. “Some people’s bodies are more sensitive to particle wear, or third body wear. This is one of the reasons the same operation will last twenty years with one person and eight with another.”

Ultimately, an important part of joint reconstruction is education. “Whenever there are any questions about any procedures, talk to experienced personnel,” Dr. Fauré advised. “Educate yourself. Ask physicians questions.”

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