Keeping Boomers Moving Past Osteoarthritis

1
Keeping Boomers Moving Past Osteoarthritis

• Brian R. Wolf, MD, MS
• Assistant Professor
• University of Iowa Orthopaedics
• Team Physician, University of Iowa Athletics

American Academy of Orthopaedic Surgeons
American Orthopaedic Society for Sports Medicine
2
Baby Boomer

• Person born between 1946 (age 62) and 1964 (age
  44)
• US Census Projections (1/2006)
• Estimated 78.2 million living baby boomers as of
  July 1, 2005
• Projected 57.8 million living baby boomers in in
  the year 2030
• 50.8 of baby boomer in 2005 are women

3
What is Osteoarthritis

• Also known as degenerative arthritis
• Abnormal wearing of the cartilage cushion
  covering the ends of bones within joints.
• Leads to pain, swelling, stiffness.

4
The Population is Getting Older
Callaghan. JBJS 80-A, 1998
5
The Older Population is Living Longer Remaining
Years of Life _at_ Age 65 Years, U.S.
Female
Male
Crowninshield et al, CORR 443, 2006
6
Arthritis Increases With Age US Population
Female
Male
Age
Crowninshield et al, CORR 443, 2006
7
Arthritis Increases with Body Mass Index U.S.
Adult Population
Incidence ()
Crowninshield. Hip International Vol. 16 2006
8
Metabolic Activity in Osteoarthritic Knees
Correlates with Body Mass Index

• Lee D. Kaplan MD, Justin D. Harris MD, et al.
• University of Wisconsin
• Obesity is associated with poor function of
  chondrocytes (cartilage cells) ? leads to
  osteoarthritis
• To be presented at AOSSM meeting, Orlando, July
  2008.

9
On the Other Hand.The Boomer Population is Active

• Baby boomers are staying more active want to
  continue their recreation
• Tennis, Basketball, Jogging, etc.
• Knee arthritis most common problem for active
  boomers
• Treatments available to keep boomers going----but
  they are a challenge.

10
The Degenerative Knee

• Goals of Treatment
• Educate the patient
• ? pain
• ? disability , ? mobility
• Impede progression of disease
• Reverse disease process not likely

11
The Degenerative Knee Non-operative Treatment

• Pharmacological
• Oral Medications
• Acetaminophen
• Glucosamine /Chondroitin
• NSAIDS
• Injections
• Corticosteroids
• Hyaluronic Therapy
• Topical Agents
• Capsaicin
• NSAIDs

• Non-Pharmacological
• Exercise/ Physical Therapy
• Muscle Strengthening
• Endurance Flexibility
• Weight Loss
• Footwear / Orthotics
• Brace / Sleeve

12
The Degenerative Knee OperativeTreatment

• Arthroscopy
• Beneficial for early stages of arthritis
• clean up or smoothe areas of wear
• Technology advancing to repair or re-grow
  cartilage
• Techniques work better in patients younger than
  boomers

Microfracture
13
Osteotomy

• Cut bone above or below knee to realign joint
• Heals like a fracture
• Change how weight is transferred through the knee
• Forces shifted to healthy cartilage

14
Knee Replacement

• Resurfacing part or all of the knee with metal
  and plastic
• Great for pain relief
• Modify high level activities
• Can loosen or wear out over time

15
The Baby Boomer Generation

• Becoming a dominant issue for orthopaedists and
  other physicians
• Arthritis in Boomers will have major impact on
  our society
• Research on how arthritis occurs and how we can
  prevent it continues.
• Treatments to keep people active evolving as
  technologies improve.

Thank You