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Ask the Doctor at Saint John’s: Why Total Joint Replacement Surgery is Growing So Rapidly:

Santa Monica, Calif. – – Q. Is it true that the number of total joint replacement surgeries is growing rapidly?

A. By Kevin Ehrhart, M.D., board-certified orthopedic surgeon, specializing in total hip, knee and shoulder replacement at Saint John’s Health Center.

Yes, more people are having total hip, knee and shoulder replacement surgery because people are more active today than ever before. I perform about 350 total joint replacement surgeries a year. And studies show that in the next 10 – 15, years the demand for such surgeries may exceed the qualified manpower to perform the procedures.

Historically a typical patient was 65 to 70 years old, was sedentary and lived with a great deal of discomfort before having total joint replacement surgery. Today, the typical patient is now 60 years old and younger.

Arthritis is often the underlying cause for the pain and the need for total joint replacement therapy – because the joints are simply worn out. Total joint replacement is a resurfacing of the end of a bone, similar to having a crown put on a tooth. We do not actually ‘replace’ the bone. For example with a total knee replacement we put a metal cap on the end of the femur and a plastic over metal cap on the end of the tibia, which allows the two bones to fit together without friction.

Patients are able to go back to their former level of activity after hip, knee or shoulder replacement surgery. I even tell my patients to “go ahead and try to wear out the replaced joints.” In other words, staying active is the best way to keep joints and bones healthy.

As the patient gets older there may be a need to revise a total joint replacement, so younger patients will probably have to have the replaced joint revised at some point.

There is no guaranteed life-span of a replacement joint, but typically a hip will last between 15 – 20 years and a knee will last for fifteen-plus years. For a 50-year-old patient, this is obviously more of an issue than it is for a 75 year old patient.

Generally we determine that a patient needs total joint replacement surgery not only based on x-rays and a physical examination, but also by asking the question, “how much does this pain or discomfort affect your lifestyle?” If the patient answers that the discomfort has a great affect on their lifestyle, then they could be a good candidate for total joint replacement surgery.

Kevin Ehrhart, M.D., is a board certified orthopedic surgeon at Saint John’s Health Center with the Santa Monica Orthopedic Group. For more information about Dr. Ehrhart and other Saint John’s services please call (310) 829-8990 or visit the website at www.stjohns.org. For a physician referral or a second opinion, please call


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