<p>Results from a new total joint replacement database show that the increase in young patients with obesity contributes to increased rates of total joint replacement in the United States, and researchers recommend hospitals and private practices implement wellness programs to improve patient outcomes.</p><p>“Postoperative rehabilitation and support programs should target improved physical activity and diet to promote weight loss and a healthier lifestyle. We should focus on standard best practices for physical therapy and health management after joint replacement surgery,” David C. Ayers, MD, chair of the Department of Orthopaedics and Physical Rehabilitation and director of the Musculoskeletal Center of Excellence at the University of Massachusetts Medical School, told Orthopedics Today. “Such standards currently do not exist. Figuring those out, and how to lose weight, should be a priority. It has to be about more than just fixing joint pain. It has to be about long-term health, function and quality of life.”</p><p>The joint replacement database, called the Function and Outcomes Research for Comparative Effectiveness in Total Joint Replacement (FORCE-TJR) database, is the result of a four-year, $12 million grant in 2010 to develop a system that tracks process and outcomes in total joint replacement (TJR).</p><p>“FORCE-TJR is already the largest joint replacement database in the nation and growing. It is also the only TJR database to include patient-reported outcomes,” Ayers said. “The information being collected by FORCE-TJR has the potential to directly influence clinical best practices, health care policy and the overall health and quality of life for more than 60 million people living with arthritis in the United States.”</p><p>The results from the first 9,000 patients enrolled in the database has shown 55% of patients younger than 65 years are obese, compared to 43% of patients who are older than 65 years. Further, 11% of patients younger than 65 years had a body mass index greater than 40 compared to 5% of patients older than 65 years.</p><p>Ayers said health wellness programs, such as those used in specialties with patients who have diabetes and heart disease, should be implemented in joint replacement programs.</p><p>“Wellness incentives are a big part of health care reform here in Massachusetts. Their effectiveness hasn’t been fully understood, but we have them for a reason,” he said. “Incentives to live a healthier lifestyle benefit the patient and ultimately reduce health care costs for everyone. When you eliminate complications, readmissions and revision surgeries, you also eliminate some very potent cost drivers in the health care system.”</p>
Fellowship-Trained, Board Certified Orthopaedic Surgeon
Specialist in Hip & Knee Surgery
Dr. Smith is a fellowship-trained, Board Certified orthopaedic surgeon with extensive training in hip & knee surgery from the prestigious Mayo Clinic in Rochester, Minnesota & the New Albany Surgical Hospital in New Albany, Ohio. He completed his Orthopedic Surgery Residency at Michigan State University & medical school..