The Wall Street Journal—October 25, 2010
For Michael Noonan, knee surgery in April was practically a breeze—an outpatient procedure that had the 41-year-old investment banker hobbling home on crutches in a matter of hours after surgeon David Altchek replaced his anterior cruciate ligament using small incisions.
The move to speedier surgeries is largely the result of new minimally invasive techniques, improvements in anesthesia and cost-cutting by insurance companies and hospitals. Surgical procedures now often use smaller incisions, cut less muscle, and result in less blood loss. Newer anesthetics allow patients to regain consciousness quickly or not go to sleep at all. Pain medications are more effective.
Some doctors say that the changing demographics of their patients also can contribute to bumpy recoveries. Dr. Altchek, who performs knee and rotator cuff surgery at Hospital for Special Surgery in New York, says that more younger patients are opting to replace troublesome knees and hips so they can resume athletic activities such as tennis and skiing; close to 42% of all knee replacements in 2008 were for patients aged 45 to 65, compared to less than 35% in 2002, and studies show that waiting too long once a joint starts to deteriorate before having surgery can make recovery more difficult.
But younger patients may also be impatient and assume they are healed, and then quit rehabilitation too early, Dr. Altchek says.
Andrew Minko, a 41-year-old patient of Dr. Altchek's who plays tennis and surfs, has had two surgeries to repair joints on his left shoulder and now needs surgery on his right shoulder. Though he healed well, he admits he was somewhat lax about doing his exercises at home and may have rushed into some activities too quickly after the previous procedures. For the upcoming surgery, he says, "I will be more diligent about the recovery."
Read the full story at wsj.com.