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Surgical Procedure Gives New Life To Those With Knee Problems

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DURHAM, N.C. — Artificial joints could last a lifetime, if you get them late in life. However, people who need knee joint replacements are getting younger, and many older patients are living longer. Now, many of them need knee revision surgery.

John Rhodes loved playing tennis until 1995, when he was 76 years old. Knee pain forced him to put his racquet away.

"[It] turned out that I had worn out the cartilage in the knee. There was no cartilage left. There was just bone on bone," he said.

Failing all conservative options, Rhodes had his right knee joint replaced. His surgeon said the joint might last between 10 and 15 years. It only made it to 11 years.

"I'd be walking along perfectly all right and then suddenly the knee would give way," he said.

Primary knee joint replacement includes resurfacing the bottom of the femur and the top of the tibia with metal. Plastic in between acts like the knee’s cartilage. Duke orthopaedic surgeon Dr. Michael Bolognesi said it's that metal-to-bone connection that typically fails.

"Invariably, there's bone loss around the knee joint itself, and that makes putting in a new part to replace the old part more of a challenge," he said.

Knee revision typically involves building up the bone around the implant and a longer metal stem. Materials and techniques have improved so that, barring any complications, today's implants should last longer.

"We should hope to see somewhere between 15 and 20 years for implant survival," Bolognesi said.

After three months of rehabilitation, Rhodes is making great progress with his right knee. Now it's the other one he's keeping an eye on.

"The left one was done two years later in 1997, and it's still doing fine," he said.

Bolognesi said most knee replacement patients are in their 60s. He said knee problems are increasing because more people are staying active longer.

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