I have talked about the extraordinary and disturbing number of knee joints that are being replaced by artificial joints. There are 600,000 knee replacements every year in the US at a yearly cost of $9 Billion. They have doubled over the last decade. (OECD iLibrary 2011). They are expected to double again in the UK over the next 2 decades! (Lancet 380:1768 2012).
Age is a factor. 70% of those 65+ show radiological evidence of osteoarthritis in at least one knee or hip joint. (J. Orthop. Res. 7:15 2012)
But one of the major causative factors is obesity. 69% of knee operations may be attributed to obesity in Croatia (Ljec. Vjesn. 131:22 2009). If all overweight and obese people were to reduce weight by only 5Kg., or until their BMI was within the normal range, 24% of OA knee surgical cases could be avoided.! (Int. J. Obes. Relat. Metab. Disord. 25(5):622 2001). Some surgeons do not operate until the patient has reduced his BMI. A BMI of 40 is considered inoperable!
Another major cause of osteoarthritis of the knee, which is rarely discussed, is inactivity. The synovial fluid of the joints is viscous and cannot function unless the joint is put under pressure. 40% of men with knee osteoarthritis are couch potatoes (Northwestern Univ. News Aug. 2011). Lower extremity muscle weakness is a risk factor for knee osteoarthritis (Arthrit. & Rheum. 41(11):1951 1998). Low muscle strength is strongly associated with knee pain, (Ann. Rheum. Dis. 57:588 1998) and muscle weakness may be an im portant factor in the pathogenesis of osteoarthritis. (Rheum. Dis. Clin. N. Am. 25(2):283 1999). Such patients require not only rehabilitation after the operation but “prehabilitation”, to increase necessary muscle strength, before the operation!
Man is the most destructive animal that has ever existed on the planet and efforts are being made to protect animal and plant species. However there seems little effort to protect the human species from the man made destruction of human health.
We are already at a point where we have to be treated to give us sufficient minimal health in order that we can be treated.