
More than 80% of total knee replacements can last for 25 years - hhs
https://www.bmj.com/content/367/bmj.l5680
======
hhs
Please note, the complete study is here:
[https://www.thelancet.com/journals/lancet/article/PIIS0140-6...](https://www.thelancet.com/journals/lancet/article/PIIS0140-6736\(18\)32531-5/fulltext)

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PopeDotNinja
A couple months ago a dude in my apartment building was walking around with a
cane which previously hadn't needed. I asked him if he'd sprained an ankle. He
said he'd gotten a new replacement earlier the same day. I had no idea that
was even remotely possible, but apparently it is...

[https://www.nhs.uk/conditions/knee-
replacement/recovery/](https://www.nhs.uk/conditions/knee-
replacement/recovery/)

~~~
mikestew
My Mom’s had both knees done. And, yup, there will be no lolly-gagging at the
knee replacement center. Said as soon as the anesthetic wore off, up she goes
out of bed being made to walk, and home she goes the same day.

Don’t let that fool you, though. She said the whole ordeal is still awful, and
if you don’t do the tearfully painful physical therapy, you pay later. Still
says she’d do it again if one wears out.

~~~
balladeer
I often end up playing badminton with a player in his 50s at the club who went
through knee replacement two years ago.

He warned me, adding that he isn’t trying to scare me, that knee wear and tear
is very real and common and that as an active long distance runner and
shuttler I’ll probably definitely have to get one if I continue this physical
regime till 40-45. I am not sure it’s that inevitable or there are precautions
an preventative measures other than stopping those physical activities.

~~~
mikestew
_I’ll probably definitely have to get one if I continue this physical regime
till 40-45._

I call bullshit. I’ve been a distance runner since I was 12 (and I’ve done my
share of 100 mile weeks) and if there’s a genetic component, see also: Mom.
I’m in my 50s, and knees are the least of my worries. Dad’s in his 70s, and
his heart limits his running, not knees. He’s not nearly as hard-core as I,
but he’s got some marathons under his belt. All anecdata, but probably as
grounded in reality as your badminton buddy. Though I admit ignorance to what
a shuttler is, so maybe that’s what your buddy is worried about. It ain’t
necessarily the running, though.

Do take care of those knees, though. Don’t ignore problems, just like anything
else. I’m just saying that though it _could_ be a problem, it is not engraved
in stone as far as I can tell from what I’ve read.

~~~
balladeer
Thank you. Shuttler is just a badminton player

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Cougher
I wonder how many of those replacements would have been unnecessary with
obesity-preventing lifestyle changes.

"What's more, the demand for [total knee replacement] surgery seems to
parallel the rise in overweight and obesity in America. In fact, the study
showed weight problems account for 95 percent of the increased demand for knee
replacement.
[https://www.medicinenet.com/script/main/art.asp?articlekey=1...](https://www.medicinenet.com/script/main/art.asp?articlekey=178890)

~~~
cableshaft
Yeah, that's one of the reasons I'm using to stay motivated to lose weight
recently, since I've been having some minor but annoying issues with one of my
knees this past year. I feel quite a bit better after just losing 15 pounds.

I've recently seen several sites claim that every 1lb of extra weight adds
4lbs of pressure on the knees, so apparently my weight loss has already
reduced the pressure on my knees by about 60lbs, which is nice.

I have a long ways to go, though, and for my bad choices the past decade I'm
probably going to pay for it with arthritis in the knees when I'm older,
unfortunately. But hopefully I'm helping to push the date when that happens to
a much later date.

~~~
Cougher
Congratulations on that choice! I lost 60 pounds over 10 years ago and it was
the first step to completely transforming my life!

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redis_mlc
I read an article on this recently. Fascinating.

Lots of progress over the years in mfg. the right plastic that doesn't flake
off inside your body.

If it works, great. But if there's side-effects like infection, boy, rough.

------
scarejunba
Not on sci-hub yet [https://sci-
hub.se/https://doi.org/10.1136/bmj.l5680](https://sci-
hub.se/https://doi.org/10.1136/bmj.l5680)

Can anyone help out?

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thrower123
It's amazing what they can do with joint replacements now. I was playing
basketball with a guy who had a hip replacement, and I was amazed, because he
was only in his 30s, and he was only a couple months post-op, and he was
running, jumping, banging bodies boxing out for rebounds. A far cry from the
way things used to be.

~~~
nradov
Check out Joe Rogan's interview of pro surfer Laird Hamilton where he talks
about his hip replacement.

[https://www.youtube.com/watch?v=FYsvhzhAK2g](https://www.youtube.com/watch?v=FYsvhzhAK2g)

------
neuro_image3
Another interesting aspect of this is that some new orthopedic prosthesis
surgery is being done in a semi-autonomous fashion using robotics. (More
autonomous in fact than more common surgical robots such as the Da Vinci,
which is mostly utilized for soft tissue surgery).

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Iwan-Zotow
It means it would be worthwhile to harvest artificial knees from dead bodies

~~~
mumblemumble
I'm not so sure about that. I would expect that the actual hardware represents
only a small portion of the total cost of getting a knee replacement. I
wouldn't be surprised if the cost savings of going with used hardware doesn't
really justify the shorter expected lifespan of the prosthesis.

Also, the wide variation in the price of a knee replacement, even within a
single market, suggests that using used hardware is probably not the low-
hanging fruit when it comes to reducing the cost. e.g.,
[https://www.bcbs.com/news/press-releases/blue-cross-blue-
shi...](https://www.bcbs.com/news/press-releases/blue-cross-blue-shield-
association-study-reveals-extreme-cost-variations-knee)

~~~
sonofgod
The big thing to add to the cost of having a human-sourced knee is being on
immunosuppressant drugs for the rest of your life, which is a significant
health risk (but significantly less than, say, not having a functional
critical organ). There are processes to clean some transplants, but I'm not
certain they work on anything other than the simplest of structures (e.g. pig
heart valves)

Corneas are the exception: they don't provoke an immune response.

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djohnston
I'm glad, and I wish we had made 1/10th the progress on spinal stenosis. It's
about as common of an ortho ailment and the treatments still suck

------
1996
Well, with impaction causing deformation of the remaining bones, risk of
infection etc I think I will wait until we can reprogram stem cells to make
cartilage

~~~
HeWhoLurksLate
That's a long ways off, to say the least.

I wouldn't recommend waiting for many years to get a 200% improvement when you
can get one now that's an 180% improvement and then upgrade later on if you
want to.

~~~
dajohnson89
what are the main technical/scientific obstacles towards cartilage
regeneration?

~~~
1996
Differentiation of the cells. We can get stem cells from fat, blood, bone
marrow etc. We can increase their lifespan (Hayflick limit) by lenghtening
telomeres. Last time I checked we were starting to understand how to turn some
cells pluripotent.

But we don't know how to reliably say to a cell "now please become a cartilage
cell forever" (or please form a tooth etc)

When we know how to achieve that, the biotech revolution will truly begin

~~~
suby
Out of curiosity, do you have an idea on what the thinking generally is in the
field in regards to if / when we'll be able to treat someone using cartilage
regeneration, or other organ / nerve / limb regenerations?

Were people expecting the breakthroughs we've already made on the timescale
that we've had them? I have a deep ignorance of the field, but from afar it
seems like we're on the verge of some truly revolutionary technologies.

~~~
carapace
Did you see "What Bodies Think About: Bioelectric Computation Outside the
Nervous System"?

[https://news.ycombinator.com/item?id=18736698](https://news.ycombinator.com/item?id=18736698)

