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INCREASING NUMBERS OF OLDER PATIENTS ARE SAFELY UNDERGOING MAJOR ELECTIVE ORTHOPEDIC PROCEDURES, EVEN AS HIP FRACTURE REMAINS A SERIOUS THREAT TO THE MOBILITY AND LIVES OF THE ELDERLY. HERE IS A SNAPSHOT OF ORTHOPEDIC-RELATED STATISTICS. Hip Fractures and Mortality About a third of people age 65 and older will fall, with hundreds of thousands suffering potentially devastating hip fractures each year. Recent research published in JAMA Internal Medicine investi- gated the effect of hip fractures on a particularly vulnerable population: those living in nursing homes. The fi ndings? More than a third died within six months after a fracture; half either died or experienced complete loss of independent locomotion. The mortality rate for hip fracture patients tracked for one year was nearly 50 percent. Go-go Octogenarians The rates of major elective orthopedic procedures performed on U.S. patients above age 80 signifi cantly increased between 2000 and 2009, according to a study in The Journal of Bone & Joint Surgery. The rate per 100,000 people rose from 40 to 102 for spinal fusion, 181 to 257 for total hip arthroplasty and 300 to 477 for total knee arthroplasty. At the same time, in-hospital mor t a l it y rate s fel l, a s d id c o m p l i c a t i o n r a t e s a m o n g knee replacement and spinal fusion patients who had few or no comorbidities. n Sources: American Academy of Orthopaedic Surgeons; CDC; Reuters; The Journal of Bone & Joint Surgery; Clinical Orthopaedics and Related Research; JAMA Internal Medicine Breaking Down ACCORDING TO AN American Academy of Orthopaedic Surgeons survey, Wyoming has the highest density of orthopedic surgeons in the United States, at 14.96 per 100,000 residents; Mississippi has the lowest, at 6.55. Surgeons identifi ed their primary or specialty areas as well, shedding light on this diverse fi eld: + Arthroscopy — 38% + Adult knee — 37% + Sports medicine — 36% + Adult hip — 28% + Total joint — 17% Orthopedics WORTH THE COST OVER A LIFETIME, the per-patient societal benefi t of surgery for displaced hip fractures exceeds the direct medical costs by an estimated $65,000–$68,000. KNEE REPLACEMENT BY THE NUMBERS By Hannah Stuart DENSITY DIVIDE 90 Percentage of knee replacement patients who experience a signifi cant reduction in pain 85 Percentage of artifi cial knees that function 20 years after surgery 60 Percentage of knee replacement patients who are women 10 Percentage of patients who require revision surgery 10 years after knee replacement SPECIAL CLINICAL SECTION: ORTHOPEDICS M D N E W S . CO M n MD NEWS Long Island | 2 1