HOBBIES ARE GOOD FOR YOUR HEALTH

Do you have a hobby? Hobbies can give meaning and purpose to your life in retirement. As Robert Putnam points out in his book, Bowling Alone, it’s easy to discount the importance of hobbies and social engagements. Putnam details the widespread decline in civic engagement, from PTA memberships to neighborhood potlucks and bowling leagues. Over a couple of generations, Americans have misplaced the concept of free time.

SPECIAL PLANS FOR YOUR SPECIAL PEOPLE

Lily is a beautiful, active and full of personality toddler who happens to have Down syndrome. Lily’s parents and I have been friends for years and I have the continuing pleasure of watching Lily and her siblings grow up. While Lily is becoming a physical therapy rock star and hitting all her milestones in a timely fashion, her parents have started planning for the future.

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WHY WE ENJOY OUR HOBBIES

The Merriam-Webster dictionary defines a hobby as “a pursuit outside one’s regular occupation, engaged in especially for relaxation.” Hobbies include anything from playing a musical instrument to gardening, bird watching or sewing. A hobby is a way of focusing on something you enjoy just for the sake of that enjoyment. It may also be a way to clear your mental palette. You could be stressed out by a situation at work or the challenges of raising children and need an escape.

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KNEE REPLACEMENT TRENDS

bring uniformity in patient selection with emerging technologies such as artificial intelligence (AI) and machine learning. Companies in the TKR industry need to remember ambulatory surgical centers, where many of these operations are performed, are smaller than in-patient hospital settings. This means they should develop products that are portable, smaller and cost effective.


Physicians agree technology has unlocked a lot of prior constraints. Surgeons tend to perform the same procedure on all of their patients. AI can help them develop a surgical plan that analyzes each case based on dynamic motion of the knee and other variables. Surgical robotics can also help. Physicians are now able to better monitor their patients remotely without having to wait six weeks or longer for a post-op check-up. As for the hardware, 3D printing has cost and design benefits. It enables surgeons to develop designs they couldn’t do with traditional manufacturing.


A couple of recent paired meta-analyses found there was 82 percent implant survivorship 25 years after TKR. The long-term survivorship data are based on older implants. Preliminary data suggest contemporary implants may last significantly longer. Outcomes are more successful when rheumatologists and primary care physicians assist orthopedic surgeons in preoperatively addressing known and modifiable risk factors, such as obesity, smoking, depression and being on opioids. These risk factors are incompatible with outpatient knee or hip replacement. Patients should get an X-ray of the replacement every five years.

Hip and knee replacement is an $18 billion market and a major growth industry. Nearly 1 million total knee replacements (TKR) are performed in the United States each year and they’re expected to increase by 2030, according to the American Academy of Orthopaedic Surgeons. The rapid growth is due to the expanding elderly population. More TKRs are being done on an outpatient basis.


This uptick in outpatient TKRs is driven by Medicare. In 2019, the U.S. Centers for Medicare and Medicaid Services took TKR off the inpatient- only list, meaning it could now be done as an outpatient procedure. In January 2020, they took total hip replacements off the list.


Recent advances in pre-, peri- and postoperative management have allowed outpatient joint replacements to be a safe and comparatively economical option for generally healthy patients. Perioperative management includes accelerated care pathways of standardized treatment that allows and encourages patients to walk within an hour or two after surgery. It includes same-day discharge, regional anesthesia with motor-sparing nerve blocks and multimodal pain management. Once-standard blood transfusions have been replaced with tranexamic acid to reduce operative blood loss. Blood transfusion was a strong risk factor for developing cardiac complications, infection and venous thromboembolism after TKA.


Physicians see opportunities to enhance patient satisfaction and

ANGELA S. HOOVER




Angela S. Hoover is a Staff Writer for Living Well 60+ Magazine