California Hospital Medical Center: younger, more active people opt for joint replacement surgery.

The idea that osteoarthritis and joint replacement surgery only affect the elderly is a myth. In reality, younger and more active people are getting hip and knee replacements, and osteoarthritis is now being diagnosed in younger patients than in previous generations.

>From 1996 to 2001, the number of total knee replacements for patients aged 38-56 years doubled from 23,000 to 48,000, according to the American Academy of Orthopedic Surgeons. This is the most significant change in patient demographics since physicians began doing joint and knee replacements in the 1970s.

According to the USC Center for Arthritis and Joint Implant Surgery and orthopedic fellowship at California Hospital, there is a misconception that only older patients have osteoarthritis. While many older people do require total joint replacements as a result of the wear and tear on their cartilage, younger individuals may also need this procedure by mid-life as a result of trauma-induces arthritis. This is common among athletes who sustained knee injuries in their 20s and 30s.

Every year, more than 250,000 Americans replace painfully crippling knee joints; 150,000 more replace hip joints. (Shoulders, elbows and ankles are replaced, as well, but much less frequently.)

The Orthopedic Program at California Hospital Medical Center in Los Angeles treats patients for general orthopedics, arthritis and implant surgery, joint and hip replacement surgery, hand surgery, and emergency orthopedic care for adult and pediatric patients. Orthopedic surgeons now providing care include:

* Dr. Edward J. McPherson, medical director of the USC Arthritis and Joint Implant Surgery and orthopedic fellowship at California Hospital;

* Dr. Thomas Schmalzried of the Joint Replacement Institute; and

* Dr. Robert M. Fay, Director of Emergency Orthopedic Surgery at California Hospital. Board Certified and Fellowship Trained Orthopedic Surgeon.

The majority of these procedures are done to relieve joint pain, improve mobility and permit patients to return to relatively normal functions. The surgery removes not only the damaged cartilage, but also adjacent bone, replacing them with smooth plastic and metal substitutes. Doctors typically recommend joint replacement surgery after medication and more conservative measures are no longer effective in relieving the patient's pain.

"Total hip and total replacement surgery is being performed on younger and more active patients," says Dr. Schmalzried. "At the same time, the health benefits of regular, moderate exercise are being recognized and widely recommended by physicians and others in healthcare. There have been advances in the materials, design, manufacturing and surgical technique for total hip and knee replacement that have improved their functional capacity and durability.

Doctors emphasize many patients could benefit from this operation but are not taking advantage of it. Many patients prefer to live with the pain, instead of opting for joint replacement surgery, because it's a major operation and they don't want to take the time to recuperate from it.

But the benefits of the surgery outnumber the time needed for recovery.

According to Dr. Fay many patients experience "significant improvement in mobility, pain reduction and overall quality of life following hip or knee replacement surgery. The most important point to emphasize is that every case of arthritis is unique and that we often can perform less invasive procedures first, however when these have failed joint replacement can often help."

Schmalzried agrees.

"Assuming that there is no other physical disability limiting activity people with a total hip or total knee replacement can walk and bicycle unlimited distances, play golf and tennis, ski and even jog," he says. "There are patients with total joint replacements who have run marathons, climbed mountains, raced mountain bikes, and even played professional baseball."

Excellent medical care. Concern for the dignity of patients and their families. These are the primary goals at California Hospital Medical Center.

California Hospital Medical Center is located at 1401 S. Grand Avenue in downtown Los Angeles. For more information or for a physician referral, please call [phone] or visit the hospital online at www.downtownhealthcare.com.