Weight Gain Common with New Knees

"Patients who undergo total knee replacement are at substantial risk for weight gain during the 5 years after the surgery, a large retrospective study showed.

The logical assumption may be that persons who are overweight or obese prior to surgery are more likely to lose weight following surgery. Because there is less pain and improved mobility, the impediments to increased activity and exercise are eased following surgery, and weight loss would logically follow," they observed.

However, that hasn't been the case.

Weight control efforts for patients having the surgery should therefore focus on long-term maintenance, they commented."

Observations of hundreds of Knee Replacement by Dr. Tarlow reinforce the conclusions in the study.  Commonly heard in my office is "I can not lose weight because my knee is worn out".  However, rarely will a patient lose significant weight or lead a more healthy, exercise focused life style despite successful knee surgery(less pain and improved mobility).  In fact, most patients have gained noticeably more weight after knee surgery.  Sometimes I wonder if I am just making it easier for people to walk to their refrigerator.   I continue to counsel and encourage patients to address the serious medical condition of obesity with frustratingly little success.  Without meaningful lifestyle change (dedication to exercise program and meal portion/choice control) people will not magically lose weight after joint replacement.  When are American's going to be accountable for their own health and well being?.  Your doctor or healthcare policy maker is not powerful enough to make you get healthy-you have to do it yourselves!

Only 1 in 5 Americans Getting Recommended Amounts of Exercise

iStockphoto/Thinkstock(ATLANTA) -- Not enough of us are getting the right amount of exercise, according to a weekly report from the Centers for Disease Control and Prevention.

The CDC's Morbidity and Mortality Weekly Report says only about 20 percent, or one in five, U.S. adults are meeting the federal government's recommendations for physical activity, which includes aerobic and muscle strengthening components.

Government health officials recommend adults get at least 2.5 hours a week of moderate-intensity aerobic activity such as walking, or one hour and 15 minutes a week of vigorous-intensity aerobic activity, such as jogging or a combination of both.  The recommendations also call for muscle strengthening activities such as push-ups, sit-ups or lifting weights.

The data, based on self-reported information from an annual phone survey by state health department, shows that 50 percent of U.S. adults are getting the recommended amounts of aerobic activity, and 30 percent are engaging in strength training.

“Although only 20 percent of adults are meeting the overall physical activity recommendations, it is encouraging that half the adults in the United States are meeting the aerobic guidelines and a third are meeting the muscle-strengthening recommendations,” said Carmen D. Harris, M.P.H, epidemiologist in CDC’s physical activity and health branch.  

Harris added that this data provides a great foundation to build on, but stressed that there is still work to do. "Improving access to safe and convenient places where people can be physically active can help make the active choice the easy choice,” she said.

Other key findings in the CDC report:

• The West and the Northeast regions had the highest proportion of adults who met the guidelines, with 24 percent and 21 percent respectively.
• Women, Hispanics, older adults and obese adults were all less likely to meet the guidelines.

Copyright 2013 ABC News Radio

Young Athletes Playing One Sport At Risk for Serious Injury

Intense, Specialized Training in Young Athletes Linked to Serious Overuse Injuries-These Injuries are preventable.  Too much is not good.

From Loyola and Lurie Children’s Hospital 

 MAYWOOD, Ill. - Young athletes who specialize in one sport and train intensively have a significantly higher risk of stress fractures and other severe overuse injuries, even when compared with other injured athletes, according to the largest clinical study of its kind.

For example, young athletes who spent  more hours per week than their age playing one sport – such as a 12-year-old who plays tennis 13 or more hours a week – were 70 percent more likely to experience serious overuse injuries than other injuries.

There were 859 total injuries, including 564 overuse injuries, in cases in which the clinical diagnosis was recorded. The overuse injuries included 139 serious injuries such as stress fractures in the back or limbs, elbow ligament injuries and osteochondral injuries (injuries to cartilage and underlying bone). Such serious injuries can force young athletes to the sidelines for one to six months or longer.

Among the study’s other findings:

• Young athletes were more likely to be injured if they spent more than twice as much time playing organized sports as they spent in unorganized free play – for example, playing 11 hours of organized soccer each week, and only 5 hours of free play such as pickup games.
• Athletes who suffered serious injuries spent an average of 21 hours per week in total physical activity (organized sports, gym and unorganized free play), including 13 hours in organized sports. By comparison, athletes who were not injured participated in less activity – 17.6 hours per week in total physical activity, including only 9.4 hours in organized sports.
• Injured athletes scored 3.3 on researchers’ 6-point sports-specialization scale. Uninjured athletes scored 2.7 on the specialization scale. (On the sports specialization scale, an athlete is given a point for each of the following: Trains more than 75 percent of the time in one sport; trains to improve skill or misses time with friends; has quit other sports to focus on one sport; considers one sport more important than other sports; regularly travels out of state; trains more than eight months a year or competes more than six months per year.
• Jayanthi offers the following tips to reduce the risk of injuries in young adults:
  Do not spend more hours per week than your age playing sports. (Younger children are developmentally immature and may be less able to tolerate physical stress.)
• Do not spend more than twice as much time playing organized sports as you spend in gym and unorganized play.
• Do not specialize in one sport before late adolescence.
• Do not play sports competitively year-round. Take a break from competition for one to three months each year (not necessarily consecutively).
• Take at least one day off per week from training in sports.

Brisk Walking May Equal Running for Health

Please see the below article.  The take home message is that we can control our health and well being.  People should consider how important their personal health and well being is, and make choices in line with their chosen ideals. 

It's a matter of how far you walk or run, not how long, said Paul Williams, a staff scientist at the Lawrence Berkeley National Laboratory in Berkeley, Calif.

"Both of these activities reduce risk factors, and if you expend the same amount of energy you get the same benefit," Williams said. The key was the more people walked or ran each week, the more their health improved, he said.

The findings suggest "there is now some choice in the exercise you want to do," he said. Some people find running more convenient, others prefer walking, especially people just starting to exercise, he noted.

The advantage of running is you can cover twice as much ground in the same amount of time as you would walking, Williams pointed out.  Other research using data from the walkers' and runners' studies found that for weight loss, running beats walking. That study appears in the April issue of Medicine & Science in Sports & Exercise.

Williams is referring to brisk walking, however. "Walking for exercise. It's not a mosey kind of thing, but actually walking for exercise,".

For the study, published online April 4 in Arteriosclerosis, Thrombosis and Vascular Biology, Williams and Dr. Paul Thompson, a cardiologist at Hartford Hospital in Connecticut, collected data from the National Runners' Health Study and the National Walkers' Health Study. More than 33,000 runners and nearly 16,000 walkers were involved.

The runners and walkers were 18 to 80 years old, but mostly in their 40s and 50s, the study authors noted.

4 Million Total Knees Walking Around the U.S.

From March, 2013 Journal of Bone and Joint Surgery

In the last decade, the number of total knee replacements performed annually in the United States has doubled, with disproportionate increases among younger adults. While total knee replacement is a highly effective treatment for end-stage knee osteoarthritis, total knee replacement recipients can experience persistent pain and severe complications. We are aware of no current estimates of the prevalence of total knee replacement among adults in the U.S.

We estimated that 4.0 million  adults in the U.S. currently live with a total knee replacement, representing 4.2% of the population fifty years of age or older. The prevalence was higher among females (4.8%) than among males (3.4%) and increased with age. 

Among older adults in the U.S., total knee replacement is nearly as prevalent as congestive heart failure. Nearly 1.5 million of those with a primary total knee replacement are fifty to sixty-nine years old, indicating that a large population is at risk for costly revision surgery as well as possible long-term complications of total knee replacement.

These prevalence estimates will be useful in planning health services specific to the population living with total knee replacement.