Joint Resurfacing: Boom or Bust?

One of the hottest topics at the 2007 AAOS was the the trend toward resurfacing rather than completely replacing joints damaged by arthritis and other causes. There are a variety of metallic, synthetic and biologic methods used in hip, knee, shoulder and extremity joint resurfacing, many designed for younger patients who wish to remain active and avoid total joint replacement.

A normal phenomenon associated with aging is the development of cracks and fissures caused by repetitive mechanical forces on the articular cartilage of joints. This gradual wearing away of articular cartilage, the smooth, white, glistening surface of joints, leads to arthritic changes resulting in pain, stiffness, and overall joint degeneration and is a major contributor to functional impairment and chronic disability among the elderly. It is estimated that nearly 46 million Americans suffer from some type of arthritis; the most common form is osteoarthritis (OA), which accounts for approximately half of those afflicted with this disease. Injury or overuse can lead to arthritic changes in any joint (e.g., hand, wrist, shoulder); however, loads placed on the weight-bearing joints as a result of sports, daily activities, and even obesity can accelerate the joint degenerative process of the hip, knee, and spine.

According to the Centers for Disease Control and Prevention (CDC), the aging of the U.S. population, alone, is expected to significantly increase the prevalence of arthritis. One in five adults...

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