What Warsaw Does Matters—to Patients (and Society at Large)

August 2011: OrthoWorx eNewsletter

The economic value of the Warsaw-based orthopedic industry cluster is well established. In April, we published an economic impact report documenting nearly 7,000 jobs are directly attributable to the orthopedic industry, and that those jobs support another nearly 6,000 jobs in Kosciusko County. In other words, without the orthopedic industry, 43 percent of the county’s jobs would evaporate.

But what about the value of the industry to society in general? Many employees in the orthopedic industry express great pride in the fact that their work leads to a significant improvement in quality of life for patients, relieving great pain and restoring lost mobility.

Projections indicate that factors, such as the aging of the Baby Boomer generation, will cause patient demand for joint replacement to soar in the next 20 years. Even today, bone and joint disorders are the leading source of disability in the United States, far exceeding heart trouble and respiratory disorders, according to Morbidity and Mortality Weekly Report (Centers for Disease Control and Prevention, May 1, 2009). Additionally, bone and joint disorders account for the greatest number of lost work days from medical conditions, according to the same study. Workers lose a total of $110 billion in wages each year from bone and joint disorders.

Twenty years ago, joint replacement was largely seen as a way to preserve some mobility and achieve pain relief, largely for those over the age of 65 or 70. Improvements in technology, and some would say the somewhat unrealistic expectations of Baby Boomers regarding their lifestyles, has caused the average age for a joint replacement patient to fall steadily. Today, many patients expect not just some restoration of their former lives, they expect to do most or all of what they were able to do before arthritis came along.

Research shows the vast majority of knee replacement patients return to work. According to an article in The Journal of Knee Surgery, more than 80 percent of patients studied who were employed returned to work following their surgery. Of those patients, 82 percent returned to the same job they had before; 12 percent returned but performed lighter work; while six percent actually performed heavier work following surgery.

Clearly this return to function and productive work has a great value to society at large that goes beyond the impact on the individual patient. ?

According to data collected and published by Biomet, the ability to overcome disabling conditions is critical:

Disabled Americans have 600 percent higher medical costs than non-disabled Americans.

Similarly, not treating individuals with bone and joint disorders can result in increased disability. For example, patients with end-stage osteoarthritis of the hip and knee show significant improvements in function following total joint replacement, and those who did not receive joint replacements showed continued declines in function. Further, total joint replacement is becoming increasingly successful. The total joint revision burden in the United States (defined as revision surgeries as a percentage of primary surgeries) has declined over the years, despite the fact that the number of younger, high-demand patients has grown rapidly. This is a remarkable and counter-intuitive fact, and is inconceivable without improvements in the durability of implant technology. Had the revision burden stayed at 1998 rates, U.S. payors would have spent an additional $2.6 billion on revision surgeries from 1999-2009. The drop in revision burden from 2008 to 2009 alone (from 11.7 percent to 11.1 percent) saved $89 million in forgone revisions.

Returning orthopedic patients to an active life has obvious and major benefits for the patient—relief of pain and the ability to enjoy normal activities with their families and friends. But perhaps less obvious are the benefits that accrue beyond the individual—society avoids the cost of addressing greater disability and recovers the tax revenues generated by patients as they return to productive and valuable work. No wonder orthopedic employees take such great pride in what they do—how many other occupations can do so much to improve peoples’ lives while returning economic benefits to society at large?