At 75 years old, Robert Elser’s golf game is as good as ever, but that wasn’t always the case. The clinical chemistry consultant and former director of biochemistry at York Hospital spent about a year in discomfort before making the decision to get a total hip replacement in April 2015.

It wasn’t that he was in pain all of the time, but certain movements — things such as swinging a golf club or crossing his legs — had gotten a little too uncomfortable. A sharp pain in his hip while playing his usual 18 holes at the Country Club of York was the final straw. He made an appointment at OSS Health Orthopaedic Hospital and was scheduled for surgery the following spring.

Elser, of Spring Garden Township, is one of a growing number of Americans seeking elective joint replacement surgery to better their quality of life, says his orthopedic surgeon, Dr. Joseph Alhadeff. He specializes in shoulder, knee and hip replacements at OSS Health.

Across the country, in Pennsylvania and in York, the number of total hip and knee replacements performed each year has risen steadily for the past decade, and those choosing to go under the knife for new hips and knees are also getting younger.

Nationwide findings by the National Center for Health Statistics show a 124 percent increase in total hip replacements between 2000 and 2010. The rate of total knee replacement for men and women almost doubled from 2000 through 2010.

Between 2004 and 2013, the number of Pennsylvanians undergoing total hip and knee replacements increased almost 39 percent, according to a recent report from the Pennsylvania Department of Health. In 2013, 53,769 adults underwent total knee or hip replacement, compared to 38,815 in 2004.

Alhadeff says his patient volume in York continues to line up with national figures.

From January to August 2015, OSS Hospital performed 235 hip replacements and 459 knee replacements. During the same time period this year, OSS surgeons performed 255 hip replacements and 521 knee replacements—about a 12 percent increase from year to year.

The increase is also being felt at WellSpan Health, said Dr. Mark Deitch, vice president of orthopedic services.

Over the past 24 months, he said, there has been a 12 percent increase in total hip and knee replacements at WellSpan York Hospital and WellSpan Surgery and Rehab Hospital, where the bulk of hip and knee patients are seen.

While total joint replacements have increased  locally and statewide, Deitch said the biggest growing age segment for hip and knee surgeries is for those between 45 and 65 years old.

“I think, as we have an increase in the demand for total joint replacement, I think patients will be looking to health systems like WellSpan who can provide that complete continuum of care,” Deitch said. “That’s where I think WellSpan is very happy to see that increase, right at the time as we’re increasing our efforts to develop comprehensive total joint programs.”

The biggest reason for the increase?

Both Alhadeff and Deitch say the baby boomer generation — those born between 1946 to 1964 after World War II — continues to age steadily together, driving up the number of joint replacements done each year. Though recently outnumbered by millennials as the largest demographic, there are an estimated 74.9 million boomers in the U.S., according to the Pew Research Center. Census estimates show about 2.2 million boomers live in Pennsylvania.

Deitch, who is just one year too young to be considered a boomer himself, said 52- to 70-year-olds are well into the age range for needing a total joint replacement because of the natural degrading of joints with age, but he continues to see younger patients.

Osteoarthritis, he said, really puts a cramp in their lifestyle, and they seek therapy to maintain that activity, which can now be treated at a younger age because of medical advancements.

“I don’t think you would have thought about doing a total joint replacement of someone in their 50s in the 1960s, but we are seeing that,” Deitch said.

One of those advancements, says Alhadeff, is the amount of recovery time that’s required of patients today. While 20 years ago patients might have had to spend weeks in a hospital, today they can be out a day or two after surgery.

“The technology hasn’t changed dramatically, but some of the surgical techniques have improved, and we’ve gotten a lot better about managing pain.”

For Elser, who falls just a few years outside the boomer age group, the decision to get a total hip replacement was one he says was made easier with pre-operative guidance, post-surgery care and minimal pain. He was back to the golf course six weeks after his surgery.

“The benefits were not immediately obvious, but post-surgery they were,” he said  as he prepared to take a shot on the club’s putting green.

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