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    Columns

    Striving to Attain a Gain on the Pain

    A growing number of orthopedic patients are wrestling with fear, perhaps fueled in part by variant virus strains believed to be more contagious.

    Striving to Attain a Gain on the Pain
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    Michael Barbella, Managing Editor02.08.21
    A bunch of strangers helped Becky Kennedy Mumm turn her life around.

    The watershed moment occurred a few years back at a winter dance in Florida, where Kennedy Mumm was struggling to move about. She wound up leaving the event early, hobbled by excruciating knee pain and humbled by much older dancers still tripping the light fantastic.

    “...I had to leave early because my knee hurt so bad,” Kennedy Mumm recalled. “There were 90-year-olds outlasting me! I reflected on my parents who had knee issues and osteoarthritis in their knees. They went from cane to walker to wheelchair, and I didn’t want that to happen to me...especially prematurely.”

    Kennedy Mumm didn’t let that happen to her, actually. Something about those nameless nonagenarian dancers convinced her to seek a third opinion about her worn-out joints and eventually undergo total knee replacement surgery.

    “It literally changed my life. I am just amazed at how far I can walk pain-free with my new knee replacements,” she said after her second TKA. “I’m doing more physical activity at 63 than I was at 55 and perhaps even 50. I initially shrugged it [TKA] off because I thought I was too young and didn’t think there was any way my knee could be bad enough to need that kind of surgery.”

    Such is the ignorance of youth. Now a bit older and (presumably) wiser, Kennedy Mumm would probably not repeat her mistake—at least not for the same reason. These days, COVID-19 is more likely to delay knee replacement surgery than pride.

    History is repeating itself as America’s coronavirus cases spike to unprecedented levels and hospitals put elective procedures on hold to better use resources. Much like last spring, patients are juggling shifting OR dates, chronic pain, and growing frustration.

    A growing number of orthopedic patients also are wrestling with fear, perhaps fueled in part by variant virus strains believed to be more contagious. A poll conducted by investment firm Needham & Company LLC found fewer older people willing to undergo elective surgery as COVID-19 cases have risen in recent months.

    A November poll showed roughly a quarter of older patients (average age, 61) amenable to elective procedures, down 10 percentage points from a September high of 37 percent. The survey also revealed a decline in patients of all ages planning to undergo elective surgeries by the end of 2020, with the fraction of determined participants shrinking from 64 percent in September to 53 percent in November.

    Needham pollsters expect most elective procedures to occur within the first half of this year, but note that it could take significant time to clear the backlog. “We expect a meaningful portion of people will continue to act with an abundance of caution, which could result in a recovery with a long tail,” Needham analysts wrote.

    The length of that tail, of course, will depend largely on the number of patients willing to undergo an elective procedure while the virus is still rampant. And data suggest that number is trending toward a minority.

    A Wakefield Research survey commissioned last fall by Zimmer Biomet Holdings Inc. found that nearly half (48 percent) of joint replacement candidates had deferred treatment over COVID-19-related fears. Wakefield conducted the U.S. poll of 1,200 joint replacement patients, candidates, and caregivers in August and September 2020; overall, it showed the vast majority of patients (82 percent) who’ve had joint replacement surgery during the pandemic have felt safe doing so, and 64 percent did not fear contracting an infection like COVID-19 at their operative site.1

    “The decision whether or not to move forward with joint replacement surgery during the COVID-19 pandemic might be difficult for many,” Becky D., a Warsaw, Ind., mother, grandmother, and TKA patient, told WLNY New York last October. “With the help of my doctor’s care and encouragement about the potential benefits of the surgery, it was an easy decision for me.”

    But not so easy for others. The pandemic has proven to be quite a deterrent for many patients—in fact, 53 percent of Wakefield’s survey participants admitted they’ve been waiting more than a year to have joint replacement surgery, and nearly two-thirds of those people (61 percent) cited COVID-19 as the main reason for the wait.

    That delay has had serious repercussions, too: Seventy-one percent of patients who postponed their joint replacement surgeries are in more pain now, 58 percent have limited mobility, and 36 percent are having trouble sleeping.1

    To help patients make better informed decisions about elective procedures, Zimmer Biomet created a multimedia campaign called “Don’t Let Pain Gain on You.” The educational resource aims to inform and empower people living with joint pain to consider moving forward with their procedure to improve their overall quality of life.

    “We understand why the pandemic has created uncertainty around elective procedures like joint replacement surgery, but we also know that for some people coping with chronic debilitating joint pain, postponing a necessary procedure could have a significant impact on quality of life and continue to cause life-altering pain and loss of mobility,” Ivan Tornos, group president for Global Businesses and the Americas, Zimmer Biomet. “With this campaign, we look to encourage people to have a proactive conversation with their doctor about joint replacement surgery and get the support and care they need to address their pain, safely and with confidence.”

    No pain, no gain. 

    Reference
    1. Wakefield. Zimmer Biomet Joint Replacement Patient and Caregiver U.S. Perception Survey. September 2020.
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