Scorn nothing. According to Dr. Wayne Paprosky, a world-renowned orthopaedic surgeon in hip and knee reconstruction on the medical staff at Central DuPage Hospital, “Hell hath no fury like a woman whose one leg is too long.”

The discrepancy Paprosky speaks of is the result of hip replacement surgery with conventional parts that do not easily accommodate women 5 feet, 5 inches and shorter.

Injury and trauma to the area can lead to surgery, but it is osteoarthritis, which is caused by a wearing away of the cartilage that cushions joints and the decrease of lubricant, synovial fluid, that most often leads to significant hip deterioration.

Though elective operations, joint replacement surgeries have become some of the most commonly performed procedures in recent years.

As the country’s baby boomers age and live longer than the generations that came before, those in the medical community find themselves charged with keeping the body nimble. According to the American Academy of Orthopaedic Surgeons, 238,130 total hip replacement surgeries were performed in 2005, 125,00 of those on women and nearly two-thirds of the more than 300,000 annual knee replacement patients are women, according to the National Center for Health Statistics.

The fairer sex makes up the majority of the patient pool for a few reasons. The first is that they typically outlive men but also because they are much more likely to develop osteoporosis, a condition that causes a loss of bone density.

Sports injuries lead to arthritic knees, but like so many other health complications, it is excessive weight that consistently leads to the condition in both sexes.

“Obese patients put more pressure on the joint making it wear away faster,” said Jeffrey Meisles, a surgeon with Orthopedic Specialists in Elmhurst and Melrose Park.

Imitating the natural hip, plastic and metal hip replacement parts are comprised of a socket, ball and stem. The fake hip becomes part of the body’s structure because bone actually grows around the prosthesis, fusing the two, but standard replacement parts are typically not sized to fit a petite woman’s anatomy. 

That has changed with the introduction of Gender Solutions M/L Taper Stem with Kinectiv Technology, a product by orthopedic industry giant Zimmer.

“With the M/L Taper Stem, once the implant goes in, a surgeon can fine-tune and adjust for patient leg length, muscle tension and hip stability,” said Paprosky, who co-developed the innovative product. “Those three things are much more of a big deal for short women than they are for most men or taller women.”

The product, which is currently in limited release, will build throughout the year, according to Zimmer representative Brad Bishop. Another innovation by the company, Epoch, is due out within the year and was developed specifically for women with osteoporosis.

“Epoch is a cylindrical rod you can raise or lower inside the bone,” explained Paprosky, who in addition to his position at Midwest Orthopaedics at Rush in Chicago will also be inducted as president of the Hip Society of North America in March. “The product is coated in a special polymer that makes it the same elasticity as the bone and keeps(the bone from deteriorating further).”

Kitty Greenwood is one woman who has been given a new lease on life following her joint replacement surgery. She relishes sitting on the floor and playing with her grandchildren, mostly because it’s something she thought she’d never be able to do.

For more than a year, Greenwood regularly received injections of Hyalgan, a solution that lubricated and cushioned her aching knees. But the relief was only temporary.

Tired of the pain, she sought the medical treatment of Meisles, who recommended knee replacement surgery.

“I had both knees replaced this past summer,” said the Franklin Park resident. “It was the best thing I’ve ever done. I’m doing things I never thought I’d do again.”
According to Meisles, who is also on the medical staff at Elmhurst Memorial Healthcare, women undergo 60 to 70 percent of knee replacement surgeries.

“The most common problem with knee replacements is with how the knee cap slides or tracks,” said Meisles, who serves on Zimmer’s gender panel for joint replacements. “If the knee doesn’t track properly it can become dislocated and can be very painful.”

In 2006, Zimmer unveiled its Gender Solutions High-Flex Knee, a plastic and metal prosthesis developed with special consideration to a woman’s anatomy. The product is narrower on the sides and contoured to fit the bone, thinner in the front so as not to feel bulky and designed to mimic the different tracking angles and abilities of a woman’s natural knee. While no studies confirm greater satisfaction amongst women who’ve undergone surgery with a gender-specific model as opposed to a conventional part, Meisles speaks of its advantages from where he sits.

“(Gender-specific pieces) give the surgeon more options to work with,” Meisles said. “Surgeons measure the bone intra-operatively and then we pick the size that most resembles the natural bone. Zimmer provides seven knee replacements, and five of the seven are made available in a female model.” 

Other companies advertise gender-specific replacements, but no other company supplies a model that comes in different sizes and shapes, Meisles said.
Also enhancing the appeal of these elective joint surgeries are minimally invasive procedures.

“In the last four or five years there has been a trend to smaller incisions for orthopedic surgeons,” said Meisles, who was at the forefront of the medical trend. “We used to pay a lot of attention to the bone, but now we’re looking at how we handle the soft tissue. The less you cut, the less time it takes to heal. We let patients put their full weight on their knee first thing following surgery.”