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Dr. Christian Christensen '88 who is an orthopedic surgeon at the Lexington Clinic in Kentucky, recently published a study comparing operative times and hospital stays in obese patients and non-obese patients.

Dr. Christensen was a physics major at Hamilton, as well as a member of the soccer team and Theta Delta Chi. He received his medical degree from Vanderbilt University. He completed a general thoracic surgery internship and an orthopedic surgery residency at Duke University Medical Center. He also completed a fellowship in hip and knee reconstruction at New England Baptist Hospital in Boston, Mass.

In a press release from the Lexington Clinic, Dr. Christensen said, "Obese patients are requiring knee replacements at a significantly younger age- 10 to 13 years earlier than their non-obese counterparts."

According to the release, despite their younger age, obese patients who needed total knee replacements were found to require longer operative times and lengthier hospital stays following their procedures. The increased length of time for the procedure and the hospital stay place higher demands on the healthcare system and generate higher medical costs. Coupled with aging baby boomers and the increasing rate of obesity, the demand placed on the healthcare system caused by this combination of factors and the corresponding costs in the future is predicted to be substantial.

Dr. Christensen, who presented his findings at the 2009 American Academy of Orthopaedic Surgeons annual meeting in Las Vegas, Nevada, also reported on the higher rate of complications faced by obese patients who had total knee replacement. Obese patients don't heal as well or as quickly as non-obese patients, leading to a greater risk of infection that can result in the necessary removal and replacement of joint implants. Obesity also makes ideal placement of implants difficult to achieve, resulting in an increased risk of the replaced joint popping out of place and the need to remove and re-implant the joint.

Following procedures and hospital stays, obese patients are far more likely to require discharge to a rehabilitation or skilled nursing facility for follow-up care rather than returning home. As healthcare cost control emerges as a top agenda item for the new administration, the need for skilled follow-up care as well as the increased necessity of multiple procedures further taxes the stressed American healthcare system.

Christensen also reported on a projected shortage of joint replacement surgeons by 2016, a time when demand for the specialty is expected to increase exponentially as the population ages and the obesity rate continues to climb. "Surgeons are retiring faster then they can be replaced. As demand for procedures increases from 400,000 in 2008 to one million in 2016, a surgeon shortage will be very problematic," said Christensen.

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