Rapid growth of medical devices in middle-age patients renews lives, remakes industry and raises worries over long-term use.
Jay Alva’s sneakers pounded the treadmill, set to the speed of a brisk walk. Sweat dripped off the 53-year-old as he hit a groove during a recent workout.
For almost two decades, the youth soccer and football coach from Eagan moved like a man who needed a walker. A degenerative hip condition prevented Alva from running with his players or even doing basic things like tying his shoes.
Brushing off a doctor’s advice that he was “too young,” Alva got artificial hips four years ago. Now pain-free, he moves with the energy of a man in his 30s, amused at the notion that he wasn’t old enough for such treatment.
“I am living so much better now in my 50s than I did in my 40s,” Alva said.
Hundreds of thousands of Americans are receiving medical devices that were once considered nearly exclusive to the elderly. The shift is profoundly changing patient care and expanding the fortunes of the medical-technology industry while amplifying concerns over the safety and oversight of some products.
The movement is so dramatic that the futures of major medical device companies such as Medtronic, St. Jude Medical and Boston Scientific — corporate giants in Minnesota — are increasingly tied to younger groups and the new markets they represent.
Middle-age Americans, in particular, are driving this trend as they seek ways to remain physically active. The number of patients ages 45 to 64 who had a hip replacement more than doubled from 2000 to 2010, according to a Star Tribune analysis of data from the U.S. Department of Health and Human Services. The increase was more pronounced for knee replacements, rising 213 percent.
“This is huge,” said Dr. Robert Hauser, a cardiologist at the Minneapolis Heart Institute who has studied the safety and effectiveness of heart devices for years. “I think it’s a tremendous step forward, but there are issues that need to be dealt with.”
Though widely celebrated, some treatments have been shadowed by reports of devices or other medical products faltering — defective wires in defibrillators, failing artificial hips and leaky drug pumps, among them. Patients have suffered complications, severe pain and even death. Every year, 25 to 40 medical devices are recalled due to high risk — meaning a patient’s life could be in jeopardy.
Device companies are facing thousands of patient lawsuits challenging the safety of some devices, and federal regulators are under greater pressure to intensify their oversight. At the same time, device makers are spending millions to promote their products to doctors and patients while simultaneously pushing to simplify governmental reviews to quicken their products’ path to market.
Doctors and device makers are converting technology to regulate heart rhythms or treat diabetes into new tools for a wider range of ailments, including overactive bladders, anxiety and migraines. The result is a wider range of devices and other medical products being implanted or connected to more nonelderly patients.
But this growing use of medical hardware should be tempered by a call for safety, public disclosure and caution, consumer advocates say.
“We’re not talking about computers or cars or toasters,” said Lisa McGiffert, director of the Consumers Union’s Safe Patient Project, a group that campaigns for better medical practices. “We’re talking about things that go inside people’s bodies.”
Replacement parts — for the body
No area of medicine is seeing more younger patients turn to medical devices than orthopedics.
In 2000, one-third of the estimated 157,000 Americans who had hip or knee replacements were younger than 65. Ten years later, the number had nearly tripled to 430,000, meaning almost half of those procedures were performed on nonelderly patients.
Two contradicting forces are pushing patients toward artificial joints. The rising rate of obesity has led to more cases of deteriorating hips and knees from excess weight. And yet, more Americans are playing sports or exercising in their 30s, 40s and 50s, which puts more wear and tear on their joints.
To get active again — and quickly — patients are more willing to consider joint replacement at a younger age than they were a decade ago, said Dr. Daniel Berry, chairman of orthopedic surgery at the Mayo Clinic in Rochester.