Previous projections of total joint replacement (TJR) volume have not quantified demand for TJR surgery in young patients (\ 65 years old). We developed projections for demand of TJR for the young patient population in the United States. The Nationwide Inpatient Sample was used to identify primary and revision TJRs between 1993 and 2006, as a function of age, gender, race, and census region. Surgery prevalence was modeled using Poisson regression, allowing for different rates for each population subgroup over time. If the historical growth trajectory of joint replacement surgeries continues, demand for primary THA and TKA among patients less than 65 years old was projected to exceed 50% of THA and TKA patients of all ages by 2011 and 2016, respectively. Patients less than 65 years old were projected to exceed 50% of the revision

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The intrinsic compressive and tensile properties of normal bovine medial menisci were measured, and the variations in these properties with respect to the structural organization of the tissue and test specimen location were examined. Using a confined compression experiment, the compressive aggregate modulus and permeability of the meniscus were determined. The permeability of the tissue was also compared with the permeability as measured experimentally using a direct permeation experiment. Deep posterior specimens are significantly stiffer in compression than deep anterior and central-anterior specimens, while deep anterior specimens are significantly less stiff than deep posterior and central-posterior specimens. Posterior specimens have a significantly higher average water content. In addition, the permeability of the bovine meniscus was found to be about one-tenth that of bovine articular cartilage. The tensile stiffness of meniscal tissue was determined from constant strain rate uniaxial tension tests. To asses the directional variations in the tensile properties, specimens were obtained from the circumferential and radial orientations. The results indicate that the femoral surface of the meniscus is isotropic in tension, while specimens from within the meniscus are anisotropic--the circumferential specimens are much stiffer than the radial specimens. Furthermore, circumferential posterior specimens from the interior of the meniscus are significantly stiffer than similar anterior specimens. Layer inhomogeneities in the tensile properties with respect to distance from the femoral surface are also present.

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