be treated by reconstructive surgery as well as by pharmaceutical or physical therapy methods. Secondly, traumatic events can occur at any time, especially when individuals are highly active (military, sporting activities etc.), where there have been remarkable successes with reconstruction. Thirdly, past the adolescence – adulthood transition, smoothing out the negatively directed irregularities on this path towards old age and death (with a bone plate for the fracture mentioned above, for example) and / or moving the whole path to the right (line 2, Figure 4) form the main focus of invasive reconstructive procedures.
Figure 4. Realistic relationships between Quality of Life and Age; 1 – Increase – steady state – decline, 2 – Effects of medical interventions in adulthood that increase longevity.
The point of no return, when adolescent / adulthood quality is experienced again but then, after a steady-state period, decreases at a substantially greater rate, could occur at any time, from adolescence transition plus one day, to ages 20, 30, 40, maybe 50, but probably not much more. Let us call this “The Inflection Point”. What follows in this book is critically dependent on this observation. Although I will concentrate on the role of medical technologies, it should be emphasized that a holistic approach here is essential; a joint replacement technology that is usually experienced quite late in life, for example, has to fit into the whole body equation that includes genetic factors, life-style and rehabilitation issues, exposure to drugs (both pharmacological and recreational), nutrition, co-morbidities and psychological factors as well as the scientific, engineering and clinical aspects of the technology itself. In full disclosure, I have two hip and one shoulder replacements myself, so I am supposed to know what I am talking about here.
These are, obviously, generic, population-based observations that do not adequately describe individual circumstances, some of which can be extremely complex. For this analysis to be of any value, we have to accommodate wide ranging scenarios such as the following: