Frequently Asked Questions about Total Joint Replacement

Joint replacement surgery involves removing an arthritic, diseased, or injured joint and replacing it with a new artificial joint, most commonly made of metal and plastic.

Most patients who undergo total hip replacement are over age 50, with the most common condition being osteoarthritis. This happens when the protective cartilage on the ends of your bones wears down over time. As this cartilage deteriorates, patients experience chronic pain while bending, walking, and going about daily activities.

We resort to total joint replacement only when all other methods of pain control have failed to provide relief, and a patient’s quality of life is severely affected. Patients go through a rigid diagnostic workup using X-rays and a physical exam to determine mobility, strength, and alignment.

The knee and hip are the most common areas, as they bear the most body weight. In fact, during activity, 5-7 times a person’s body weight is transported across the hips.

In knee replacement surgery, a 5-8 inch incision is made in the front of the knee, and the worn out surfaces of the knee are resurfaced with metal and plastic components. In a total hip replacement, the surgeon may perform a posterior hip replacement (from the back with a 5-8 inch incision) or in some cases can perform an anterior (from the front) replacement. The artificial “ball and socket” component of the hip is then fitted into the bone or cemented into place.

Pain after knee or hip replacement surgery varies from person to person, but modern medications and improved anesthesia techniques greatly help our ability to control pain and discomfort. We focus on multi-modal pain relief, which means approaching pain pathways from all different directions — including various types of anesthesia, local nerve blocks, medications applied locally at the site of surgery, and post-operative medications that help reduce pain and nausea.

Over the last 10 years, there has been a strong focus to get patients mobile quickly to help reduce the risk of blood clots or other complications after surgery. The artificial joints are also made of better materials and technology. They used to last about 10-15 years, now we think they will last 20 years or more.

Total hip replacement is a surgical procedure where the worn out surfaces of the hip are replaced with man-made components. Over time, cartilage that cushions the bones can wear away, cause pain and discomfort, and make simple pleasures like walking and shopping unbearable. Hip replacement can reduce or eliminate pain, allow easier movement and get you back to life.

Hip replacement surgery may be considered for individuals suffering from arthritic hip pain that severely limits daily activities. It is only recommended after careful examination and diagnosis of your particular joint problem, and only after more conservative measures such as exercise, physical therapy and medications have proven ineffective.

There are many kinds and designs of hip implants available today, and no one design or type is best for every patient. Surgeons select the implant they believe is best for their patient’s needs based on a number of factors including age, activity level, the implant’s track record, and his or her comfort with the instruments associated with the particular implant. If you have questions regarding implants, your surgeon will be happy to answer them for you.

Even though hip replacement surgery is considered a successful procedure, it is major surgery, and as with any surgery, there are risks. Possible complications include:

• Blood clots in your leg veins
• Infection
• Implant loosening
• Fractures
• Nerve or blood vessel damage
• Hip dislocation
• Change of leg length

Your surgeon and healthcare team will take great care to minimize the risk of these and other complications. Keep in mind that complications are rare, but they need to be understood by you and your family. Your surgeon will be happy to answer any questions.

Total hip replacement is recognized as one of the most successful procedures in all of medicine. In the United States, over 285,000 people have their hips replaced each year.1  

1.     Total Hip Replacement, American Academy of Orthopaedic Surgeons website. Retrieved on June 8, 2013, from http://orthoinfo.aaos.org/topic.cfm?topic=A00377.

Total knee replacement is a surgical procedure where the worn out surfaces of the knee are resurfaced with metal and plastic components. Over time, the cartilage that cushions the bones can wear away, cause pain and discomfort, and make simple pleasures like walking and shopping unbearable. Knee replacement can reduce or eliminate pain, allow easier movement and get you back to normal life.

Knee replacement surgery may be considered for those suffering from arthritic knee pain that severely limits the activities of daily living. It is only recommended after careful examination and diagnosis of your particular joint problem, and only after more conservative measures such as exercise, physical therapy, and medications have proven ineffective.

There are many kinds and designs of knee implants available today, and no one design or type is best for every patient. Surgeons select the implant they believe is best for their patient’s needs based on a number of factors including age, activity level, the implant’s track record, and his or her comfort with the instruments associated with the particular implant. If you have specific questions regarding implants, your surgeon will be happy to answer them.

Even though knee replacement surgery is considered a successful procedure, it is major surgery, and as with any surgery, there are risks. Possible complications include:

• Blood clots in your leg veins
• Infection
• Implant loosening
• Fractures
• Nerve or blood vessel damage
• Knee stiffness

Your surgeon and healthcare team will take great care to minimize the risk of these and other complications. Keep in mind that complications are relatively rare, but they need to be understood by you and your family. Your surgeon will be happy to answer any questions.

Total knee replacement is recognized as one of the most successful procedures in all of medicine. In the United States, over 600,000 knee replacements are performed each year.1

Most patients opting for a total knee replacement found improvement in pain, functional status and an overall quality of life.2 

1. AAOS website, http://orthoinfo.aaos. org/topic.cfm?topic=A00389, accessed June 2013

2. Hamilton D, Henderson GR, Gaston P, et al. Comparative outcomes of total hip and knee arthroplasty: a prospective cohort study. Postgrad Med J 2012;88:627–31

With improvements in surgical techniques and post-op care, it is now common for many patients to be able to go home from the hospital after two or three days. Of course, each patient is different, but the goal should be for you to recover in the comfort and privacy of your own home as soon as possible.

Recovery can vary from person to person, but most people will need to use an ambulation aid such as a walker for 4 weeks or so. Driving may be possible in 2 to 3 weeks, and activities such as golf and bowling can be resumed in as few as 10 to 12 weeks. Some activities such as singles tennis and skiing are not recommended after hip replacement. Most people will be able to go straight home from the hospital, though some patients, particularly those that live alone, may need to spend a few days at a rehab center or nursing home. Keep in mind that healing and recovery times can vary.

You will experience some discomfort after surgery, but be assured we will do everything we can to keep you as comfortable as possible. Pain after surgery varies from person to person, and is not entirely predictable, but modern medications and improved anesthetic techniques greatly enhance our ability to control pain and discomfort after surgery.

Your surgical team will do everything possible to minimize bleeding, but some blood loss after joint replacement is unavoidable. Whether or not a blood transfusion is required will depend on highly individualized factors, including your condition prior to surgery, cardiac history, age, etc. Be sure to discuss these issues with your surgeon.

Just give us a call: 978-937-6380. We are happy to answer any questions you have. And be sure to ask us about our upcoming seminars on knee and hip pain — we’d love to see you!