Dr. David Prybyla, Medical Director of the Joint Replacement Program at Lowell General Hospital, talks about total joint replacement. Board-certified in Orthopedics, Dr. Prybyla is a graduate of Yale University and Albany Medical College. He completed his residency training at the University of Massachusetts Medical School in Worcester, followed by his fellowship training in adult joint reconstruction surgery at the New England Baptist Hospital in Boston.
Joint Replacement Surgery – Is It for You? FAQs
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.
Most patients should be able to graduate from using a walker or crutches to a cane in 1-4 weeks and to independent walking and driving within 4-8 weeks.
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.
Seeing patients up and moving within hours of their surgery — they are surprised and often tell me they wish they had done it sooner!
Motion is life — and if a patient can’t enjoy the things they love to do like golfing, walking through the mall, or chasing their grandchildren — that’s not living. There’s nothing more rewarding than helping restore a patient’s mobility, function, and quality of life.