Joint Replacement

What is joint replacement surgery ?

Joint replacement surgery encompasses removing a damaged joint and surgically replacing it with an entire new joint or a part of a joint. Joint sites in the human body mean places where two or more bones come together, such as the knee, hip or shoulder. The most frequently replaced joints involve the hip and knee, but other joints being replaced include ankles, elbows, fingers, wrist and shoulders. The type of doctor performing the surgery is called an orthopedic surgeon.

Why replace a joint ?

Joints in your body undergo damage from arthritis, fractures, other diseases, and injuries. Damage to the cartilage lining the ends of the bones creates joint pain, stiffness limping, muscle weakness, limitation of motion and swelling. Individuals complain about the problems encountered in performing ordinary activities like walking, putting on socks and shoes, entering and exiting their car and climbing stairs. Physicians try non-surgical modes of treatment like medications, physical therapy and alterations to daily activities. If these treatments fail to relieve pain and debility, your physician may advise joint replacement surgery.

What is the replacement joint like ?

A replacement joint, called a prosthesis, can be constructed of plastic, metal or ceramic. The prosthesis replicates the action of a natural, healthy joint. Surgeons place cemented joints more frequently in older individuals who fail to move around a lot. The cement makes the new joint adhere to the bone. Surgeons recommend uncemented joints for younger, more active people and individuals with healthy bones. Uncemented takes longer to heal due to the need for the bone to grow and attach to the prosthesis.

Do a lot of people obtain joint replacements ?

The number of people obtaining joint replacements increases every year. Greater than 1 million Americans acquire a hip or knee replacement each year. Since older individuals express a decrease in pain and an improvement in moving around, this older age group describes the improvement in their quality of life after the surgery.

Every surgery presents some risks, but risk of joint replacement surgery depends on the state of health before surgery, how severe you disease is, and type of surgery planned.

What can you expect before the surgery ?

The doctor or nurse will ask you to list down all your medications. Always tell the health professional about all the medications you take, even the drugs, supplements and herbal medication you buy without a prescription or over-the-counter.

Within two weeks prior to your surgery, the doctor may ask you to stop taking medications that act on blood clots so bleeding is less likely to occur. The medications to stop taking include aspirin, ibuprofen (Advil, Motrin), naproxen (Naprosyn, Aleve), blood thinners like warfarin (Coumadin) and other drugs as advised by your doctor.

You may need to stop other medication that suppress your immune system or increase your likelihood to get an infection. Medications like methotrexate, Enbrel or other drugs affecting the immune system need to be stopped.

Ask your doctor what medications you need to take on the day of surgery.

If your health conditions include diabetes, heart disease or other medical condition, your surgeon may advise you to see your doctor who treats these conditions.

If you drink a lot of alcohol (more than 1 to 2 drinks a day), let your doctor know.

If you smoke, you need to stop 2 weeks before surgery. Smoking slows down wound and bone healing. If you continue smoking, your recovery can be prolonged. Please ask your doctor or nurse for assistance in stop smoking. New methods exist to help you stop smoking.

If you develop cold, flu, fever, herpes outbreak or other health problems before your surgery, always let your doctor know.

Your doctor may want you to visit a physical therapist before surgery to learn some exercises.

Set up your home to make your daily routines easier.

If appropriate, you should practice using a cane, walker, crutches or a wheelchair correctly.

What can I expect on the day of surgery ?

You will be asked to not drink or eat anything for 8 to 12 hours before the procedure.
Swallow pills with a sip of water on the day of surgery that your doctor told you to.
Your doctor or nurse will let you know what time to arrive at the hospital for the surgery.

What happens during the surgical procedure ?

The surgical team will first give you medicine to put you to sleep so you won’t feel any pain (anesthesia). The surgeon and his team then replace the damaged or injured joint with a prosthesis.

Since each surgery is different, the amount of time it takes varies due to the degree of damage of the joint and type of surgery. Joint replacement for a knee or hip takes around 2 hours or less. After surgery, you go to recovery room for 1 to 2 hours until you fully wake up.

What can I expect after the surgery ?

Your hospital stay will probably last from 3 to 4 days. During the hospital stay, you will be recovering from anesthesia and the surgery effects. It is important to follow the directions of the nurse to get up and walk around on the first day after surgery.

Full recovery takes anywhere from 4 months to 1 year.

If your doctor thinks it is necessary, you may need a short stay in a rehabilitation center after leaving the hospital, and before returning home.

Will my surgery be successful ?

The success of one’s surgery depends on what you do when you go home. Follow your doctor’s advice about what food to eat, what medicines to take, and what exercises to perform. If you have any trouble with pain, with moving around, or with exercising, you need to let your doctor know.

New joints will usually last 10 to 15 years.

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