Is It Time For a Joint Replacement?

Millions of people suffer from chronic knee or hip pain resulting from severe osteoarthritis. If you’ve seen a clinician and tried conservative treatments like physical therapy and medication, you may consider turning in your worn-out joints for new ones.

“More than 90 percent of people have good to excellent results with total joint replacement,” says Matthew Chorney, MD, orthopedic surgeon with Lehigh Valley Orthopedic Institute. “They get pain relief and can return to normal activities.”

Joint replacements are only recommended after conservative treatment fails. Before opting for a joint replacement, you might try:

• Using pain medicine
• Losing weight to ease stress on the joint
• Cutting back on activities that cause pain
• Doing exercises to promote fitness and keep muscles and joints flexible and strong

“Most people having joint replacement surgery are in their 60s or older,” Dr. Chorney says. “Younger people may have other choices, such as changing to a less physically demanding job. Or they could have a different type of procedure that realigns or only replaces part of a joint.”

The younger you are when you get a new joint, the more likely you are to need surgery to revise the joint replacement in the future. Because health care clinicians shape and remove bone to accept the new joint, repeated surgery also leaves less bone to attach to each new joint. Lehigh Valley Orthopedic Institute orthopedic surgeons are experts in revision surgeries should one be necessary.

Making the decision to have a joint replacement is not easy, but Anthony Falvello, MD, orthopedic surgeon with Lehigh Valley Orthopedic Institute, says your doctor can help.

“This is mostly a quality-of-life decision,” Dr. Falvello says. “Pain, an X-ray showing joint damage and other symptoms are factors to consider.”

Some signs you may benefit from a joint replacement include:

• Severe pain during activity, such as walking or getting up from a chair
• Pain that stops you from doing some activities
• Pain at night that prevents you from sleeping

Years ago, having a joint replacement procedure often meant a hospital stay of two-to-three nights. However, new techniques being used to perform joint replacements, including  robotic surgery, have changed the recovery time.

“The time you spend in the hospital can vary. Some people go home the day of surgery and others may need a night to recover,” Dr. Falvello says. “Our patients are always up walking day of surgery with a walker or cane to help with circulation. But you’ll need time to heal.”

At first, you may need items like crutches or a walker after a hip or knee replacement. “Within a few months, you should be able to return to most of your normal daily activities without help,” Dr. Chorney says. “You may need physical therapy.”

Recovery from joint replacement surgery may involve some pain for two to three months or more. But it’s often a different type of pain and will improve as you get better.

It’s important to have realistic expectations for a new joint. “You should expect modifications as necessary after consulting with your doctor. Your clinician will tell you whether you should avoid any activities or positions,” Dr. Favello says.

Artificial joints often last 10 to 15 years or more. But they will eventually change from wear and tear, even with normal use. “The joint may need to be replaced at some point, especially if the person is younger at the time of surgery,” Dr. Chorney says. “The good news is that new materials are giving artificial joints a longer life.”