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What if I’m Not Ready for Total Joint Replacement Surgery?


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Eric Lebby, MD, is LVHN's Chief, Division of Orthopedics, and an orthopedic surgeon for LVPG Orthopedics. He performs more than 600 knee and hip replacements annually on patients ranging in age from 19 to 94.

Let’s say you have a nagging soreness in your hip or knee that just won’t go away and an orthopedic specialist has told you that sooner or later you’ll need total joint replacement surgery to correct the problem.

Joint replacement surgery? You? Maybe you feel you’re too young or too active to need such a dramatic step. Maybe you feel your joint is painful but not THAT painful. Maybe for any number of reasons, you’re just not ready to have that hip or knee replaced. Are there other options you can consider?

First, you must understand that other options essentially means managing the pain as best you can for finite period of time. Here are some options:

  • Work with a physical therapist – This can be beneficial with arthritic conditions. Exercises to strengthen joint muscles can have a positive impact, as can electrical stimulation or hot/cold applications to the affected area. Physical therapy can be helpful in managing pain and may restore some lost joint function as well.
  • Pain and/or anti-inflammatory medication – You can find pills or ointments, often over the counter, that can alleviate your soreness. Acetaminophen for pain and ibuprofen as a nonsteroidal anti-inflammatory drug come to mind as popular relief medications. How effective they are tends to depend on the individual and the extent of the damage to the joint area.
  • Joint injection – This is a more direct approach to alleviating joint pain. An anti-inflammatory or lubricating treatment is injected into the joint to alleviate discomfort. Some people have had success putting off total joint replacement surgery for several years utilizing this option, and others not so much. Again, how successful it is in easing pain and how often such a treatment will continue to be effective depends on the individual and the damage.
  • Surgery other than joint replacement – Cleaning away debris with an arthroscopic procedure can give you some relief, although be advised this is not something that will correct the problem and the pain will eventually return. A more involved, invasive procedure for arthritic conditions would be an osteotomy, where bone is essentially sheared enough so weight-bearing can be transferred to a more stable joint area where applicable. Recovery time from such a procedure has been known to be extensive, but you can put off joint replacement for a good many years with this option.

The thing to keep in mind is all of these alternatives are temporary. Ultimately, total joint replacement will be the only option that is designed to eliminate your pain completely. In my experience, once you’re ready for it, you’ll be glad you did it.

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