Frequently Asked Questions
If you're like most potential patients, you have a lot of questions about total joint replacement. Below, we offer answers to the most commonly asked questions. As you explore the possibility of joint replacement surgery, your orthopaedic surgeon is your best resource. If you and your surgeon decide that joint replacement is the right choice for you, our Joint Program Coordinator will guide you through every step of the program.
What is total joint replacement?
Total joint replacement is a surgical procedure in which certain parts of an arthritic or damaged joint, such as a hip, knee, or shoulder joint, are removed and replaced with a plastic or metal device called a prosthesis. The prosthesis is designed to enable the artificial joint to move just like a normal, healthy joint.
Hip replacement involves replacing the femur (head of the thighbone) and the acetabulum (hip socket). Typically, the artificial ball with its stem is made of a strong metal, and the artificial socket is made of polyethylene (a durable, wear-resistant plastic). In total knee replacement, the artificial joint is composed of metal and polyethylene to replace the diseased joint surfaces. The prosthesis is anchored into place with bone cement or is covered with an advanced material that allows bone tissue to grow into it.
Total joint replacements of the hip and knee have been performed since the 1960s. Today, these procedures have been found to result in significant restoration of function and reduction of pain in 90% to 95% of patients. While the expected life of conventional joint replacements is difficult to estimate, it is not unlimited. Today's patients can look forward to potentially benefiting from new advances that may increase the lifetime of a joint prostheses.
Am I a candidate for joint replacement surgery?
Total joint replacement is usually reserved for patients who have severe arthritic conditions. Most patients who have artificial joints are over 55 years of age, but the operation is being performed in greater numbers on younger patients thanks to new advances in artificial joint technology.
Circumstances vary, but generally patients are considered for total joint replacement if:
Functional limitations restrict not only work and recreation, but also the ordinary activities of daily living
Pain is not relieved by more conservative methods or treatment, such as those described above, by the use of a cane, and by restricting activities
Stiffness in the joint is significant
X-rays show advanced arthritis or other problems
How long will a joint replacement last?
Advancing technology has significantly increased the life of total joint implants. Still, just as your original joint wore out, a joint replacement will wear over time as well. The life expectancy of your implant will depend on your age, weight, activity level and medical condition. Every patient is different, and we cannot guarantee that any implant will last for any specific length of time.
What are the major risks of joint replacement surgery?
While risks are low, they do exist. The two most serious complications are infection and blood clots. To avoid these problems, we use antibiotics and blood thinners. We also take special precautions in the operating room to reduce the risk of infections.
What should I expect after surgery?
In the Hospital - The day of surgery our staff will help you sit on the side of the bed. You will have discomfort following surgery, but we will try to keep you comfortable with the appropriate medications. For hip and knee replacements, you will already be walking with the help of a walker the day after surgery. During your hospital stay, you will participate in group therapy sessions and enjoy many meals with your coach, our staff, and the patients you meet during the pre-surgery class. Shoulder replacement patients will have individualized therapy in their rooms should your surgeon request it.
Discharge - Most patients stay in the hospital 2-3 days and are able to go directly home. Some patients may transfer to a sub-acute facility, where they will stay for 3-5 days. Our social worker or case manager will help you with this decision and make the necessary arrangements. You should check with your insurance company to see if you have sub-acute rehab benefits.
At Home - For the first several days or weeks, depending on your progress, you will need someone to assist you at home. If possible, plan to get assistance from family or friends. If necessary, our social worker or case manager can arrange for a home health care nurse to come to your home.
Will I need home medical or assistive equipment?
Yes, we recommend that you use a walker, cane or crutches for about six weeks for hip and knee replacements. You may also benefit from assistive devices to help with lower body dressing, a bath seat, and grab bars in the bathroom. If you have hip replacement surgery, you will also need a high toilet seat for about three months. Shoulder replacement patients will need to obtain a sling at your surgeon's office prior to surgery. You will bring this to the hospital on the day of surgery. Some other equipment that may be helpful is a long handled sponge and a shower chair. Our social worker or case manager can arrange for equipment you will need.
Will I need physical therapy or an exercise program?
Yes, both are essential for recovery. The number of physical therapy sessions varies for each patient, but exercise must be a lifetime commitment. Your surgeon and physical therapist will design an exercise program for you.
When can I resume regular activities?
Driving - For hip and knee patients, if the surgery was on your left side and you have an automatic transmission, you could be driving at two weeks. If the surgery was on your right side, your driving could be restricted as long as six weeks. For shoulder patients, your physician will determine when you are able to return to driving.
Working - We recommend that most people take at least one month off work. You may be able to work sooner if your job is sedentary and you can use crutches at work. Your physical therapist can make recommendations for joint protection and energy conservation on the job.
Activity - Your surgeon and physical therapist will share many more details related to walking, using stairs, and resuming recreational activities like dancing and more.
How often will I follow-up with my surgeon?
You will go to your first postoperative office visit 2-3 weeks after discharge. After this visit, the frequency of follow-up visits will depend on your progress. Many patients are seen at six weeks, twelve weeks and then yearly.