What is arthritis and how does it affect my joint?
In a healthy joint a gelatin-like structure called cartilage cushions the area where two bones meet. The cartilage prevents the two bones from coming into direct contact with each other and irritating the nerve endings. Over time, the cartilage begins to wear away, and the ends of the thigh bone (the femur) and the shin bone (the tibia) begin to rub on each other. This constant rubbing is responsible for the pain, swelling and stiffness associated with an inflamed bone or arthritis.
What is a total joint replacement?
“Total joint replacement” is a misleading term. Rather than inserting a brand new joint, the ends of the femur and tibia are reduced and capped with an implant device, or prosthesis.
In a knee replacement, a plastic spacer attached to the prosthesis creates a cushioning effect like the original cartilage, relieving the bone-on-bone contact and eliminating pain.
In a hip replacement, the hip is not totally removed and a new hip inserted. Rather, the head of the thigh bone is replaced with a metal ball. The area of the hip bone where the thigh bone fits in is reduced and a metal cup with a liner is put into place.
Will my new joint set off security sensors when traveling?
The prosthesis used to replace your worn joint is made from a metal alloy, so it may or may not be detected by some security devices. To avoid problems, ask your surgeon about getting a medic alert card indicating that you have an artificial joint.
What is the success rate for total joint replacements?
Approximately 90-95% of patients report good to excellent results in terms of pain relief. Most are able to significantly increase mobility and return to activities they enjoyed prior to arthritis pain.
Am I too old for this surgery?
Overall health is more of a determining factor than age. Prior to surgery, you will be asked to see your family doctor to assess any health risks. All measures will be taken to prepare you for a successful surgical outcome.
How long will my new joint last?
While the average prosthesis lasts for 10-20 years, there are no guarantees on how long your new joint will last. Factors like weight, activity type and activity level can affect your prosthesis’ usable life.
Will I need to have my joint replaced again in the future?
Some people have joint replacements that last their entire lives; others need to have the procedure repeated. If the bone doesn’t bond properly to the first replacement, it becomes unstable and needs to be replaced. If the plastic spacer that cushions the joint becomes extremely worn, it may also require replacement.
Are there major risks associated with this type of surgery?
All surgeries carry a certain amount of risk, but most of our joint patients are fine and ready to leave the hospital within a few days. This is in part because we take special care to safeguard you from infection with antibiotics before and after the surgery and a streamlined surgical procedure that takes less time. We also get you up and walking soon after surgery to reduce the risk of blood clots.
What is an anti-coagulant?
Anti-coagulants are types of medication commonly known as blood thinners. Their purpose is to prevent blood clots from forming in your veins and arteries. Blood thinners are given as a precautionary measure to promote a safe recovery.
How long does knee replacement surgery take?
The surgery takes approximately 2 hours. After surgery you will be monitored closely in the Post Anesthesia Care Unit until the anesthesia wears off. Once you are awake and stable you will return to your room.
Who will be doing the surgery?
Your orthopaedic surgeon will perform the surgery, and an assistant often helps.
Will I be awake during the surgery?
You and your anesthesiologist can discuss the best type of anesthetic for you, but generally you will be “put to sleep” and provided with total pain relief.
What will my scar look like?
The scar will be approximately six-inches long, starting above the knee and traveling down the center of the knee. If you have a scar from a previous knee surgery, it may be possible to enter over the old scar.
Other than the scar, will my joint be any different?
Some people notice a minor clicking sound when they bend their joints. This is a result of the artificial parts coming in contact with each other. It is normal and not a cause for concern. Also, kneeling may be a bit uncomfortable during the first year, but it normally becomes less noticeable over time.
Will I be in a lot of pain?
Following surgery, you will have an IV connected to a PCA pump. If you begin to feel uncomfortable, simply press the button on the pump for a dose of pain medicine. Most people don’t require strong pain medication after the first day and can switch to oral medications.
Will I need a private nurse after surgery?
Your surgery doesn’t require a private nurse, but we will arrange for one if you request it.
How long will I be confined to bed after surgery?
On the day of surgery, you will probably stay in bed for the most part. Early the next morning you will be up and ready to start the day’s activity. Usually, patients are up and walking with a walker or crutches by the afternoon.
How long will I be in the hospital?
Joint replacement patients usually stay with us about three to four days before going home. However, before leaving you need to be comfortable using a walker or crutches, and you must meet certain goals established in your group exercise class.
Will I need a walker, crutches or cane?
Normally, patients use an assistive device like a walker, crutches or cane for about four to six weeks. Your doctor will tell you when it’s time to retire them.
When can I go home?
Most of our patients go home on the second or third day following surgery. Occasionally, some patients require a longer stay, but it is not common.
Will I need help at home the first week?
It may be necessary to have someone assist you with meals, medication, dressing, etc. If you go directly home from the hospital, we can arrange for a home health care nurse to visit your home, as needed. Be sure to let us know if you live alone. Also, be sure to prepare your home before coming to the hospital—get prescriptions filled, change the sheets, do the laundry, get someone to cut the grass and stock up on frozen foods.
Will I need physical therapy when I go home?
Most patients do receive physical therapy after leaving the hospital. We can make arrangements for you. The number of physical therapy sessions you need will be based on your individual progress.
Why should I exercise before surgery?
The better the condition of your muscles before surgery, the easier and faster your recuperation is expected to be. It is important to learn the exercises and be comfortable with them prior to surgery so you can continue them later at home.
After leaving the hospital, when do I need to see my surgeon again?
You should plan a follow-up visit two to three weeks after surgery. Normally, a patient follows up with the surgeon again at six weeks and 12 weeks, but ask your surgeon when scheduling appointments.
Are there any activities that I should avoid initially?
You should keep your new joint moving, but return to normal activities gradually. Avoid high-impact activities like jogging, singles tennis, basketball, downhill skiing, football, etc. Ask your surgeon prior to participating in any high-impact or injury-prone sports.
Are any activities better than others?
Exercise is beneficial to your whole body, but especially for your new joint. Ask your doctor when it’s safe to incorporate low-impact activities like dancing, golf, hiking, swimming, bowling and gardening back into your normal routine.
When can I return to work?
The physical demands of your job and your individual progress will determine when you can return to work. Typically, people take a one-month leave of absence, but some with very sedentary jobs may return sooner. Your surgeon will tell you when you can return to work.
When can I drive?
It can be as little as four weeks or as long as six weeks or more. It depends on your individual progress and the mechanics of your car. If you had a left knee replaced and your car has an automatic transmission, you may be able to drive in as little as four weeks. However, you should not consider driving as long as you are taking prescription pain medication.
When can I resume having sexual intercourse?
Most people feel ready after about four to six weeks. It takes time to regain strength and confidence in your new knee, so talk to your surgeon if you have any questions.
Will my medications affect my ability to engage in sexual intercourse?
Some medications can affect performance and/or enjoyment during intercourse. These include decreased interest in sex, vaginal dryness, abnormal erections and delayed orgasms. If you sense your medication is causing these effects, try having sex in the morning before your first dose or in the evening before your last dose. DO NOT adjust or stop taking your prescribed medicine without talking to your doctor.
What if sex doesn’t go well?
Remember, you’re still healing, and it may take time to regain your former stamina. Realize that these changes to your sex life are temporary and necessary to protect your new knee joint. You’ll be back to your old self in no time.