Do I need a joint replacement?

This is the most important question that we discuss and is ultimately decided by you. It is exceedingly rare to say “You NEED a joint replacement”. This is an elective surgery and it’s up to you if and when you want it to get done. There are many people out there living with arthritis who are able to tolerate that without surgery using non-surgical means, like medications, injections, losing weight, and modifying their activities to eliminate activities that cause them pain.

The questions you need to ask yourself before planning on a joint replacement are “Is this limiting the activities that I want to be able to do?”, “Is this severely affecting my quality-of-life?”, and “Does it hurt me every day?”. If the answers to these questions are “Yes”, then you may benefit and it’s reasonable to discuss joint replacement surgery. We can’t give you your ‘normal’ hip or knee back again. Our goal is to make you BETTER. Most studies show that 80-90% of the time, patients feel like their quality-of-life improved after this surgery.

What is the recovery time?

After surgery, you will be using a walker for about the first 1-2 weeks after surgery. When ready, you will transition to using a cane. By 4 weeks after surgery, many patients might not need to use any external supports. We ask that you use a walker and/or cane to help with balance, and it will also help you weight-bear as comfort allows. “Recovery” is different for every patient, and even different from one knee to the next. No two patients are the same, and no two joints are the same. As a rule of thumb, it can take approximately 3 months to return to 80% “recovered” and you can continue to improve up to about 1 year after surgery and get to your new normal. Just keep in mind that everyone heals and recovers at a different pace.

How long will my replacement last?

This is a common question and particularly important for younger patients. A general rule of thumb is that there is a risk of needing a repeat operation due to any cause of about 1% per year. That means you have a 99% chance it will last at least one year, and an 80% chance it will last at least 20 years. I think and hope your implants will last longer than that with today’s newer implants - but we can’t say that definitively. If your implants are positioned correctly then they should outlast you.

When will I be able to walk?

Our goal is to get you up and walking as soon as it is safe to do so, usually the same day of surgery. Your joint will structurally be able to withstand your entire weight while walking immediately after surgery. Because of normal pain after surgery, most people need some type of assistive device (cane, walker, crutches) usually for a few weeks.

Will I have pain after surgery?

Yes. This is a major surgery and pain is NORMAL, but should always be at a TOLERABLE level. In general, the first 48 hours are the worst, but it should be consistently improving day by day after that. Many people require narcotic pain medications for about 3 weeks or so, then are able to manage with simple Tylenol and/or ibuprofen. We utilize a variety of agents to try and minimize your pain and block it from multiple angles. Your attitude towards pain control can also affect how well you manage your pain after surgery. If you believe that the pain will be uncontrollable or unmanageable, your pain and distress will worsen. If you believe that your pain can be managed and controlled, then it will be. Research studies have shown a positive attitude can actually improve the effectiveness of pain medication.

When can I drive?

When you can safely get in and out of a car and are able to slam on the brakes in case of an emergency. For right sided surgery this may take 6 weeks. For left sided surgery, patients can usually drive around 3 to 4 weeks after surgery. There is no driving clearance form, and everyone recovers a bit differently. It is very important that you are off all narcotics and are not using an assistive device before you start to drive. You want to make sure that you are comfortable and confident that you are able to operate your car safely. We suggest practicing in an empty lot prior to driving on the road.

When can I travel?

You may travel after your first in clinic post-operative appointment. It is safe to travel, though not as comfortable if you are able to wait longer. It is recommended that you get up and either walk or stretch at least once each hour during long trips. This is to help prevent blood clots. If you are thinking of going on a long trip within the first 3 months after surgery, we suggest you take one 81 mg of Aspirin twice daily beginning 2 days prior to your trip and complete this regimen 2 days following your trip.

When can I return to work?

That answer depends on your occupation. If you have a more sedentary job and are not on your feet all day, you could return after 4 to 6 weeks. If you have a more labor-intensive job where you don’t have the opportunity to sit at work and rest, it could be 12 weeks before you can return to your job. We suggest that all patients plan to be off work a minimum of 6 weeks, and we can adjust as needed depending on your recovery and progression.

What kind of activities are not allowed or are allowed after a joint replacement? I’ve heard you “can’t run” after a hip or knee replacement.

We’re doing this surgery for your quality-of-life, to get you back to the activities that you enjoy, so there are typically no formal restrictions. But this isn’t a normal hip or knee. So while your joint is structurally sound, strenuous activities might cause you more discomfort. Higher impact activity like running or jumping can also potentially wear out the plastic liner sooner, but it is impossible to say how much activity will do this.

Patients should avoid any high impact activities for a minimum of 4 months after surgery due to the need for your body to fully heal. Please discuss your particular concerns if you have any questions regarding specific activities.

What Results Should I Expect?

You should plan for and expect a successful outcome from your joint replacement surgery. Generally, patients experience less pain and more mobility in their joint, and can resume most of the activities they enjoyed before the onset of arthritis. Long-term studies show that over 90% of artificial joints are intact and fully functional after 10-years, and 80-85% at 20 years. Your artificial joint will last longer if you maintain your ideal weight, engage in low impact exercise, and undergo routine follow-up examinations.