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Our Expert on Orthopedics
Q: Why do people need joint replacements?Ask Our Expert About Joint Replacement
Q: Why do people need joint replacements?A: A joint replacement may be necessary when the cartilage that protects the hip, knee or other joint wears out. This cartilage normally cushions the bone in the joint, absorbing shock and helping with movement. When the cartilage wears out and the joint becomes inflamed and painful, it is called arthritis. Q: What causes joints to wear out?A: The most common causes are injuries, increased body weight, heredity and the wear and tear that comes with aging. Q: When do I know it's time for a joint replacement?A: It may be time for a joint replacement when pain restricts your activity, making it difficult to enjoy even the simplest daily activities. In the early stages, arthritis can be treated with medication, injection, physical therapy, braces, exercise and by restricting more rigorous activities. But when you have difficulty walking and doing simple tasks, it may be time to consider joint replacement. Your doctor should consider your pain level and activity limitations, along with the results of an X-ray. Keep in mind that an MRI is not necessary to evaluate your arthritis. An MRI is only necessary under certain circumstances. Q: Can any joint be replaced?A: Knees and hips are by far the most common joint replacements. Some advances are being made on ankle replacements, but they typically do not last as long as knee and hip replacements. Consequently, they are far less common. Although shoulders and elbows also are replaced, you do not regain full range of motion. There is a new "reverse" shoulder replacement that is helping older adults with severely torn rotator cuffs relieve their pain and regain more range of motion. Q: What is joint replacement surgery like?A: The average surgery takes 45-75 minutes. Usually, you go to the hospital on the day of surgery and stay for three days after surgery. Most people can go home at that time, as long as they have family or other support at home. Some people need a week of rehabilitation in a skilled nursing facility like Lehigh Valley Hospital’s Transitional Skilled Unit (TSU) before returning home. Q: How long and painful is the recovery?A: Typically, it takes 6-8 weeks before you can be moderately active again. If you have a desk job, you can return to work in about three weeks. More physically demanding jobs require a longer time off. It usually takes about three months before you’re ready to resume all activities. Physical therapy is an important part of the recovery process. We've made advances in reducing pain and speeding up recovery. We use minimally invasive techniques to reduce the size of incisions and resulting scars. To reduce pain, we’re using longer-lasting anesthesia during surgery and sustained-release medication after surgery. Anti-inflammatory and anti-nausea drugs before, during and after surgery help you get active right away and speed your recovery. Q: What are artificial joints made of?A: Artificial joints are called prosthetics. The parts that go into the bone haven’t changed much in recent years. They are metal and usually made with metal alloy, titanium and cobalt chrome. The design of the rest of the artificial joint has improved in recent years. Today’s standard is a more durable plastic called cross-linked polyethylene. Sometimes metal is used for all surfaces. Ceramics are another option, although there is no long-term research to show that ceramic joints last longer. There is also a higher risk of them breaking, and they are much more costly. Q: How long does an artificial joint last?A: Although the life span of an artificial joint varies, it should last at least 10-15 years. It depends on your activity level and the amount of stress you put on the new joint. You should give up running and any sport that involves cutting and pivoting movements, like basketball. Bicycling, golfing and swimming are healthier exercise alternatives. Q: Can you have more than one joint replacement?A: Yes. Originally joint replacements were for older adults and expected to last the duration of their lifetime. Now, we are doing this surgery for younger people and replacing artificial joints one or two more times. However, it is important to note that the artificial joint can cause the bone to weaken, making a bone graft necessary for second or third replacement surgeries. Q: Can I have just part of the joint replaced?A: You can have a partial joint replacement, but it is not as common. This is good for some people who have arthritis on just the inside or outside of the joint. There is a risk that arthritis will eventually develop on the healthy side and a full replacement will be necessary. Q: Who can't have joint replacement?A: We don't recommend total joint replacement for people who are in a wheelchair or bed bound, who have other medical conditions that may lead to complications or whose bones are too weak to accept the transplant. Some patients may be required to lose a significant amount of weight prior to the safe performance of a total joint replacement. Want To Know More? Click here to read more about joint replacements.
This page last updated 2/12/08 04:08 PM
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