FREQUENTLY ASKED QUESTIONS
What Can Happen to My Joints?
Joints can be damaged by arthritis and other diseases, injuries, or other
causes. Arthritis or simply years of use may cause the joint to wear away.
This can cause pain, stiffness, and swelling. Bones are alive, and they
need blood to be healthy, grow, and repair themselves. Diseases and damage
inside a joint can limit blood flow, causing problems.
What Is a New Joint Like?
A new joint, called a prosthesis (pronounced praas-THEE-sis), can be made
of plastic, metal, or both. It may be cemented into place or not cemented,
so that your bone will grow into it. Both methods may be combined to keep
the new joint in place.
A cemented joint is used more often in older people who do not move around
as much and in people with “weak” bones. The cement holds
the new joint to the bone. An uncemented joint is often recommended for
younger, more active people and those with good bone quality. It may take
longer to heal, because it takes longer for bone to grow and attach to it.
New joints generally last at least 10 to 15 years. Therefore, younger patients
may need to have the same damaged joint replaced more than once.
Do Many People Have Joints Replaced?
Joint replacement is becoming more common. About 773,000 Americans have
a hip or knee replaced each year. Research has shown that even if you
are older, joint replacement can help you move around and feel better.
Any surgery has risks. Risks of joint surgery will depend on your health
before surgery, how severe your arthritis is, and the type of surgery
done. Many hospitals and doctors have been replacing joints for several
decades, and this experience results in better patient outcomes. For answers
to their questions, some people talk with their doctor or someone who
has had the surgery. A doctor specializing in joints will probably work
with you before, during, and after surgery to make sure you heal quickly
and recover successfully.
Do I Need to Have My Joint Replaced?
Only a doctor can tell if you need a joint replaced. He or she will look
at your joint with an x-ray machine or another machine. The doctor may
put a small, lighted tube (arthroscope) into your joint to look for damage.
A small sample of your tissue could also be tested.
After looking at your joint, the doctor may say that you should consider
exercise, walking aids such as braces or canes, physical therapy, or medicines
and vitamin supplements. Medicines for arthritis include drugs that reduce
inflammation. Depending on the type of arthritis, the doctor may prescribe
corticosteroids or other drugs. However, all drugs may cause side effects,
including bone loss.If these treatments do not work, the doctor may suggest
an operation called an osteotomy (pronounced aas-tee-AAHT-oh-me), where
the surgeon “aligns” the joint. Here, the surgeon cuts the
bone or bones around the joint to improve alignment. This may be simpler
than replacing a joint, but it may take longer to recover. However, this
operation is not commonly done today.
Joint replacement is often the answer if you have constant pain and can’t
move the joint well – for example, if you have trouble with things
such as walking, climbing stairs, and taking a bath.
What Happens During Surgery?
First, the surgical team will give you medicine so you won’t feel
pain (anesthesia). The medicine may block the pain only in one part of
the body (regional), or it may put your whole body to sleep (general).
The team will then replace the damaged joint with a prosthesis.
Each surgery is different. How long it takes depends on how badly the joint
is damaged and how the surgery is done. To replace a knee or a hip takes
about 2 hours or less, unless there are complicating factors. After surgery,
you will be moved to a recovery room for 1 to 2 hours until you are fully
awake or the numbness goes away.
What Happens After Surgery?
With knee or hip surgery, you may be able to go home in 3 to 5 days. If
you are elderly or have additional disabilities, you may then need to
spend several weeks in an intermediate-care facility before going home.
You and your team of doctors will determine how long you stay in the hospital.
After hip or knee replacement, you will often stand or begin walking the
day of surgery. At first, you will walk with a walker or crutches. You
may have some temporary pain in the new joint because your muscles are
weak from not being used. Also, your body is healing. The pain can be
helped with medicines and should end in a few weeks or months.
Physical therapy can begin the day after surgery to help strengthen the
muscles around the new joint and help you regain motion in the joint.
If you have your shoulder joint replaced, you can usually begin exercising
the same day of your surgery! A physical therapist will help you with
gentle, range-of-motion exercises. Before you leave the hospital (usually
2 or 3 days after surgery), your therapist will show you how to use a
pulley device to help bend and extend your arm.
Will My Surgery Be Successful?
The success of your surgery depends a lot on what you do when you go home.
Follow your doctor’s advice about what you eat, what medicines to
take, and how to exercise. Talk with your doctor about any pain or trouble moving.
Joint replacement is usually a success in more than 90 percent of people
who have it. When problems do occur, most are treatable. Possible problems include:
Infection – Areas in the wound or around the new joint may get infected. It
may happen while you’re still in the hospital or after you go home.
It may even occur years later. Minor infections in the wound are usually
treated with drugs. Deep infections may need a second operation to treat
the infection or replace the joint.
Blood clots – If your blood moves too slowly, it may begin to form lumps of
blood parts called clots. If pain and swelling develop in your legs after
hip or knee surgery, blood clots may be the cause. The doctor may suggest
drugs to make your blood thin or special stockings, exercises, or boots
to help your blood move faster. If swelling, redness, or pain occurs in
your leg after you leave the hospital, contact your doctor right away.
Loosening – The new joint may loosen, causing pain. If the loosening is bad,
you may need another operation. New ways to attach the joint to the bone
Dislocation – Sometimes after hip or other joint replacement, the ball of the
prosthesis can come out of its socket. In most cases, the hip can be corrected
without surgery. A brace may be worn for a while if a dislocation occurs.
Wear – Some wear can be found in all joint replacements. Too much wear
may help cause loosening. The doctor may need to operate again if the
prosthesis comes loose. Sometimes, the plastic can wear thin, and the
doctor may just replace the plastic and not the whole joint.
Nerve and blood vessel injury – Nerves near the replaced joint may be damaged during surgery,
but this does not happen often. Over time, the damage often improves and
may disappear. Blood vessels may also be injured.
As you move your new joint and let your muscles grow strong again, pain
will lessen, flexibility will increase, and movement will improve.