Your hips don't lie: Faster, easier options for joint replacement
Hip, knee and shoulder replacements just aren’t what they used to be—thankfully. Today’s improved joint replacements require shorter hospital stays and recovery times. As a result, these surgeries are more often a first choice for those with active lives rather than a last-resort option for the severely disabled.
And joint replacement patients are getting younger: A decade ago, patients were more likely to be in their 60s or older, but surgeons now mostly treat patients who are 50 and older.
“People don’t want to live with a disability if they can help it, as more and more are leading a more active lifestyle these days. So, with improved treatment options, patients are going for a replacement rather than living life in pain,” says Dr. Riley Hale, an orthopedic surgeon at Banner Health Clinic specializing in orthopedic surgery and orthopedics in Greeley, CO.
Not only are the typical joint replacement patients different than they were a decade or two ago, so is the surgery itself. Most of the physicians who specialize in joint replacements today have completed hundreds, and in many cases, thousands of these surgeries, and know how to anticipate complications.
How it works
Your hip, knee and shoulder joints are lined with cartilage that helps them move easily. When that cartilage is worn away by arthritis or other diseases, it hurts to move the joint. During joint replacement surgery, the damaged joint lining is replaced by a metal, plastic and/or ceramic prosthesis, generally a ball and a socket.
Joint replacement parts come in many more sizes than they used to, adjusted for women and men as well as for the size of the patient.
“That makes for better customization and a better fit for most patients,” says Dr. Hale.
“Joint replacements are also helped these days by significant improvements in bearing surfaces, which improves the longevity of the replacement,” he explains.
A typical traditional replacement joint will last 20 years. Hopefully, new surfaces will last longer, but the longevity varies depending on the patient and joint condition.
Surgeons are also using advanced imaging and intraoperative imaging to better align replacement joints.
“Better alignment may improve outcome, help reduce complications and improve longevitiy,” says Dr. Hale.
Before exploring joint replacement, your doctor typically will have you try a range of over-the-counter and prescription remedies for pain management, which can help avoid surgery for some time. An arthritis brace--a custom device that is more substantial than an Ace bandage--can help shift your gait and alignment, thus reducing pain when the joint is used. Other braces may keep a joint warm, also reducing pain.
Cortisone injections, which typically combine a corticosteroid medication and a local anesthetic, may help reduce pain for up to three months. In addition, weight loss can help decrease the strain on arthritic joints.
Up and at ‘em
If surgery does become necessary, rehab typically begins right away after the operation, which generally takes up to one and a half hours for a hip or knee replacement, and two hours for a shoulder replacement.
Most surgeons like to have their patients up and walking (with assistance, of course) the same day as their surgery, Dr. Hale explains.
The hospital stay for joint replacement usually is three days. You’ll receive physical therapy starting in the hospital, and then either at home or as an outpatient, likely three times a week.
You’ll probably be able to participate in your favorite activities again post-surgery, possibly within six to eight weeks. But Dr. Hale urges sticking to low-impact sports such as walking, swimming or golf.
“You may think you can go back to doing any activity you did when you were younger, but activities like jogging or a run on the treadmill can really take its toll,” he says.
Making the decision
Although some joint replacement surgery is necessitated by a fall, a car accident or other trauma, the more common reason is the cumulative effects of arthritis and chronic diseases.
The actual decision to go for surgery is in the patient’s hands, and not necessarily what an X-Ray says.
“When the patient can’t participate in activities that keep them healthy and happy that’s when surgery comes in the picture,” explains Dr. Hale.
FIVE reasons to consider joint replacement surgery Source: American Academy of Orthopaedic Surgeons
FIVE reasons to consider joint replacement surgery
Source: American Academy of Orthopaedic Surgeons