Douglas Cooper, MD, Orthopedic Surgeon at Grundy County Memorial Hospital, offers tips for knowing when it is time for joint replacement surgery.
Why is total joint replacement necessary?
The goal is to relieve the pain in the joint caused by the damage done to the cartilage. The pain may be so severe, a person will avoid using the joint, weakening the muscles around the joint and making it even more difficult to move the joint. A physical examination, and possibly some laboratory tests and X-rays, will show the extent of damage to the joint. Total joint replacement will be considered if other treatment options will not relieve the pain and disability.
Douglas Cooper, MD, is an Orthopedic Surgeon at Grundy County Memorial Hospital.
How is a total joint replacement performed?
You will be given an anesthetic and the surgeon will replace the damaged parts of the joint. For example, in an arthritic knee, the damaged ends of the bones and cartilage are replaced with metal and plastic surfaces that are shaped to restore knee movement and function.
In an arthritic hip, the damaged ball (the upper end of the femur) is replaced by a metal ball attached to a metal stem fitted into the femur, and a plastic socket is implanted into the pelvis, replacing the damaged socket.
Although hip and knee replacements are the most common joint replaced, this surgery can be performed on other joints, including the ankle, foot, shoulder, elbow, and fingers.
The materials used in a total joint replacement are designed to enable the joint to move just like a normal joint.
The prosthesis is generally composed of two parts: a metal piece that fits closely into a matching sturdy plastic piece. Several metals are used, including stainless steel, alloys of cobalt and chrome, and titanium. The plastic material is durable and wear resistant (polyethylene). A plastic bone cement may be used to anchor the prosthesis into the bone.
Joint replacements also can be implanted without cement when the prosthesis and the bone are designed to fit and lock together directly.
What is the recovery process?
In general, your orthopedic surgeon will encourage you to use your new joint shortly after your operation. After total hip or knee replacement, you will often stand and begin walking the day after surgery. Initially, you will walk with a walker, crutches, or a cane.
Most patients have some temporary pain in the replacement joint because the surrounding muscles are weak from inactivity and the tissues are healing. This will end in a few weeks or months.
Exercise is an important part of the recovery process. Your orthopedic surgeon or the staff will discuss an exercise program for you after surgery. This varies for different joint replacements and for differing needs of each patient.
After your surgery, you may be permitted to play golf, walk, and dance. More strenuous sports, such as tennis or running, may be discouraged.
The motion of your joint will generally improve after surgery. The extent of improvement will depend on how stiff your joint was before the surgery.
Is total joint replacement permanent?
Most older persons can expect their total joint replacement to last a decade or more. It will give years of pain-free living that would not have been possible otherwise.
Younger joint replacement patients may need a second total joint replacement. Materials and surgical techniques are improving through the efforts of orthopedic surgeons working with engineers and other scientists.
The future is bright for those who choose to have a total joint replacement to achieve an improved quality of life through greater independence and healthier pain-free activity.
Your orthopedic surgeon is a medical doctor with extensive training in the diagnosis and nonsurgical and surgical treatment of the musculoskeletal system, including bones, joints, ligaments, tendons, muscles, and nerves.
Grundy Center resident, Maris Byrnes, used to experience this pain on a daily basis. Maris has been a dedicated walker, walking twenty-four blocks every day. But as the pain in her knee got worse, she started to decrease the number of blocks, first to twelve, then to six, and eventually she was not walking at all. "The pain was interfering with the daily activities and not allowing me to do the things I've always done. That was when I knew, it was time to have my knee replaced," explained Byrnes.
Now, five months after surgery, Maris walks 20 blocks every other day and has even gotten back to 24 blocks on a couple of occasions. She says, "It's just wonderful. Now when I walk, there is no pain. I can do the things I want to do; I have my quality of life back."