Knee Pain

Is pain from stiff knees or sore hips keeping you up at night? Chronic pain doesn’t have to be a daily part of life, and joint replacement surgery is one possible solution. Here’s what you need to know about the procedure, recovery, and outcomes.

Do I Need Joint Replacement Surgery?

Joint replacement surgery may be helpful for those with serious knee and hip pain. Surgeons perform more than 600,000 knee replacements and 300,000 total hip replacements in the United States each year.

Your doctor may recommend surgery if you have a severe fracture, bone cancer, osteoarthritis, or rheumatoid arthritis, or if your condition hasn’t responded to less invasive treatments like:

  • Braces or other supports
  • Anti-inflammatory medicines, such as ibuprofen or naproxen
  • Heat and ice
  • Corticosteroid, hyaluronic acid, or platelet-rich plasma joint injections
  • Physical therapy

These treatments can provide temporary relief, but they don’t solve the underlying cause of the problem. According to James DeLullo, MD, of the UPMC Hamot Orthopaedic Institute, once the pain is severe enough to keep you up at night, surgery might be the answer.

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Am I Too Old or Too Young For Joint Replacement?

Age isn’t always the deciding factor for joint replacement. Your doctor will consider factors like chronic conditions, weight, and past surgical complications. “We see patients in their 60s who are not candidates for surgery because of their health, but we also see patients in their 80s who are actually really good candidates,” says Dr. DeLullo.

What Happens During Surgery?

If you and your doctor decide surgery is the right choice, you’ll receive some prep instructions. You might get preoperative exercises to build the muscles that will help you recover. Your doctor will let you know ahead of time when to stop eating and drinking before the surgery.

On the day of your surgery, a member of the anesthesia team will administer medicine to make you relax and to numb the joint. This person may also monitor your vital signs during surgery. The surgeon will make an incision near the joint, remove the damaged joint, and replace it with an artificial one. For a knee, this includes fitting a metal cap over the thigh bone (femur). For a hip, the surgeon may replace the entire ball and socket joint.

Surgery takes about one to two hours for full hip replacement and up to two hours for knee replacement. Some patients opt to have both knees replaced at once, which makes for a longer time in surgery.

What Does Recovery Look Like?

After the surgery, you’ll go to a recovery area. Some people stay in the hospital for a few days, and others go home the same day. It’s good to get moving as soon as possible, so physical therapy usually begins the day after surgery. You should expect to use crutches or a walker until your doctor decides you can walk unassisted.

Pain is normal during the recovery process. Your doctor will recommend either prescription or over-the-counter pain medicines. Dr. DeLullo says most patients are back at work in about six weeks. At three months, joint function is near normal, save for some stiffness and soreness. But, he cautions, “I always tell patients it’s probably the better part of a year before you are not thinking about that joint anymore.”

Are There Complications?

As with any surgery, there are risks involved. For joint replacement, these can include:

  • Blood clots
  • Infection at the site of the incision or around the joint
  • Dislocation or loosening of the new joint
  • Injury to a nearby nerve or blood vessel

Often, complications first appear as pain, redness, and swelling. You may also experience a high fever or chills. If you develop any of these issues, call your doctor right away.

How Long Does a New Joint Last?

According to the National Institutes of Health, most people can expect a new joint to last anywhere from 15 to 20 years. Beyond that, the joint surface may start to wear away. If that happens, a second surgery could be required.

What Should I Do Next?

If joint replacement surgery sounds like it might be right for you, talk to your doctor or an orthopaedic specialist. They’ll help you weigh the benefits and risks and put you on the path to living with joints that work for you.

Sources

Jane E. Brody. Should You Have Knee Replacement Surgery. New York Times. https://www.nytimes.com/2018/10/15/well/live/should-you-have-knee-replacement-surgery.html

National Institute of Arthritis and Musculoskeletal and Skin Diseases. Joint Replacement Surgery. National Institutes of Health. https://www.niams.nih.gov/health-topics/joint-replacement-surgery

National Library of Medicine. Medline Plus Magazine. Joint replacement surgery: What you need to know. National Institutes of Health. https://magazine.medlineplus.gov/article/joint-replacement-surgery-what-you-need-to-know

OrthoInfo. Total Knee Replacement. American Academy of Orthopaedic Surgeons. https://orthoinfo.aaos.org/en/treatment/total-knee-replacement/

OrthoInfo. Total Hip Replacement. American Academy of Orthopaedic Surgeons. https://orthoinfo.aaos.org/en/treatment/total-hip-replacement/

About UPMC Orthopaedic Care

As a national leader in advanced orthopaedic care, UPMC treats a full range of musculoskeletal disorders, from the acute and chronic to the common and complex. Whether you have bone, muscle, or joint pain, we provide access to UPMC’s vast network of support services for both surgical and nonsurgical treatments and a full continuum of care. As leaders in research and clinical trials with cutting-edge tools and techniques, UPMC Presbyterian Shadyside appears on U.S. News & World Report’s rankings of the top hospitals in the country for orthopaedics.