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Categories > Muscles and Joints > Joint replacement

Joint efforts
For the hip
For the knee

Is surgery in the cards?
Is surgery in the cards?

If you’re experiencing any of the following, you may want to talk with your healthcare provider about joint replacement surgery:

  • You can’t sleep because of your joint pain.
  • Pain medicine doesn’t work or stopped working.
  • Pain is keeping you from daily activities, such as grocery shopping, or from performing basic functions, like getting up from a seated position.

Your lust for life hasn’t diminished. It’s just too bad no one told your knees or hips about it. Those poor joints have carried a lifetime of weight, so it’s no wonder they can eventually break down, causing you aches and pains. Your pain may be from osteoarthritis (also called “wear-and-tear arthritis”), rheumatoid arthritis (an inflammatory joint disease) or a joint injury.

Like any other condition that requires treatment, surgery is almost always the last resort. For example, your healthcare provider may recommend pain medicine, a brace for an ailing knee or physical therapy and a cane or a walker for hip pain. But if all else fails, you may want to talk with him or her about joint replacement. Many of these procedures can last up to 20 years.

For the hip

Total hip replacement requires a surgeon to make a 10- to 12-inch incision, remove the end of the thighbone and replace it with a metal ball, which fits into a plastic and metal socket in the pelvis and allows for movement. Most people who have total hip replacement surgery are age 60 years or older.

Recovery time: Most people can resume some level of their activities six to eight weeks after surgery. Full recovery usually takes at least six months.

The outcome: Total hip replacement is typically effective in 90 percent of cases, decreasing pain and allowing better joint movement. However, it can’t allow you to do things you couldn’t do before surgery.

Minimally invasive total hip replacement is much like a traditional total hip replacement and uses the same implants. However, the surgeon makes either a single incision of only three to six inches or two smaller incisions. This procedure tends to work better for people who don’t have a joint deformity, those who aren’t heavy or muscular and those who don’t have wound-healing problems.

Recovery time: Because the incisions cause less muscle damage, you may expect less pain, faster recovery and days shaved off of your hospital stay.

The outcome: More research is needed to determine the long-term benefits and risks of this type of surgery compared to the traditional procedure.

Hip resurfacing, done for years overseas, received Food and Drug Administration approval in 2006. Hip resurfacing reshapes and preserves the end of the thighbone instead of removing it as is done in total hip replacement—letting enough healthy bone remain for a total hip replacement down the road, if needed. A metal implant is then fitted into the joint socket. While hip resurfacing tends to be performed on younger people—those under age 60—doctors don’t usually recommend the procedure for patients with bad bone damage, reduced kidney function or severe obesity.

Recovery time: Many patients experience less surgical trauma and recover quicker. Depending on the individual, regular activities may be resumed in as little as a couple of weeks. Full recovery can take several weeks or more.

The outcome: As the years go on, more data will be available about how hip resurfacing stands the test of time. However, some surgeons already consider the procedure to be a viable alternative to hip replacement for some patients.

For the knee

Total knee replacement replaces your natural knee joint with an artificial one, or an implant. Through an incision in the knee, the surgeon moves the kneecap aside and cuts the ends of the thighbone and shinbone to fit the implant. The implant may be metal, plastic, ceramic or a combination of materials. This procedure may be performed at almost any age.

Recovery time: Recuperation varies, but most people can resume normal activities a month or two after surgery. Full recovery can take up to a year.

The outcome: At least 90 percent of patients experience relief. However, the range of knee motion is limited, and you may have to avoid certain activities, such as jogging or high-impact sports.

Minimally invasive total knee replacement is performed in almost the same way as total knee replacement and accomplishes the same goal. However, instead of the eight- to 10-inch long incision with traditional surgery, minimally invasive surgery requires only a four- to six-inch-long cut. The procedure is traditionally reserved for nonobese patients with no significant joint deformities.

Recovery time: Some studies show that smaller incisions may result in a shorter hospital stay—one to three days—and faster rehabilitation time.

The outcome: While you may experience a shorter recovery time, more research about the effectiveness of these techniques is needed. Possible complications include poorer positioning of the implant, which can lead to earlier wear and tear on the device.

Partial knee replacement removes either the inner (medial) or outer (lateral) compartment of the knee (or joint) and replaces it with an implant instead of replacing the entire knee. Patients who are older, slim and have a sedentary lifestyle are the best candidates for partial knee replacement, since the implant may not be able to withstand high levels of activity.

Recovery time: Because it involves only one part of the knee and requires smaller surgical incisions, which don’t cut the main muscle controlling the knee, your hospital stay may be shorter (most patients go home a day after surgery). Your rehabilitation may also be quicker and you may be able to return to normal activities sooner than with a traditional total knee replacement. You’re also likely to experience less pain after surgery.

The outcome: In addition to shorter recovery times, most patients have a better range of motion following this type of surgery. And, if you need a total knee replacement down the road, the implant may be easily changed.