Is It Time for a New Joint?
Millions of us struggle with pain and loss of motion because of joint damage caused
by arthritis. If other treatments don’t help, you may wonder about turning in your
worn-out joints for new ones.
Surgery may not be your first choice. But if you are a candidate for total joint replacement,
know that more than 90% of people have good to excellent results. They get relief
from pain and can return to normal daily activities.
Should you have surgery?
Joint replacement should be a final step in treatment. Other treatments are often
suggested before joint replacement. They are:
Using pain medicine
Losing weight to ease stress on the joint
Cutting back on activities that cause pain
Doing exercises to keep muscles and joints flexible, promote fitness, and strengthen
muscles that support damaged joints
While most people having joint replacement surgery are in their 60s or older, younger
people may have it when their condition supports it. But younger people may have other
choices available to them. They may be able to change to a less physically demanding
job. Or they could have a different type of procedure that realigns or only replaces
part of a joint.
The younger you are when you get a new joint, the more likely you are to need surgery
to revise the joint replacement in the future. Surgery to fix or replace artificial
joints has an increased risk of infection and other problems. Because healthcare providers
shape and remove bone to accept the new joint, repeated surgery also leaves less bone
to attach to each new joint.
When do you need surgery?
An X-ray showing joint damage is one of the factors used to decide who should have
this surgery. Your pain and other symptoms are the main things to keep in mind when
deciding. This is mostly a quality-of-life decision.
Think about joint replacement surgery if you have 1 or more of these symptoms:
Severe pain during activity, such as walking or getting up from a chair
Pain that stops you from doing some activities
Pain at night that prevents you from sleeping
What can you expect?
To get ready, work with your healthcare provider to be sure you can handle anesthesia.
Have dental problems fixed before surgery to lower the risk for infection. Any health
problems should be addressed before surgery.
Total joint replacement usually involves a 2-day or 3-day hospital stay. Many hip
and knee patients can walk the next day using a walker. You'll likely be released
from the hospital on the second or third day. But you'll need time to heal.
At first, you may need items like crutches or a walker after hip replacement. Within
a few months, you should be able to return to most of your normal daily activities
without help. You may still need physical therapy.
After shoulder replacement surgery, you can start shoulder exercises with someone
else moving the joint for you. About 3 to 6 weeks after surgery, you'll do exercises
a therapist gives you. In time, you'll start to stretch and strengthen your shoulder
so you can get back to normal use with far less pain than you had before the surgery.
Recovery from joint replacement surgery may involve some pain for 2 to 3 months or
more. But it's often a different type of pain and will improve as you get better.
Will a new joint last?
Experts warn against unrealistic expectations for a new joint. You shouldn't expect
it to bear activities that involve jumping or the kind of stress that would be hard
on a natural joint. Your healthcare provider will tell you what activities you shouldn't
do after surgery. They may also tell you to stay away from certain joint positions
to prevent dislocation of the joint. The limits given will depend on the joint that
is replaced, as well as your situation.
An artificial joint will eventually change from wear and tear, even under normal use
and activity conditions. It may need to be replaced at some point. Artificial joints
often last 10 to 15 years or more. A person who is younger at the time of the surgery
may one day need to have the new joint replaced. The good news is that new materials
are giving artificial joints a longer life span.