Here are a few common questions that patients may have regarding joint replacement surgery. The responses have been prepared by physician members of the Conemaugh Health System orthopedic team.
What is total hip or knee replacement?
This is a common procedure to replace a diseased hip or knee to allow the patient to return to a normal and active lifestyle. In total hip replacement, the ball of the femur is removed and a prosthetic stem is inserted into the femur. We remove the diseased bone from the hip socket, and an artificial socket and new prosthetic head is inserted. In total knee replacement, the ends of the thighbone and shinbone are removed and replaced with artificial parts. If needed, the underside of the kneecap is also removed and replaced. Usually, no more than one half inch of bone is removed from the tibia and femur.
What is a mobile-bearing prosthesis?
In a total knee replacement, damaged and worn weight-bearing surfaces are replaced with a prosthesis, also known as an implant. Most people get a “fixed-bearing prosthesis.” However, excessive activity or extra weight can quickly wear down a fixed-bearing implant and cause pain. That’s why younger, more active or overweight individuals are now choosing a “mobile-bearing prosthesis” that can reduce wear and tear, as well as its potential to loosen from the bone. Both implant options are available at Memorial Medical Center.
What is a “gender-specific” replacement?
Memorial Medical Center is one of the first in the region to offer “gender-specific” knee replacements that reflect the unique shape and size of women’s knees. Specially designed for women, the replacement has a thinner profile and is better proportioned for women’s anatomy. The result? More natural movement of the kneecap and increased range of motion. The replacements also help reduce damage to surrounding ligaments and tendons, often caused by bulkier implants that can hang over the bone and irritate nearby tissues.
Am I too old or too young for a total hip or knee replacement?
You are never too old or too young to improve your quality of life and get you back on your feet. Patients who have total hip or knee replacements tend to be age 60 or older. However, thanks to improved safety measures and longer-lasting implants, the patients can range from ages 20 to 100 depending on the condition of the hip or knee and the patient. More and more patients in their 50s are now having hip and knee replacements.
When will I be able to come home after the total hip or knee replacement surgery?
If you choose to have the procedure performed at Memorial Medical Center, you can expect to return home three days after surgery. Our physical therapy program will help get you walking before you leave the hospital. Occupational Therapy will instruct you in the best ways to carry out activities of daily living.
What type of anesthesia will I need during total hip or knee replacement surgery?
We offer several options, including short-acting spinal anesthesia and skin patches that don’t require patients to “go to sleep” and help them recover more quickly. General anesthesia can also be used.
How long will my total hip or knee replacement last?
The success rates at Memorial Medical Center for total hip replacement surgery stand at 95% for the first 5-10 years. Ninety percent of our total knee replacement surgeries remain successful after 10 years. Typically joint replacements will last at least 10-15 years under normal wear, but they can wear out sooner if subjected to frequent vigorous activity. However, many patients have gone beyond that period without complications and remain pain-free. Newer technologies such as the rotating platform ("swivel" knee) may last longer. People under age 50 returning to high levels of physical activity after surgery may need a second operation sooner.
What is the pain like right after total hip or knee replacement surgery?
There is post surgery pain, but it is minimal compared to the months and years of pain that you have already suffered. After surgery, we will supply strong medication to reduce any pain you may have. We also may provide patient-controlled anesthesia during the recovery, allowing you to press a button and release pain medicine for relief.
What will happen during the total hip or knee replacement procedure?
This common procedure lasts between one and two hours. We remove the damaged cartilage and bone, and then position the new metal and plastic joint to restore the function of your hip or knee. Once the new joint is in place, we use a special surgical cement to fill the gap between the prosthesis and the remaining natural bone to secure the artificial joint. In younger patients, we use a noncemented, porous prosthesis, allowing the natural bone to grow into the prosthesis.
Are there any complications or risks associated with total joint replacement surgery?
At Memorial Medical Center, our complications or risks associated with hip or knee replacements are extremely low because we constantly monitor our two biggest concerns - joint infection and blood clots. Antibiotics are routinely used to minimize the risk of infection, which occurs in less than 2% in Memorial joint replacement patients. Special support hose, inflatable leg coverings and blood thinning medication are used to ward off blood clots.
Is surgery recommended all the time for hip or knee pain?
We will try the less invasive methods first, unless we determine your hip or knee is too damaged for non-surgical treatments to provide relief. We can prescribe medicines to reduce pain and inflammation of the joint, provide canes or walkers to reduce stress on the hip or knee and recommend changes in diet and exercise to strengthen the hip or knee joint area. However, since arthritis only worsens with time, these options only provide temporary relief. Total hip or knee replacement is the long-term answer for pain relief and returning to an active lifestyle.
How successful is total hip or knee replacement surgery?
Total joint replacements are a very common procedure and have been performed in the United States since 1970. Today more than 400,000 joint replacements are performed each year in the U.S. This operation has become routine for us at Memorial Medical Center and is successful around 90%-95% of the time. It is by far the best method for long-term treatment of the pain and restoration of function lost because of severe arthritis.
How do I know if I have some sort of hip or knee disease?
The biggest "red flags" to hip or knee disease are when you experience pain when weight is applied to the joint, making it difficult to walk or move the joint normally, or when your range of motion in the hip or knee is reduced and the joint feels stiff. We can diagnose hip or knee disease through the use of x-rays, MRIs and blood tests. These tests allow us to determine how extensively your hip or knee is degenerating.
How do I know when it's time for a total hip or knee replacement?
When you have tried all of the temporary relief efforts, such as medication and physical therapy, and your pain is still limiting you from your everyday activities such as walking or bending, it's time. With a simple procedure, you can start to live your life the way you want to, instead of letting your hip or knee decide what you can and cannot do.
How will the doctor determine if I need a total hip or knee replacement?
One of the experienced orthopedic doctors at Memorial Medical Center will check your medical history and ask questions about your hip or knee pain and how it affects your ability to perform daily activities. A physical examination will assess your hip or knee mobility, strength and alignment. X-rays will determine the extent of the hip or knee damage. Occasionally we will perform blood tests, an MRI or a bone scan to determine the condition of the bone and soft tissues of your hip or knee.
What causes me pain and the loss of mobility in my hip or knee?
The most common cause of chronic hip or knee pain and disability is arthritis. In the hip or knee joint there are smooth layers of cartilage lining both ends of the joint. This cartilage serves as a gliding surface and cushion and allows for smooth motion in your hip or knee. Arthritis wears this cartilage away, and the rubbing of bone against bone is what causes your discomfort, swelling and stiffness.
What will my stay in the hospital be like after total hip or knee replacement surgery?
Your stay should last no longer than three days at Conemaugh Memorial Medical Center. After surgery, you will be moved to a hospital room and given pain medication to make you as comfortable as possible. As a member of Joint AdVentures, you will receive daily newsletters informing you of the day's activities and you will be dressed in casual clothing instead of hospital gowns. We make the recovery process interesting and effective by providing group therapy, as well as an innovative "Walk Your Way to San Francisco" series, allowing you to measure your daily progress by walking across the country.
How big and where is the incision for total hip or knee replacement surgery?
The majority of patients are candidates minimally invasive techniques and smaller incisions – usually less than 6 – 8 inches. These techniques help shorten the hospital stay, reduce the risk of complications, lessen the pain associated with surgery, speed the recovery process and enhance rehabilitation.
If you have additional questions, please talk with your doctor or contact us at (814)534-5276.