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Total hip and knee replacement 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. The diseased bone is removed 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.
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, active individuals 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 Conemaugh Memorial Medical Center.
Conemaugh 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 is 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.
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 the hip or knee. Arthritis wears this cartilage away, and the rubbing of bone against bone is what causes your discomfort, swelling, and stiffness.
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.
One of the experienced orthopedic doctors at Conemaugh Memorial Medical Center will check each patient's medical history and ask questions about how hip or knee pain impacts ability to perform daily activities. A physical examination will assess hip or knee mobility, strength, and alignment. X-rays will determine the extent of the hip or knee damage. Occasionally the patient will have blood tests, an MRI, or a bone scan to determine the condition of the bone and soft tissues of the hip or knee.
Total hip or knee replacement surgery should be considered after temporary relief efforts, such as medication and physical therapy, no longer eliminate pain, and the pain limits daily activities.
Conemaugh's team utilizes will try the less invasive methods first, unless it is determine the hip or knee is too damaged for non-surgical treatments to provide relief. Physicians 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.
Total joint replacements are a very common procedure and have been performed in the United States since 1970. More than 400,000 joint replacements are performed each year in the United States. This operation has become routine at Conemaugh 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.
An individual is never too old or too young to improve quality of life. 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 patients in their 50s are now having hip and knee replacements.
This common procedure lasts between one and two hours. Surgeons remove damaged cartilage and bone, and then position the new metal and plastic joint to restore the function of the hip or knee. Once the new joint is in place, a special surgical cement is used to fill the gap between the prosthesis and the remaining natural bone to secure the artificial joint. In younger patients, a noncemented, porous prosthesis is used, allowing the natural bone to grow into the prosthesis.
At Conemaugh Memorial Medical Center, complications or risks associated with hip or knee replacements are extremely low thanks to constantly monitor of two main concerns - joint infection and blood clots. Antibiotics are routinely used to minimize the risk of infection, which occurs in less than 2% in Conemaugh Memorial joint replacement patients. Special support hose, inflatable leg coverings, and blood thinning medication are used to prevent blood clots.
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.
Conemaugh Memorial offers several options, including short-acting spinal anesthesia and skin patches that do not require patients to “go to sleep” and help them recover more quickly. General anesthesia can also be used.
There is post surgery pain, but it is minimal compared to the months and years of pain that the patient experiences prior to surgery. After surgery, Conemaugh's team will supply medication to reduce pain. Patient-controlled anesthesia may also be provided during recovery, allowing the patient to administer his or her own pain medicine for relief via monitored equipment.
A joint replacement patient's stay should last no longer than three days at Conemaugh Memorial Medical Center. After surgery, the patient will be moved to a hospital room and given pain medication. As a member of Joint AdVentures, the patient will receive daily newsletters of the day's activities. Conemaugh's team makes the recovery process interesting and effective by providing group therapy, as well as an innovative "Walk Your Way to San Francisco" series, allowing each patient to measure daily progress by virtually walking across the country.
The procedure performed is at Conemaugh Memorial Medical Center, the patient can expect to return home three days after surgery. Conemaugh's physical therapy program will help the patient walk before leaving the hospital. Occupational Therapy will instruct patients in the best ways to carry out daily activities.
The success rate at Conemaugh Memorial Medical Center for total hip replacement surgery is 95% for the first 5-10 years. Ninety percent of 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.