Do I Need to Have My Joint
Replaced?
Only an orthopedic surgeon can tell if you need a joint
replaced. They will look at your joint via Xray or MRI
scans. The surgeon may put a small, lighted tube (arthroscope)
into your joint to look for damage. A small sample of your
tissue could also be tested.
After looking at your joint, the surgeon may say that you
should consider exercise, walking aids such as braces or
canes, physical therapy, or medicines and vitamin
supplements. Medicines for arthritis include drugs that
reduce inflammation. Depending on the type of arthritis, the
doctor may prescribe corticosteroids or other drugs.
If these treatments do not work, the surgeon may suggest
an operation called an osteotomy, where the surgeon aligns
the joint. Here, the surgeon cuts the bone or bones around
the joint to improve alignment. This may be simpler than
replacing a joint, but it may take longer to recover. This
operation is not commonly done today, however.
Joint replacement is often the answer if you have
constant pain and can’t move the joint well – for example,
if you have trouble with things such as walking, climbing
stairs, and taking a bath.
What Happens During Joint
Replacement Surgery?
First, the surgical team will give you medicine so you
won’t feel pain (anesthesia). The medicine may block the
pain only in one part of the body (regional), or it may put
your whole body to sleep (general). The team will then
replace the damaged joint with a prosthesis.
Each surgery is different. How long it takes depends on
how badly the joint is damaged and how the surgery is done.
To replace a knee or a hip takes about 2 hours or less,
unless there are complicating factors. After surgery, you
will be moved to a recovery room for 1 to 2 hours until you
are fully awake or the numbness goes away.
What Happens After Joint
Replacement Surgery?
With knee or hip surgery, you may be able to go home in 3
to 5 days. If you are elderly or have additional
disabilities, you may then need to spend several weeks in an
intermediate-care facility before going home. You and your
team of doctors will determine how long you stay in the
hospital.
After hip or knee replacement, you will often stand or
begin walking the day of surgery. At first, you will walk
with a walker or crutches. You may have some temporary pain
in the new joint because your muscles are weak from not
being used. Also, your body is healing. The pain can be
helped with medicines and should end in a few weeks or
months.
Physical therapy can begin the day after surgery to help
strengthen the muscles around the new joint and help you
regain motion in the joint. If you have your shoulder joint
replaced, you can usually begin exercising the same day of
your surgery! A physical therapist will help you with
gentle, range-of-motion exercises. Before you leave the
hospital (usually 2 or 3 days after surgery), your therapist
will show you how to use a pulley device to help bend and
extend your arm.
Determining The Success of
Joint Replacement Surgery
The success of your surgery depends a lot on what you do
when you go home. Follow your doctor’s advice about what you
eat, what medicines to take, and how to exercise. Talk with
your doctor about any pain or trouble moving.
Joint replacement is usually a success in more than 90
percent of people who have it. When problems do occur, most
are treatable. Possible problems include:
- Infection – Areas in the wound or
around the new joint may get infected. It may happen
while you’re still in the hospital or after you go home.
It may even occur years later. Minor infections in the
wound are usually treated with drugs. Deep infections
may need a second operation to treat the infection or
replace the joint.
- Blood clots – If your blood moves
too slowly, it may begin to form lumps of blood parts
called clots. If pain and swelling develop in your legs
after hip or knee surgery, blood clots may be the cause.
The doctor may suggest drugs to make your blood thin or
special stockings, exercises, or boots to help your
blood move faster. If swelling, redness, or pain occurs
in your leg after you leave the hospital, contact your
doctor right away.
- Loosening – The new joint may
loosen, causing pain. If the loosening is bad, you may
need another operation. New ways to attach the joint to
the bone should help.
- Dislocation – Sometimes after hip
or other joint replacement, the ball of the prosthesis
can come out of its socket. In most cases, the hip can
be corrected without surgery. A brace may be worn for a
while if a dislocation occurs.
- Wear – Some wear can be found in
all joint replacements. Too much wear may help cause
loosening. The doctor may need to operate again if the
prosthesis comes loose. Sometimes, the plastic can wear
thin, and the doctor may just replace the plastic and
not the whole joint.
- Nerve and blood vessel injury –
Nerves near the replaced joint may be damaged during
surgery, but this does not happen often. Over time, the
damage often improves and may disappear. Blood vessels
may also be injured.
As you move your new joint and let your muscles grow
strong again, pain will lessen, flexibility will increase,
and movement will improve. |
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