Joint Replacement FAQs
Why does my knee/hip hurt?
Joint cartilage is a tough, smooth tissue that covers the ends of bones where joints are located. It helps cushion the bones during movement, and because it is smooth and slippery, it allows for motion with minimal friction. Osteoarthritis, the most common form of arthritis, is a wear and tear condition that destroys joint cartilage. Sometimes, as the result of trauma, repetitive movement or for no apparent reason, the cartilage wears down, exposing the bone ends. Over time, cartilage destruction can result in painful bone-on-bone contact, along with swelling and loss of motion. Osteoarthritis usually occurs later in life and may affect only one joint or many joints.
What is total joint replacement?
The term total joint replacement is misleading. For total knee replacements, the knee itself is not replaced, as is commonly thought, but rather an implant is used to re-cap the worn bone ends. This is done with a metal alloy on the femur and a plastic spacer on the tibia and patella (kneecap). This creates a new, smooth cushion and a functional joint that can reduce or eliminate pain. For a partial knee or unicondylar knee replacement surgery, only one of the three knee compartments is re-capped with the prosthesis. With total hip replacements, the socket of the hip joint is smoothed and lined with a prosthetic cup and liner. Then the head of the femur (thigh bone) is removed and a metal stem is inserted into the shaft of the femur.
How long will my new joint last and can a second replacement be done?
All implants have a limited life expectancy depending on an individual's age, weight, activity level and medical condition(s). A total joint implant's longevity will vary in every patient. It is important to remember that an implant is a medical device subject to wear that may lead to mechanical failure. While it is important to follow all of your surgeon's recommendations after surgery, there is no guarantee that your particular implant will last for any specified length of time.
What are the major risks?
Most surgeries go well, without any complications. Though rare, infection and blood clots are two potentially serious complications. To avoid these complications, your surgeon may use antibiotics and blood thinners. Surgeons also take special precautions in the operating room to reduce the risk of infection. Strict adherence to the MOST pre-operative cleansing protocol will also reduce your risk of infection.
How long will I be in the hospital?
Most patients will get out of bed on the day of surgery depending on surgeon orders and clearance by your physical therapist. Patients are generally in the hospital for two to three days after surgery. There are several goals that must be achieved before discharge.
What if I live alone?
You may return home and receive help from a relative or friend. You may need a home health nurse and physical therapist to visit you at home for two or three weeks. You may also stay in an inpatient rehabilitation unit or sub-acute facility following your hospital stay, depending on your insurance and your progress.
How do I make arrangements for surgery?
After your surgeon has scheduled surgery, you will attend a pre-op class at the hospital, then the joint care coordinator (JCC) will contact you. The JCC will guide you through the program and make arrangements for both pre-op and post-op care.
What happens during the surgery?
The hospital reserves approximately two and one half hours for surgery. Some of this time will be taken by the operating room staff to prepare for surgery. You may have a general anesthetic, which most people call "being put to sleep." Some patients will have to have a spinal or epidural anesthetic, which numbs the legs and does not require you to be asleep. The choice is between you, your surgeon and the anesthesia providers.
Will the surgery be painful?
Joint replacement surgery provides long term relief to chronic arthritis pain, but post-operatively you will experience some pain and/or discomfort, this is normal and to be expected. Your team will work very hard to manage your pain to allow your body to heal and to continue your rehabilitation process. Pain can be chronic (lasting a long time) or intense (breakthrough). Pain can change through the recovery process. If you need more help with your pain management, talk to your nurse, the JCC or your doctor.
How long and where will my scar be?
Surgical scars will vary in length, but most surgeons will make it as short as possible. For knee surgery it will be straight down the center of your knee, unless you have previous scars, in which case your surgeon may use an existing scar. With hip surgery the scar location will vary depending on the technique your surgeon uses for your surgery. There may be lasting numbness around the scar.
Will I need a walker, crutches or a cane?
Patients progress at their own rate. Normally we recommend that you use rolling walker for the first two weeks, then a cane for four to six weeks. The case manager can arrange for them if necessary.
Where will I go after discharge from the hospital?
Most patients are able to go home directly after discharge. Some patients may require additional rehabilitation and transfer to a skilled nursing facility or inpatient rehabilitation unit. The case manager will help you with this decision and make the necessary arrangements. You should check with your insurance company to see if you have inpatient rehab or skilled nursing benefits.
Will I need help at home?
Yes, for the first few days or weeks, depending on your progress, you will need someone to assist you with meal preparation, etc. If you go directly home from the hospital, the case managers will arrange for a home health nurse to come to your house if needed. Family or friends need to be available to help if possible. Preparing ahead of time, before your surgery, can minimize the amount of help needed. Having the laundry done, house cleaned, yard work completed, clean linens put on the bed and single portion frozen meals will help reduce the need for extra help.
Will I need physical therapy when I go home?
Yes, you will have either outpatient or in-home physical therapy two to three times per week. Patients are encouraged to utilize outpatient physical therapy. The case manager will help you arrange for an outpatient physical therapy appointment. If you need home physical therapy, we will arrange for a physical therapist to provide therapy in your home. Following this, you may go to an outpatient facility two to three times a week to assist in your rehabilitation. The length of time for this type of therapy varies with each patient.
Will my new joint set off security sensors when traveling?
Your joint replacement is made of a metal alloy and may or may not be detected when going through some security devices. Inform the security agent you have a metal implant. The agent will direct you on the security screening procedure. You should carry a medic alert card indicating that you have an artificial joint. Check with your surgeon on how to obtain one.
Should I use heat or ice on my painful joint?
It depends! Ice is used to decrease inflammation and localized pain in your hip or knee. Ice should be used after you exercise, take a long walk or if you notice your joint is more red or swollen than usual. Ice should always be used after you have a knee or hip replacement – especially for the first few months.
Heat is used to warm-up muscles, tendons and ligaments prior to exercise, or just to "loosen up" your joints. Typically heat is used in chronic conditions, such as arthritis, to stimulate blood flow to the area and alleviate soreness and stiffness. Since heat causes vasodilation (or widening of your blood vessels) you never want to place heat on a new joint replacement. While heat causes a natural relaxation of the body and muscles, it will increase the inflammation and blood flow to your new joint replacement, which results in increased soreness and stiffness tomorrow morning.
For more information, please call (601) 936-2381.