Who Needs a Knee Replacement?
If you have difficulty walking, climbing stairs, or moving from sitting to standing, then your doctor may recommend knee replacement surgery after more conservative approaches have failed to resolve your pain and discomfort. Persistent or reoccurring pain in your knees that prevents you from daily activities or sleeping can lead to stiff, swollen knee joints. Arthritis is the most common reason for knee replacement. Here are three types of arthritis and how they can affect the knee joint.
Osteoarthritis and Knee Replacement
Osteoarthritis is the most common form of arthritis and is commonly referred to as “wear and tear arthritis.” As you age, your joints can start to break down over time. The cartilage in your joints that supports healthy joint functioning and prevents bones from rubbing together will start to break down. Damage to cartilage in your knees can lead to pain and inflammation as the bones rub together and cause friction, stiffness, and swelling. Knee replacement for osteoarthritis is one of the most common reasons people get this type of joint surgery.
Rheumatoid Arthritis and Knee Replacement
Rheumatoid arthritis is an autoimmune disease where the body’s immune system starts to attack its own healthy tissues. Inside the knee joint, synovial fluid helps keep your joints moving smoothly. If you have rheumatoid arthritis, your immune system will attack this joint lining and even damage the cartilage, ligaments, and bones in the joint to become damaged. People with severe rheumatoid arthritis in their knees may benefit from joint replacement surgery.
Traumatic Arthritis and Knee Replacement
If you suffered a knee injury in a car accident, while playing sports, or from a slip and fall, you could develop traumatic arthritis afterward. Significant damage to the cartilage in your knee joint can affect how your knee moves, and the cartilage may wear down more quickly. Traumatic arthritis can also get worse if you are overweight, do not exercise regularly, or experience multiple knee injuries.
Who Needs a Hip Replacement?
Hip replacements are common among older adults, typically between ages 50 and 80. The most common reason people get a hip replacement is due to arthritis that affects the hip joint. Typically, conservative approaches to managing hip pain and symptoms of arthritis include the use of walkers or canes and low-impact exercises. If these conservative treatment options do not effectively manage your symptoms, your doctor may recommend surgery. Here are the three main types of arthritis that affect the hip joint and when a hip replacement may be necessary.
Osteoarthritis and Hip Replacement
Osteoarthritis is a degenerative form of arthritis where the cartilage slowly breaks down due to wear and tear on the body as you age. If you experience osteoarthritis in your hip, you may have difficulty finding a comfortable position to sit or sleep in. Osteoarthritis in the hips can also limit your ability to participate in certain activities.
Rheumatoid Arthritis and Hip Replacement
Rheumatoid arthritis can cause joint inflammation because of how the body’s immune system targets and attacks healthy tissues, like the lining of your hip joints. If you have rheumatoid arthritis, you may first experience it in your hands and feet before it moves into larger joints like the hips. Rheumatoid arthritis in the hips may cause severe enough pain and reduced mobility that a joint replacement may be necessary to improve your quality of life.
Traumatic Arthritis and Hip Replacement
A sudden hip injury from a slip and fall or car accident could lead to traumatic arthritis afterward. An injury to your hip can damage healthy tissues like cartilage that support your hip joint. A hip injury can also change the healthy functioning of your joint and cause certain parts of the joint to wear down before others, leading to arthritis. When conservative treatment approaches fail to manage your traumatic arthritis, a hip replacement may be the best solution.
How Your Weight Can Affect Joint Replacement
If your doctor recommends a total hip or knee joint replacement, your doctor may talk to you about how your weight could impact the success of the surgery. People with a higher BMI, or body mass index, can experience serious complications during or after a serious surgery like joint replacement. In some cases, your doctor may recommend you lose weight before undergoing a joint replacement surgery to reduce your risk for complications and improve your chances for a successful outcome. People who are overweight or obese tend to have higher rates of health conditions like high blood pressure or diabetes, which can increase your risks during surgery. Before you undergo a serious surgery like joint replacement, you want to be in the best health possible. A person’s weight can lead to challenges during surgery like ensuring adequate oxygen and airflow and locating a vein for general anesthesia. Complications after joint replacement surgery can include a greater risk for blood clots, poor wound healing, and infection.
How Diabetes Can Affect Joint Replacement
If you have been diagnosed with diabetes, then your orthopedic surgeon will talk to you about how this might impact your joint replacement surgery. People with diabetes are at greater risk of developing an infection after the surgery. Your wounds and incisions from surgery may take longer to heal. When blood sugar levels are too high, typically because of improper diet or lack of exercise, you are at greater risk for health conditions like heart disease and neuropathy. Diabetes can create a domino effect of health complications, so it is important to make sure your diabetes is under control before you undergo a serious procedure like joint replacement. People who have diabetes are also at greater risk of having higher weight or obesity, which can complicate joint replacement surgery. Uncontrolled type 2 diabetes can put you at greater risk for complications from surgery, so preparing for surgery is key to ensuring a successful outcome.
Before You Have Joint Replacement Surgery
Many lifestyle factors can impact both your weight and your diabetes. Physical inactivity and an unhealthy diet put you at a disadvantage. To prepare for joint replacement surgery, your doctor may recommend physical therapy for “prehab” to prepare your body for undergoing this type of procedure. Prehab can help you ward off infection, reduce the risk of inflammation, and improve your strength and mobility so you can get back on your feet as soon as possible after surgery. An orthopedic surgeon and physical therapist will take into account a wide variety of factors, including your age, weight, activity level, and overall health, to determine whether you are ready for joint replacement surgery. While the surgery itself may only take a few hours, your rehabilitation and recovery process afterward can take months. Prehab with a physical therapist can help better prepare your body and mind for recovering from joint replacement.
What Happens During a Joint Replacement
Joint replacement surgery is typically a hospital procedure performed by an orthopedic surgeon. You will get hooked up to an IV for necessary nutrients and undergo general anesthesia, so you will be asleep during the surgery. The surgery may last a few hours and will involve a surgical cut above the joint so the surgeon can get to the damaged cartilage and bone. They will affix a prosthetic joint made of flexible plastic and metal that will reconnect all the bones in your joint. Here’s what you can expect during a knee joint vs. hip joint replacement.
Knee Joint Replacement
During a knee joint replacement, your surgeon will make a surgical incision above the front of your knee and replace the damaged joint tissue and bone with a prosthetic joint. They use specialized pins and screws to help secure the prosthetic to joint your femur and tibia. Once the prosthetic is in place and the bones have been rejoined successfully, the surgeon will close the wound with stitches and wrap the knee in a bandage.
Hip Joint Replacement
During a hip joint replacement, your surgeon will make a surgical incision along the thigh to reach the hip joint or through a muscle-sparing procedure through the anterior or posterior hip. They will remove the damaged hip joint and replace it with a hip joint prosthesis made of a metal or ceramic ball and socket with a metal rod that helps stabilize the connection to the thigh bone. Then they will close the incision site with stitches and wrap the area with a bandage.
What To Expect After Joint Replacement Surgery
After joint replacement surgery, you will wake up in a hospital recovery room where staff monitor your vitals and help manage your pain. Once you are declared stable, you may be cleared to go home, or they may move you into a room where you may need to stay in the hospital for up to 3-5 days afterward. A physical therapist will help you get moving soon after the surgery to avoid muscle weakness and atrophy from lack of movement. Whether you recover for the first few days in the hospital or at home, you want to make sure you are surrounded by people who can support you through the process. You may need someone to drive you to appointments and help you get comfortable moving through your home and going about daily activities like getting into bed or sitting on the toilet. After joint replacement surgery, you may experience some pain and stiffness. Physical therapy begins as soon as possible to promote healthy blood flow to help the tissues in your affected joint get used to the new structures. Physical therapy will typically continue for weeks or months after the initial procedure to ensure your best chances for success and to help avoid complications afterward.
How to Support Recovery from Joint Replacement
When recovering from a total joint replacement surgery, it is best to plan ahead as much as you can so you are prepared for the challenges that will come along. The first few days are typically the most difficult, so surround yourself with caring individuals who can help take care of you when you need it most. Follow all your doctor’s recommendations after joint replacement surgery to ensure a successful recovery. You may need a walker or crutches at first and help with medications and wound care. Make sure you can get to and from all medical appointments, including follow-up appointments with your surgeon and regular physical therapy. Talk to your doctor about what daily rehab plan they recommend, and make every effort to stay mobile and speed up your recovery.
If you have a joint replacement surgery scheduled, you can meet with one of our orthopedic surgeons or physical therapists at AICA Orthopedics to talk about your options. Learn more about how AICA Orthopedics can support you through prehab as you prepare for surgery and physical therapy afterward while you recover. With multiple locations around metro Atlanta, you can find an AICA Orthopedics near you with a team of doctors who work together to provide you with a comprehensive treatment and recovery plan so you can get back on your feet in no time.
