Total joint replacement is a surgical procedure in which a damaged, dysfunctional, or arthritic joint or joint surface is replaced with a plastic, metal, or ceramic prosthesis. The orthopedic prosthesis is designed to move just as a normal, healthy joint would. Joint replacement surgery is generally recommended when severe joint pain or joint dysfunction is unresponsive to other treatments, such as physical therapy, medication, and lifestyle change. Though total joint replacement can seem like an intimidating step as an option to relieve the pain of arthritis, multi-center trial studies with thousands of patients show excellent long-term benefits from joint replacement. In fact, in patients 55 and older who have had total knee replacement, 93 percent still have good function 20 years later. For total hip replacements, 95 percent are still functioning well after 20 years.
Arthritis is defined by the wearing out of cartilage lining the joints of the body. When the cartilage becomes worn out, motion becomes limited and painful. Though there are many treatment options available for arthritis, many times surgery is the only solution to achieving full use of the affected joints.
Total joint replacement surgery at The Orthopedic & Sports Medicine Institute involves using cutting-edge prosthetic devices to replace that worn out cartilage and bone at the end of arthritic joints. This allows the joints to once again function smoothly and without pain. Our arthritis specialists in the DFW area take a patient-centered and compassionate approach to helping you return to normal, active living through athletic knee replacement and hip replacement surgery. Shoulders are also commonly treated with surgical procedures.
The most common joint replacement surgeries are performed on the hip and the knee, however, successful joint replacement surgeries can be done on other joints including:
- Wrist
- Ankle
- Elbow
- Shoulder
Causes of Joint Pain and Cartilage Degeneration
A normal joint is lined with tissue and enclosed in a capsule with cartilage (a rubbery cushion which keeps the bones from rubbing together) covering the ends of the bones. Degeneration of the cartilage leads to:
- Pain
- Swelling
- Limited motion
When a joint is limited and not exercised, surrounding muscles may shrink and become weaker, and eventually, unable to bear weight. Common causes of joint pain and cartilage degeneration which can result in the need for total joint replacement include:
- Severe arthritis
- Trauma, such as serious fracture
- Injury that doesn’t heal properly
- Avascular neurosis (hip joint degeneration)
- Congenital deformities or abnormalities
Benefits of Total Joint Replacement Surgery
Total joint replacement surgery is usually recommended when the covering of a normal joint is damaged or worn, causing the joint to be unable to move freely or without pain due to the friction o bone rubbing against bone. Benefits of total joint replacement surgery include:
- Reduced pain
- Range of motion restoration
- Improved strength
- Increased mobility and weight bearing capacity
- Enhanced quality of life
Preparing for Total Joint Replacement Surgery
Preparing for total joint replacement surgery involves a complete examination of your general health. X-rays will be taken of the affected joint in order to select the proper design and size of your implant. Depending on your age and medical history, your surgeon may also require additional tests including:
- Blood tests
- Urine tests
- Electrocardiogram (EKG)
- Chest x-ray
Before your joint replacement surgery, you should acquire any assistive items that your surgeon recommends for your postoperative recovery, such as a walker, long-handled reacher, shower bench, or hand rails. Prepare yourself physically in the weeks prior to surgery by:
- Eating a well-balanced diet
- Exercise or lose weight (according to your doctor’s recommendation)
- Abstain from smoking and consuming alcohol
- Be sure to have a family member or friend available to assist you for at least a few days after your surgery.
Your total joint replacement surgery will typically take a few hours, during which you will be under a general anesthesia. During the procedure, the damaged bone and cartilage will be removed and replaced with the prosthesis. After surgery, you’ll be moved to a recovery room for one to two hours until you are fully awake. If you have had knee replacement surgery, expect to wake up with your knee in a continuous passive motion (CPM) device, which bends the knee back and forth to restore range of motion. The length of your hospital stay will depend on the type of joint surgery you have, with 4-7 days being the average.
Our program designed for those requiring total joint replacement in the DFW area features:
- All private rooms
- Care delivered by a dedicated staff specially trained to work with joint replacement patientstotal-joint-replacement-pic2
- Area dedicated specifically for patients having joint replacement surgery
- A family member or friend can be your designated coach to help speed your recovery and assist with therapy
- Back in casual clothes soon after surgery
- Group exercises
- A comprehensive screening
- Coordinated care after discharge
Throughout all of your care at the Orthopedic & Sports Medicine Institute, we strive to provide you with the most comfortable and patient-oriented environment possible. We know that total joint replacement therapy can be a stressful time in your life, and our support staff is always here to help in any way possible.
Complications with Total Joint Replacement Surgery
Although joint replacement surgery is considered safe, any surgical procedure carries inherent risk. Some of these risks include:
- Infection: Like all surgery, joint replacement carries the risk of infection. If this occurs, it can be a serious complication and may even necessitate removal of the implant. There are two types of infection associated with joint replacement:
- Early Infection: Infection may occur in the days or weeks following the surgery.
- Late infection: Infection may occur years down the road. To reduce the risk of infection once you have a joint replacement, you may be told to take antibiotics any time you undergo an invasive procedure, such as dental work or colonoscopy.
- Blood Clots: As with any surgery, there is the risk of developing a blood clot, although the use of blood-thinning medication and compression stockings helps minimize this risk.
- Stiffness: Stiffness can be the result of scar tissue buildup, which is why it is so important to begin activity immediately and adhere to a physical therapy program.
- Implant Loosening or Failure: Though they are designed to last much longer than they used to, over time implants can loosen or wear out. This may require revision surgery (replacement of the implant).
Be assured that most complications that may arise after some joint replacement surgeries can be successfully treated.
Recovering From Total Joint Replacement Surgery
Total joint replacement surgery initially requires several weeks of rehabilitation and healing. Early mobilization is considered a key component in a successful and speedy recovery. Your doctor will instruct you on when and how to begin movement and weight bearing activity. Physical therapy will play an important role after your joint replacement surgery. A graduated exercise program over a span of several months will be customized for you to assist in and enhance your smooth recovery. At OSMI, we are committed to providing high-quality individualized care to return you back to an active lifestyle as quickly as possible.
Post-Operative Hospital Stay
The average hospital stay for joint replacement surgery is three days. Here’s what you can expect from those three days:
- Day 1: This is a recovery day. You will still have anesthesia circulating in your body. You may feel groggy and experience discomfort in the joint. Still, expect to get up and get moving. Most patients are up and moving the same day as surgery, as it is important to start moving the joint immediately.
- Day 2: This is a transition day. You will feel more awake and alert. Your surgical dressing will be changed and you will be out of bed, moving around, and starting physical therapy.
- Day 3: This is game day. In order to go home, you need to meet specific goals, such as walking a certain distance and navigating stairs safely.
While recovery varies from individual to individual, on average most patients experience a full recovery within three to six months.
- Weeks 1-2: During your first two weeks at home, you’ll likely have a nurse who pays home visits. The nurse will check on your recovery and perform some early mobilization exercises with you. You will probably need to use a walker during these first two weeks.
- Weeks 3-4: After your two-week recovery period at home, you’ll visit the clinic and have your sutures removed. You will begin more rigorous outpatient physical therapy. During this time, you may transition from a walker to a cane. By the end of week four, most people no longer need an assistive walking device.
- Weeks 4-12: You will continue with physical therapy. Your physical therapist will outline specific benchmarks of recovery and guide you through a progression of strengthening exercises.
Most patients experience a full recovery within three to six months. The goal is to return to full strength and activity level.
Our goal at OSMI is to provide our patients quality, cutting-edge orthopedic treatments, both surgical and non-surgical. If you have questions about total joint replacement surgery, joint pain, or physical therapy, please submit an online appointment request or contact our office at 817-529-1900.
