TOTAL JOINT REPLACEMENT: HIP & KNEE
A normal cartilage layer in joints allows nearly frictionless and pain-free movement. When it is damaged or diseased, joints become still and painful. After examination, joint replacement is considered if other treatment options have been tried and not successful and/or it is determined that other treatment options will not relieve the pain and disability. The most common procedures performed by our joint replacement physicians to treat your condition are, total knee replacement, total hip replacement, hip or knee revision surgery.
Steven Hollis, M.D.
Chief of Orthopedic Surgery at Beverly Hospital
President - Coastal Orthopedic Associates
Adult Hip and Knee Reconstruction, Trauma, Fracture
Joint replacement surgery involves treatment of the joints of the hip, knee or shoulder with specialized, manufactured implants. The materials used in a joint replacement are designed to enable it to move just like a natural joint. Joint replacement surgery can eliminate pain, help to increase your mobility, and ultimately allow you to participate in activities that you personally enjoy with reduced or eliminated pain.
We recognize that the decision to undergo joint replacement surgery is a significant decision. Your physician will fully explain the recommended procedure to you and also explain that total joint surgery can bring increased mobility and function back to your life. Your options will be thoroughly explained to you and your personal risk factors will be reviewed in detail with you, as part of the “shared decision” making process.
In addition, you may have undergone previous joint replacement surgery and due to the age of the replacement or other factors, you find yourself in need of a revision. Our experts at Coastal Orthopedic Associates specialize in not only initial joint replacement surgery, but also revision joint replacement surgery.
Should a decision be made to undergo a joint replacement procedure, either initial or a revision, you can expect that state of the art procedures will be used to ensure that you have an exceptional experience that leads to the best possible outcome.
Healthier patients may have the option of having their hip or knee replacement done at an outpatient surgery center if they wish, instead of the hospital. Outpatient surgery centers are less costly and may be a good option if you and your physician determine that you are a good candidate to have your surgery in this type of location.
In general, your orthopedic surgeon will encourage you to use your “new” joint shortly after your operation. For hip and knee replacements, you will often stand and begin walking the day after surgery. Initially, you will walk with a walker, crutches or a cane. Most patients have some temporary pain in the replaced joint because the surrounding muscles are weak from inactivity and the tissues healing.
Exercise is an important part of the recovery process. Your orthopedic surgeon will discuss an exercise program and/or physical therapy program for you to follow after surgery. This varies for different joint replacements and for the differing needs of each patient.
Although hip and knee replacement surgery has become quite common, there are still risks. Potential risks depending on the procedure include:
Infection of a joint replacement
Leg length difference
Hip implant loosening
Stiffness of the knee replacement
Your physician at Coastal Orthopedics will have a thoughtful discussion with you to discuss the overall potential risks as well as your individual risk factors. We will make sure that you fully understand the risk associated with this procedure and that you are fully informed prior to making a decision to go forth with hip or knee replacement surgery.
Coastal Orthopedic hip surgeons and specialists provide a wide range of treatments for hip problems and injuries including hip replacement surgery, also known as hip arthroplasty. This procedure provides pain relief and restores movement to people who have hip pain or stiffness caused by hip arthritis. This procedure is also sometimes used as a treatment for injuries such as a broken hip, a hip that is growing incorrectly and for other conditions.
Most hip replacements, however, are performed to remedy hip arthritis. Hip arthritis occurs when the cartilage between the bones of your hip joint wears down.
Your bones scrape together, causing more damage, as well as pain and stiffness. Arthritis of the hip can make it painful for you to walk, get out of a chair, or even perform the most routine daily activities, which has a great impact on your life. In addition to pain, symptoms that patients complain of include tightness, stiffness, limping, and hip joint popping or clicking. Hip pain often times waxes and wanes, with improvement and worsening varying over time. Symptoms commonly worsen with activity, and night pain can affect sleep.
During hip replacement surgery, the damaged sections of your hip joint are replaced with an artificial implant that is meant to function in the same way as a normal hip. The procedure involves removal of the bone and cartilage on the ball and socket hip joint. This is performed using precise instruments to create surfaces that can accommodate the implant perfectly. Hip replacement surgery performed by our hip surgeons has a very high success rate and is one of the most common surgeries performed internationally across all specialties.
Knee replacement surgery is among one of the common elective surgeries in the country. Approximately 700,000 knee replacement procedures are performed annually in the United States. This number is projected to increase exponentially in to the future. Part of the reason for this is that we have a generation of people that have been active and athletic through not just adolescence, but through adulthood. This “sportiness” in adulthood has led to injuries, which can cause arthritic damage. In addition, over recent years, there has been a change in expectations about the level of activity that should be possible as we age. Now, patients are proactively electing knee replacement surgery in order to maximize their mobility as they move in to their 50’s, 60’s and 70’s so that they can fully enjoy these years as pain free as possible.
Despite advanced surgical techniques to treat knee injuries, arthritis of the knee may be the long-term outcome from past traumatic episodes. In addition, with aging, one can lose cartilage; this is termed degenerative or osteoarthritis. Conservative measures are typically the first line treatment approach for these problems, including non-steroidal anti-inflammatories (NSAIDs), therapeutic exercises and activity modification. If conservative measures fail, total knee replacement is one option to relieve pain and to restore function to an arthritic knee. The most common reason for knee replacement is that other treatments (weight loss, exercise/physical therapy, medicines and injections) have failed to relieve arthritis-associated knee pain.
The knee joint is a complex joint. It has two compartments, the medial and lateral compartments, formed from the bottom of the thigh bone (femur) which sits on top of the major lower leg bone (tibia). In the front of the joint, forming the third compartment is the kneecap (patella) which lies in the quadriceps tendon and rides in a groove in the end of the thighbone (femur). The knee joint has ligaments and surrounding muscle that help to provide support.
When a knee replacement is performed, the bone and cartilage on the end of the thigh bone (femur) and top of the shin bone (tibia) are removed. This action is performed using special instrumentation to prepare the surfaces so that the implant will fit perfectly. The implant is placed in to position so that it may function as a new knee joint. Depending on the condition of the cartilage underneath the kneecap, the kneecap surface may also be replaced.
The goal of knee replacement is to relieve pain, improve quality of life, and maintain or improve knee function. The procedure is performed on people of all ages, with the exception of children, whose bones are still growing.
WHEN YOU SHOULD MAKE AN APPOINTMENT WITH OUR HIP AND KNEE SPECIALIST
If you have any of the following symptoms it is highly recommended that you schedule an appointment for an evaluation with one of our specialists:
Pain in your joints that is constant or unrelenting or prevents you from sleeping or performing normal activities
Instability in your joint, the feeling that your joint is going to “give out on you,” or a feeling of having restricted movements due to your joints
Swelling, weakness or stiffness in your joints.
Changes in your gait or limping .
Pain that is not able to be controlled with Ibuprofen or Acetaminophen.
If you feel a “pop” in your joint or if your joint appears swollen or deformed.
If you are unable to bear weight on your joint.
Here are some helpful hip & knee resources provided by the American Academy of Orthopaedic Surgeons (AAOS) to help manage your bone and joint health:
Hip articles, videos, and resources to help manage your bone and joint health:
Knee articles, videos, and resources to help manage your bone and joint health: