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Beyond Arthritis: Hip and Knee Replacements for Women

More and more women are seeking knee and hip replacements to maintain their active lifestyle.

Know Your Joint Replacement Options continued...

"It's a smaller operation and the recovery time is a little faster, and the knee feels more like a normal knee," says Mayman. "But the downside is a higher failure rate." Mayman says his hospital sees a 10% failure rate for partial knee replacements after 10 years. It takes 20 years for total knee replacements to hit a 10% failure.

And what about "hip resurfacing?" That, too, sounds like it might be easier than getting a whole hip replaced. But in this case, the opposite is true. "It's actually a bigger incision with longer recovery time," says Mayman. "It does save bone in the femur, but there are a number of negatives for women."

First, women -- especially those with osteoporosis -- face a higher risk of femoral neck fracture after hip resurfacing. Also, since the surgery involves a metal-on-metal-bearing surface, elevated levels of cobalt and chromium can be found in the blood after surgery. No ill effects have been shown due to these metals so far, but most surgeons won't do hip resurfacing in women of childbearing age since the metals can cross the placenta.

You can also discuss some of the newer joint replacement options with your surgeon, such as ceramic and crosslinked polyethylene bearings, which may last longer than previous generation joints, as well as new knee designs that "should act more like a normal knee," says Mayman.

Some doctors, including Mayman, now use computer navigation to aid joint replacement surgery. It doesn't change the implant itself, or the operation, but it's a more precise guide to putting the joint in place.

"If you use standardized guides, you're within the ideal alignment range about 80% of the time. With computerized guides, it's about 95% of the time," he says. "That should benefit the patient in the long term, because we know that outcomes are better if the joints are within that ideal alignment."

Don't Forget to Check for Osteoporosis

Here's one last tip for women considering joint replacement surgery: Get screened for osteoporosis.

"If you have hip or knee pain and arthritis that's got you thinking about surgery, it's a good time to be screening for osteoporosis," says Mayman. "It's something all women this age should be thinking about, and if you're replacing a joint, it's important to be thinking about protecting the bone that you have."

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Reviewed on November 27, 2007

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