After a skiing injury 30 years ago, Bert Pepper, MD, got osteoarthritis in his left knee. "I stopped skiing and gave up tennis, running, and other sports that are tough on the knee," he says. "I turned to speed-walking to stay fit, but the knee kept me from walking at a good pace."
As his pain got worse and walking became harder, he looked into having a knee replacement. It's not a decision to make lightly, Pepper says. "It's a major life event. You have to be prepared to lose a few months to pain after surgery, limited mobility, and vigorous rehabilitation."
The pain of arthritis makes it tough for many people to get a good night’s sleep. Worse yet, tossing and turning at night can actually increase the perception of pain.
“There’s a reciprocal relationship between pain and poor sleep. The poorer people sleep, the more pain they tend to be in,” says Kevin Fontaine, PhD, assistant professor of rheumatology at Johns Hopkins University. “If people with arthritis can improve the quality of their sleep, they can usually reduce their day-to-day pain.”
And like any surgery, it's important to weigh the risks and benefits carefully.
"There are two main reasons to have a joint replacement," says Charles Bush-Joseph, MD, professor of orthopedic surgery at Rush University Medical Center. "The best reason is pain relief."
During a hip or knee replacement, a surgeon removes the damaged surfaces of the joint and replaces them with plastic or metal implants. This gets rid of the pain because the diseased cartilage and bone are no longer there.
The second reason is to improve how well your joint works, Bush-Joseph says, but these results are less predictable. After a new hip or knee is put in, many people can walk more easily. Some may be able to ride a bike or play golf. But there are no guarantees.
Joint replacements carry the same dangers as other major surgeries, like a chance of infections or blood clots. You're most at risk for these problems if you have heart disease, diabetes that's not well controlled, or a weak immune system -- your body's defense against germs. Your surgeon may prescribe antibiotics and blood thinners to try to prevent some complications.
The other major risk is that the new joint may not work as well as you hoped. It might feel weak or stiff, particularly the knee. "Patients who don't actively rehabilitate will not regain the maximum range of motion," Bush-Joseph says. To get the best results from your knee surgery, stick carefully to your rehab schedule of exercise, rest, and medicines.
It's less common, but it's possible that your implant can become loose or get dislocated. Also, keep in mind that your replacement joint can wear out after about 20 years. That means you may need another surgery down the road.