Your Guide to Joint Replacement for Osteoarthritis
By 2030, nearly 3.5 million Americans will undergo total knee replacement surgery every year, and more than half a million will get total hip replacements. The vast majority of these surgeries are performed on people with osteoarthritis (OA) that has not responded to standard OA treatment.
Joint replacement or other surgical procedures are sometimes considered the “treatment of last resort” for people with osteoarthritis. Doctors frequently tell patients to wait as long as possible before joint replacement, but to get the best results, it should also not be delayed too long. How do you know when it’s time to seek joint replacement surgery?
It's a catch-22 when you have knee pain from osteoarthritis. It hurts, so you don't want to move. But if you exercise, it can eventually make your knees feel better.
"I've gone a period of time when I haven’t moved a joint much and, when I first start, it's a little bit sore," says Denver physical therapist Eric Robertson, who has osteoarthritis. Robertson knows what it's like to be achy when he first starts moving. Your knee may hurt and ache, but it shouldn't keep you from doing your usual activities,...
Can I still do the things I enjoy doing, like golfing, shopping or playing with my grandchildren?
Do the medications I take, and/or physical therapy, still alleviate the pain reasonably well?
Can I sleep at night without waking up multiple times due to pain?
Can I still do daily activities, like getting out of a chair, going up and down stairs, using the toilet, and getting into and out of the car without much difficulty?
If the answers to all of these questions are yes, then you probably don’t need to consider joint replacement surgery yet. On the other hand, if you answered “no” to most of them, then you should discuss joint replacement surgery as a possible option with your doctor.
Just because your arthritis is severe enough to warrant joint replacement surgery, however, does not mean you are automatically a safe candidate for an operation. There are several conditions that may make joint replacement surgery riskier, including:
Obesity. Your doctor may ask you to lose some weight before undergoing surgery, which will both lessen the risks of surgery (such as infections, bleeding, and problems with anesthesia) and give your new hip or knee a better chance of success.
Age. If you’re in your 90s, your doctor may discuss with you whether or not the risks of surgery are greater than the long-term benefits you may get from a new joint.
Bone density. Severe osteoporosis needs to be considered and treated before undergoing joint surgery.
Preparing for the Surgery and Its Aftermath
Before you consider surgery, you will also need to prepare for what comes afterward and have realistic expectations of how much improvement to expect and how much work you will need to do to get the best outcome.
The vast majority of people who undergo joint replacement surgery experience dramatic reductions in pain and a great improvement in their ability to do everyday things like going to the store, cleaning house, walking around town, and engaging in light exercise like walking, swimming, ballroom dancing, and stair climbing.
But a joint replacement is not the original joint, and you can still have some restrictions on your activities. High impact activities should be avoided for the rest of your life. Here are some activities that you should probably avoid after hip or knee replacement, but speak with your doctor first:
Jogging, running, or skiing
Playing football, basketball, soccer, and other high-impact sports