Frequently Asked Questions
I have heard that people should postpone joint replacement surgery as long as possible. Is that correct?
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Not always, once your orthopaedic surgeon tells you the Xray or MRI is bad enough to consider joint replacement, the rest depends on how symptomatic and painful the joint is. Once your arthritic hip or knee stops you from enjoying everyday activities and impairs your quality of life, it is time to consider treatment. Sometimes non-operative treatment with physical therapy, medicine, injection, or bracing can eliminate or delay the need for surgery. If non-operative treatment fails, there often is no good reason to put off surgery and live with the pain. Joint replacement surgery is very successful and results usually last for 15 years.
What can I expect during recovery and rehabilitation from joint replacement?
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Each patient recovers differently. Patients are usually in the hospital 2-3 nights, relatively home-bound for about a month, taking pain medicine for a few weeks, and 90% recovered by three months, these are rough averages. Many patients recover faster and some slower than these parameters.
Am I going to have much pain after surgery?
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Many patients find that the pain after surgery is tolerable, treatable, and subsides gradually over a few weeks. Post-operative pain must be properly managed so that the patient is able to perform the necessary physical therapy. Therefore, multiple modalities are incorporated into the post-operative pain regimen including nerve blocks, numbing injections, long and short acting oral pain medicines, IV pain medication, and anti-inflammatory medications.
How long will I be in the hospital?
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The typical hospital stay is two to three days.
Should I be concerned about anesthesia during surgery?
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Modern anesthesia is very safe and spinal anesthesia is recommended for almost all patients that undergo hip or knee replacement at our institution. The spinal makes you numb from the waist down for a couple hours. The anesthesiologist will give you plenty of sedation so you are not anxious, and may not even remember anything about the procedure. You will be very relaxed. The anesthesiologist also usually places a femoral nerve catheter using ultrasound guidance for knee replacements.
Will I recover at home or at a rehabilitation facility?
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Most people are able to go home soon after surgery. A few need to recover at a rehabilitation center. This decision depends on the availability of family or friends to help you with daily activities; home environment and safety considerations; and your overall evaluation after surgery. Dr. McCrosson, the Roper case worker, the applicable rehabilitation hospital(s), and your insurance company participate in the decision, which cannot be made until after surgery.
When can I resume normal activities, such as working or driving?
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Many patients are able to drive again in three to six weeks, so long as you can tolerate not taking narcotic medications. If your job is not physically demanding, you may be able to return to work after four to six weeks, however some patient require up to three months to return to work. A few go back to work in one week. You can control some of your recovery, but not all of it. Patients should plan on being out of work for at least a month, but hope that they may be ready for sedentary work sooner.
What about minimally invasive surgery?
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There are some early studies of minimally invasive surgery (MIS) that have shown benefits such as less blood loss, shorter hospital stays, and better motion. Other studies, however, have shown more complications, poor implant positioning, and no difference in the length of recovery. Dr. McCrosson performs minimally invasive hip replacements, however he has concerns about minimally invasive knee replacements. A surgeon's experience and expertise is more important that the incision-size, he believes.
How long will the implant last?
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The success of your joint replacement is measured by whether or not you are satisfied with the decrease in pain and the increase in mobility you should have, as well as the durability of your implant over time. Hip and knee replacement in general are very successful operations. In fact, according to an Arthritis Foundation study, outcomes for total hip and knee replacement generally have 90% to 95% patient satisfaction and many implant designs have a lifespan greater than 95% at 10 and 15 years.
How can I pay for my knee replacement?
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Knee replacement surgery is considered medically necessary and is typically covered by both private insurance and Medicare. Your out-of-pocket expenses may be impacted by either your co-pay or deductible, so you should check with your insurance company for complete information. If you do not have private insurance or Medicare, you may want to visit the website www.covertheuninsured.org to research resources in your area.
How can I prepare my family and myself before surgery?
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Roper Hospital offers a pre-operative free educational joint replacement class. Roper Hospital has also prepared Hip and Knee Notebooks with valuable information available to you. Speak with your family members and/or friends about the role they will play in your recovery. Explain the recovery process to them and the care you will need after surgery.
What else should I be aware of?
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The way a hip or knee replacement will perform depends on your age, weight, activity level and other factors. There are potential risks and recovery takes time. If you have conditions that limit rehabilitation you may not be a satisfactory candidate for joint replacement surgery.