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Joint Replacement Center

Frequently Asked Questions

What are the causes of serious hip and knee problems?

Problems with major joints like the hip and knees are usually the result of arthritis.

Osteoarthritis is the most common form of arthritis. It is most often related to “wear and tear” on the joints over the years. Its onset is usually after age 50. Factors that predispose someone to this condition include family history, obesity, previous surgery or fractures in the area of the joint.

Rheumatoid arthritis is a chronic inflammatory disorder affecting the joints. These joints include the hip, knee, shoulder, elbow, wrist, hands and feet. Rheumatoid arthritis is likely autoimmune in origin, which means the body produces cells that irritate the membranes in the joint, leading to destruction of the cartilage. This form of arthritis may occur in any age group and is characterized by stiffness, swelling in the joints, pain and decreased range of motion.

What is total knee replacement surgery?

The knee joint is composed of three parts: the end of the femur (thighbone), the top of the tibia (shinbone), and the patella (kneecap). In a normal knee, these three bones are covered with a smooth cartilage that cushions the bones and enables them to move easily. In the arthritic knee, the cartilage layers are destroyed, resulting in bone rubbing against bone, which causes pain, muscle weakness and limited motion.

Total knee replacement surgery involves the resurfacing of the knee joint. Metal components are attached to the ends of the bones and a plastic liner is inserted between them. The kneecap is resurfaced with a plastic liner. These components move together to allow normal motion of the knee joint. Bow leg or knock knee deformity can usually be corrected by the new alignment.

What is total hip replacement surgery?

The hip joint is composed of two parts: the round head of the femur (the ball) and the acetabulum (the cup or socket in your pelvis). In a normal hip joint, these two bones are coated with a smooth articular cartilage that allows them to move against each other without friction or pain. In an arthritic hip, the cartilage layers are destroyed, and bone rubs against bone, causing pain and limiting motion.

Hip replacement surgery replaces your arthritic hip joint with an artificial joint composed of a ball component and a socket component. The metal ball is attached to a stem that fits into your thighbone. This component can be cemented or non-cemented depending on your age and the condition of your bone. A socket with an outer metal socket is secured into your pelvis. A combination of a cemented ball and a non-cemented socket may also be used. Your orthopaedic surgeon will choose the type of prosthesis that best meets your individual needs. Once in place, the artificial ball and socket function in essentially the same manner as your natural hip.

What are the risks associated with joint replacement surgery?

As with any surgery, you should be aware that there are risks involved. These risks could include, but are not limited to, problems with anesthesia, infection, bleeding, blood clots, nerve or blood vessel damage, dislocation or failure of the joint replacement, unresolved pain, stiffness in the joint and death. Be sure to discuss the risks and benefits of surgery with your physician.

What results can be expected from a joint replacement?

Anticipated results are increased mobility and range of motion in the affected joint, giving you the ability to resume an active lifestyle with little or no pain, and deformities corrected. Long-term success rates vary from 10-20 years, depending on age, weight, activity level and other factors.

Each person is different, so you should discuss expected outcomes and results with your orthopaedic surgeon.

Why do I have to wear elastic stockings (TEDS) and how long do I have to wear them?

You will need to wear the TED stockings to help prevent blood clots in your legs. These are long, tight fitting “socks” that keep mild pressure on the legs. Your surgeon will specify how long you should wear them, but typically they are worn four to six weeks after surgery. If you have a history of poor circulation, you may be required to wear them for a longer period of time.

What are hip precautions and how long do I need to maintain them?

Hip precautions are instructions about which positions the leg should be kept in order to prevent the artificial hip from becoming dislocated. Your surgeon will advise you on how long you need to maintain hip precautions, but it is typically six to eight weeks after surgery. Further instructions will be given during your educational classes. Hip precautions do not apply if your surgeon uses an anterior approach to surgery. Your physician will determine if you are a candidate for the anterior approach.

When can I start driving?

Your surgeon will advise you on when you will be able to operate a motor vehicle. Typically, you will be able to drive six weeks after surgery. You should never operate a motor vehicle if you are taking pain medications.

How long should I continue to do the exercises?

Exercise should be done until you have met the goals set by you and your physical therapist. Regular exercise should be a lifetime commitment for everyone.

What are my discharge goals?

You will be able to go home safely when:

Hip goals:

  • Get in and out of bed

  • Get up and down from chair and toilet

  • Get in and out of the shower by yourself

  • Walk with a walker on a level surface for 250 feet

  • Be able to go up and down stairs if you have them at home or where you’ll be recovering

  • Understand all the hip precautions

  • Get dressed with hip precautions

  • Get in and out of your car

  • Perform hip exercise program independently

Knee goals:

  • Get in and out of bed

  • Get up and down from chair and toilet

  • Get in and out of the shower by yourself

  • Extend your knee to zero degrees

  • Bend your knee to 90 degrees

  • Walk with a walker or crutches on a level surface for 250 feet

  • Be able to go up and down stairs if you have them at home or where you’ll be recovering

  • Get dressed

  • Get in and out of your car

  • Perform knee exercise program independently