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Hip Pain
When To Consider Joint Replacement
Can I have a joint replacement at my age?
After the age of 80, some individuals may feel they are too old for joint replacement surgery. However, these individuals should consult with their doctor and base their decisions on the quality of their present life. As long as an individual has reasonably good potential for walking after surgery, then joint replacement may be appropriate, regardless of age. Joint replacement was once limited almost entirely to individuals over 60 years of age because these individuals usually subjected their new joints to less stress than younger individuals. Due to improved implants and techniques, increasing numbers of younger individuals are receiving joint replacements. Currently, about one-third of hip replacements are in adults less than 65 years of age. Joint replacement is a highly effective and successful procedure. Close to 3% of all individuals over 65 years of age have at least one artificial joint.
If I have a joint replacement, how long will I have to be in the hospital?
Every individual is different and every treatment plan is different. The length of hospital stay after joint replacement varies and depends on many factors including age and physical ability.
You should discuss your post-operative treatment plan with your health care provider. Usually patients are encouraged to stand and walk (with help) a few days after surgery. Your health care provider will tell you when the time is right for you.
As the days progress, the patients usually become more independent using two crutches or a walker. Physical therapists and nurses give the patient instructions on:
- How to get out of bed
- How to use the bathroom
- How to get dressed
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Will I have to go to a physical therapist after the surgery?
Your orthopaedic surgeon works closely with nurses, physical therapists, and other health care professionals to ensure the success of the surgery and rehabilitation. Following joint replacement the physical therapist begins an exercise program to be performed in bed and in the therapy department. The physical therapist or another member of the staff works with the patient to help the patient:
- Regain muscle strength
- Increase range of motion
Discharge from the hospital depends, to some extent, on when the patient "graduates" from physical therapy. The physical therapist will often give the patient a list of activities, exercises, and "do's and don'ts" when he or she leaves the hospital. In addition to the physical therapist, an occupational therapist or nurse may work with the patient to assist with special needs.
What are the risks of joint replacement surgery?
Serious complications may occur with any surgical procedure. These include but are not limited to: problems with anesthesia, cardiovascular problems including heart attack, vascular problems including thrombus, bronchopulmonary problems including emboli, genitourinary problems, and gastrointestinal problems. Certain additional complications related to joint replacement surgery in particular may include but are not limited to: bleeding problems, blood clots in the legs and/or lungs, wound healing problems, damage to nerves and blood vessels, limb length discrepancy, bone erosion or abnormal bone formation, dislocation, infection, pain, bone fracture or non-union, component wear or fracture, component loosening. Complications may require medical intervention including additional surgery and, in rare instances, may lead to death. Your doctor should discuss these potential complications with you. Blood clots are the most common complication. To prevent blood clots following surgery, your orthopaedic surgeon may prescribe measures such as:
- Special support hose
- Medications to thin your blood
How much blood would I have to deposit before joint replacement surgery?
Two units of blood is usually the amount which is suggested for pre-deposit prior to joint replacement. This blood can be deposited up to 42 days before surgery, but is needed at least 14 days before surgery. After pre-depositing blood, the patient is usually given an iron supplement and a healthy diet is encouraged to ensure an appropriate blood count before surgery. Some patients may not be allowed to pre-deposit blood if they have conditions such as heart failure, cancer, or anemia.
What things can I do after joint surgery?
The vast majority of individuals who have joint replacement surgery experience a dramatic reduction in joint pain and a significant improvement in their ability to participate in the activities of daily living. However, joint replacement surgery will not allow you to do more than you could before you developed your joint problems. Your health care provider will tell you what activity level is best for you. Your health care provider will let you know when you can resume driving your car.