As an orthopedic surgeon specializing in hip and knee joint replacement, I see many patients who have gone through all possible treatments to manage their joint pain and are now grappling with the question of having surgery. Part of that decision-making journey includes asking questions, and there are some common themes. We encourage our patients and anyone undergoing medical treatment to ask questions of their care teams. Here are answers to some commonly asked questions about joint replacement surgery.
Are joint replacement surgeries minimally invasive?
Yes. Joint replacement surgeons aim to remove only the damaged or diseased parts of the joint that is affected by arthrosis (also known as osteoarthritis), respecting natural soft tissue planes, and then replace or resurface joints with safe, durable, biocompatible materials. We also work to incorporate newer techniques and technologies into surgery, based on best evidence, which minimize trauma to the healthy and normally functioning structures and soft tissues surrounding an arthritic joint.
Minimally invasive techniques allow us to avoid cutting any muscles around the joint, which leads to less pain, faster recovery, and excellent outcomes.
Always ask your surgeon about the types of surgery available for your procedure, as there are a wide range of options. For example, at the Total Joint Center at The Miriam Hospital, we have many successful minimally invasive techniques for hip, knee, or shoulder replacements used by excellent surgeons.
How is the replacement attached to my bone?
There are two main methods in use: cement or ingrowth of patient’s own bone. Cemented implants have been the gold standard for years and provide good immediate fixation, but we are always striving to improve outcomes and reach that next level. While cemented implants are an excellent option for some patients, in younger, more active patients, cement can loosen over time. Using a knee replacement implant that is fixed through ingrowth of a patient’s own bone avoids an intermediary fixative and has the promise of providing a stronger, more durable and longer lasting knee replacement in our high activity patients.
We have been at the forefront of cementless technologies at The Miriam Hospital. We were the first in New England to trial some of the newest 3-D printed titanium total knee replacement designs, and in our ongoing studies, these designs have shown to be very promising for longer term fixation of implants.
How quick is recovery from joint replacement?
Recovery varies depending on each individual. On average, a knee replacement patient might feel recovered from surgery by six weeks. A hip replacement patient may feel recovered in one month. For full recovery, it takes about a full year.
Based on statistical evaluation of our results and those of our peers, the vast majority of our patients will benefit from joint replacement surgery with SIGNIFICANT pain relief and improvement of function and motion.
Will I have pain after surgery?
Yes – despite our advanced replacements, surgical techniques, and anesthesia blocks, most patients feel some degree of pain after surgery. We have made great strides with the incorporation of multimodal pain control at The Miriam Hospital, which includes medications we deliver before, during, and after surgery, specialized anesthesia techniques using spinal anesthesia and nerve blocks in some instances, and of course, state-of-the-art minimally invasive surgery.
Still, it is normal for patients to feel pain during their period of recovery. Knee replacement surgery is typically a little bit more painful in the postoperative period compared to hip replacement surgery and recovery takes a little bit longer.
Having the right attitude is key. It’s important to be goal-oriented and motivated, and stick with the physical therapy regimen for knee replacement patients. For knee replacements, since regaining range of motion is so essential to a patient’s success, it is much more common for patients to use strong pain medication as prescribed in the first six weeks to control their pain in order to perform optimally at physical therapy.
Hip replacements tend to be less painful. Most commonly, patients use a combination of Tylenol and oxycodone to manage pain. We encourage patients to taper pain medication as early as possible due to its addictive potential and our commitment to responsible prescribing. That said, these medications can be beneficial, so we continue to prescribe them carefully for our patients.
Ice can be beneficial early after surgery. We are also trialing newer pain medications and modalities of treatment, including patches and other new approaches. As a leading academic center of excellence, we aim to connect patients to state-of-the-art treatments locally and beyond.
Are the replacements you use custom made for me?
Everyone is a little different and replacing an individual’s joint is not one size fits all. Your implant will be sized specifically for you. We are after the best results—putting that extra effort into planning and preparation leads to consistently excellent results and likelihood of long-term success.
Here at Brown University Health, we are fortunate to have exceptional caring professional people in our surgical teams as well as the resources to support multiple different technology-assisted options for the benefit of our diverse joint replacement patients. If you are experiencing joint pain that is preventing you from living an active life, the Total Joint Centers of Brown University Health can help you determine if joint replacement surgery is right for you and answer these and any other questions you may have.
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