When to consider knee or hip replacement

The answer depends on you, according to Marshfield Clinic joint replacement surgeons.

“Patients are encouraged to come to their decision about knee replacement or hip replacement on their own and take their time,” said Dr. Mark Earll, an orthopedic surgeon at Marshfield Clinic. “Most patients look back after having the surgery and wish they would have had it done sooner.”

Arthritis commonly causes joints to become painful and stiff because cartilage – the tissue that protects bones in a joint – breaks down and wears away. Treatment usually starts by trying more conservative approaches such as medication, physical therapy and changes to physical activity before considering joint replacement surgery.

Factors in the decision

“Patients visit our office and describe symptoms ranging from very mild to severe,” said Dr. David Simenstad, also a Clinic orthopedic surgeon. “The first visit focuses on understanding their condition and possible treatment approaches. But the decision is really about an individual’s quality of life while considering the risks and benefits of specific treatments, including surgery.”

Joint replacement implants can last a long time, but not forever.

“Although joint replacement implants have improved, younger patients need to consider they have higher probability of needing to replace the joint again during their lifetime,” Simenstad said.

The number of younger people needing joint replacement is expected to increase over the next 30 years. This is coupled with more people being heavier overall, a health problem that also affects knee and hip health.

“Weight loss can improve overall health and have an impact on joint pain,” Simenstad said. “To prepare for surgery and help with recovery, we encourage patients to make lifestyle changes promoting weight loss and smoking cessation. We expect patients to take an active role in their recovery.”

Talk about expectations

Joint replacement can substantially improve pain and function, Earll said.

“But I don’t want anyone to think they’re going to feel like they did when they were 20,” he said. “Most high-impact physical activity is discouraged after surgery.”

Recovery for knee and hip replacements usually requires one to three days in the hospital and may include physical therapy. Often patients are able to get out of bed and weight-bear on their new joint the same day or day after surgery.

“We want you to get moving again doing some common-sense activities around the house,” Earll said. “In about six weeks you may feel pretty good, but it may be several months before the recovery is fully behind you.”

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