This post was written based on the appearance of Dr. Roy Small, orthopedic surgeon, on the television program PBS HealthLine.
Advancements in surgical approaches and assistive technology have changed what joint replacement can look like, offering patients more alternatives for individualized procedures and faster recovery.
What can I try before resorting to joint replacement surgery?
Before discussing surgery, an orthopedic provider typically starts a patient’s first visit with imaging to establish a baseline and determine how severe the arthritis or joint damage may be.
For patients with hip or knee complaints, an X-ray usually makes identifying advanced arthritis easy. If the provider needs more imaging, they may order an MRI.
Treatment typically begins with conservative options, which can include activity modification, such as changing how a patient uses the joint or the activities they do so it’s less painful. Pharmacological interventions may involve anti-inflammatory medications, weight loss, steroid injections and hyaluronic acid injections.
Patients can try a variety of nonoperative treatments either at home or in the office.
Can I have a partial knee replacement instead of a total knee replacement?
The knee joint has three separate compartments: the medial, the inside compartment of the knee; the lateral, or the outside; and then the patellofemoral, the kneecap joint. An orthopedic surgeon can replace any one of those three joints individually.
The inside compartment of the knee is the most common place for arthritis to develop. In these cases, a surgeon can resurface the inside of the knee, using robotic assistance. This is much less invasive than a full knee replacement and preserves more of the ligaments on the inside of the knee. The ACL also stays, which is normally removed during a full knee replacement. This type of surgery often leads to more natural knee motion and faster healing. For most, recovery typically takes around six weeks versus three months for more invasive procedures.
What is robotic surgery, and how much control do surgeons have over what happens during the procedure?
Robotic-assisted knee replacement can support several stages of care. Before surgery, the orthopedic team may use a CT scan of the hip, knee and ankle to create a three-dimensional model of the knee and plan the procedure before the patient enters the operating room.
During surgery, the robotic platform acts as a guided saw tool that helps the surgeon make very accurate, precise bone cuts. The surgeon still performs the procedure manually. The technology supports both surgical planning and execution.
For partial knee replacements, the system uses a burr tool to carve out the specific area needed for the implant with sub-one-millimeter accuracy.
How long does it take to recover from total knee replacement surgery?
Patients undergoing total knee replacement should expect recovery to typically take about three months, although full recuperation can take up to six months.
Most procedures are performed as same-day surgeries, with patients walking shortly after surgery and returning home the same day. Patients generally start with a walker, progress to a cane within the first week or two and begin physical therapy between days three and five.
During the first two weeks, patients focus on rest, ice and elevation to control swelling. Weeks two through six focus on regaining motion and mobility. From around weeks 6 to 12, patients work on rebuilding strength.
Most patients can return to many of their usual activities by the 12-week mark, while strength, walking ability and activity levels may continue improving for up to six months.
Will I need another joint replacement later in life?
Hip and knee replacements have excellent long-term survivorship. After 30 years, more than 90% of implants are still functioning.
For most patients, one joint replacement may last for the rest of their life. Newer press-fit implants can also attach directly to the bone without cement, allowing a patient’s own bone to grow onto the implant.
Can hip replacement be done as an outpatient procedure?
In general, recovery is a little easier after a hip replacement than after a knee replacement. There are a few reasons for that, but similarly, it’s a same-day procedure. With an anterior hip replacement — when a surgeon accesses the joint through the front of the thigh —most patients can walk and return home the same day.
How long does it take to recover from hip replacement?
After a direct anterior hip replacement, patients may not routinely need physical therapy.
During the first couple of weeks, patients focus on rest while continuing to get up and move to keep blood flowing. From weeks two through six, they typically continue recovering on their own.
Hip replacement recovery generally takes about six weeks. After that, the orthopedic team may take X-rays to check the implants before allowing patients to return to activities as they feel comfortable.
Find care
Having surgery is a big commitment. However, if you’re experiencing pain in your joint, having it replaced could help you enjoy life again. Talk with your healthcare provider about your options for joint replacement.
To schedule orthopedic care in Allen County, call Ortho NorthEast at 260-484-8551 or click to request an appointment. To find orthopedic care outside of Allen County, click to view PPG - Orthopedics locations.
