Is It Time for a New Joint?

Millions of us struggle with pain and loss of motion because of joint damage caused by arthritis. If other treatments don’t help, you may wonder about turning in your worn-out joints for new ones.

Surgery may not be your first choice. But if you are a candidate for total joint replacement, know that more than 90% of people have good to excellent results. They get relief from pain and can return to normal daily activities.

Should you have surgery?

Joint replacement should be a final step in treatment. Other treatments are often suggested before joint replacement. They are:

• Using pain medicine

• Losing weight to ease stress on the joint

• Cutting back on activities that cause pain

• Doing exercises to keep muscles and joints flexible, promote fitness, and strengthen muscles that support damaged joints

While most people having joint replacement surgery are in their 60s or older, younger people may have it when their condition supports it. But younger people may have other choices available to them. They may be able to change to a less physically demanding job. Or they could have a different type of procedure that realigns or only replaces part of a joint.

The younger you are when you get a new joint, the more likely you are to need surgery to revise the joint replacement in the future. Surgery to fix or replace artificial joints has an increased risk of infection and other problems. Because healthcare providers shape and remove bone to accept the new joint, repeated surgery also leaves less bone to attach to each new joint.

When do you need surgery?

An X-ray showing joint damage is one of the factors used to decide who should have this surgery. Your pain and other symptoms are the main things to keep in mind when deciding. This is mostly a quality-of-life decision.

Think about joint replacement surgery if you have one or more of these symptoms:

• Severe pain during activity, such as walking or getting up from a chair

• Pain that stops you from doing some activities

• Pain at night that prevents you from sleeping

What can you expect?

To get ready, work with your healthcare provider. Have dental problems fixed before surgery to lower the risk for infection. Any health problems should be addressed before surgery.

Some people go home the same day of the surgery. Some people stay in the hospital for 1 to 3 days or go to a rehab facility. This depends on several factors, such as pain control, mobility, and medical stability. After your surgery, you will work with a physical therapist. Many hip and knee patients can walk the same day using a walker.

At first, you may need items like crutches or a walker after a hip or knee replacement. Within a few months, you should be able to return to most of your normal daily activities without help. You may still need physical therapy.

After shoulder replacement surgery, you’ll start a gentle exercise program. This program may begin as soon as the day of your surgery. Your exercise program is a vital part of your recovery. How much strength and movement you regain in your shoulder and arm depends on how well and often you do your exercises.

Recovery from joint replacement surgery may involve some pain for 2 to 3 months or more. But it's often a different type of pain and will improve as you get better.

Will a new joint last?

Experts warn against unrealistic expectations for a new joint. You shouldn't expect it to bear activities that involve jumping or the kind of stress that would be hard on a natural joint. Your healthcare provider will tell you what activities you shouldn't do after surgery. They may also tell you to stay away from certain joint positions to prevent dislocation of the joint. The limits given will depend on the joint that is replaced, as well as your situation.

An artificial joint will eventually change from wear and tear, even under normal use and activity conditions. It may need to be replaced at some point. Artificial joints often last 10 to 15 years or more. A person who is younger at the time of the surgery may one day need to have the new joint replaced. The good news is that new materials are giving artificial joints a longer life span.