What is Joint Replacement?
A joint replacement is a surgical procedure in which a worn or injured joint is replaced with an artificial joint. The surgery will benefit you by reducing pain, increasing strength, and providing easier movement.
How is the joint replaced?
An incision is made through the skin over the location of the joint. For a knee replacement, the incision is made on the front or side of your knee and the damaged bone is cleared away. The surfaces are prepped and shaped to hold the new joint. The new joint is aligned and secured to the remaining bone in the joint.
How long will the surgical procedure take?
The actual time in surgery is one to two hours, but the total time in the surgery area, including the preparation and time in the recovery room, will be two to three hours, on average.
Will I need blood after the surgical procedure?
A small percentage of patients require a blood transfusion - this depends on your pre-operative blood count, and other factors that are patient-specific. You can talk to you surgeon about "donating" your own blood ("autologous" donation). If you choose this option, this process may begin up to 35 to 40 days prior to surgery, but no longer than 42 days (shelf-life of donated blood).
How long will I be in bed and how long will I be in the hospital?
You will be assisted out of bed the evening of your surgery. Patients who are active immediately after surgery have a smoother recovery and fewer complications. You will be assisted out of bed the morning after surgery for breakfast and you will be eating while sitting in a chair for all meals afterwards. The standard of care is for patients to remain in the hospital for 3 days after surgery after which time discharge to home or an intermediate care setting is arranged.
Will I have pain during and after the surgery?
An anesthesiologist will work closely with your surgeon during the operation. The anesthesiologist will administer medications to control your pain. You may either be given General Anesthesia, in which you will be unconscious during the procedure or a spinal anesthetic or nerve block to block the pain around the incision. What you receive will depend on the type of surgery, your health history, and what the anesthesiologist feels is best for you.
General anesthesia is given through an intravenous line or by breathing s special mixture of gases from a mask. It is like a deep sleep that happens very quickly. Spinal anesthesia is given through a catheter that the anesthesiologist inserts into your spinal column or nearby your surgical site. These medications may cause numbness from the mid-chest area all the way down to your toes.
After surgery, you will have some pain, but your physicians will order medications to control your discomfort. The nursing and rehabilitation staff will get you moving soon after surgery - this has proven to lessen pain by promoting blood circulation and increasing joint motion. Your physicians will try to avoid the use of narcotic medications as these alter your appetite and decrease your ability to participate in your care.
Will I need to exercise prior to surgery?
When possible, patients are encouraged to exercise to develop as much mobility as possible prior to surgery. Good muscle tone facilitates the recovery process. Your surgeon or a physical therapist can assist you by making suggestions for exercises for you to perform prior to surgery.
Will I need physical therapy after surgery?
Physical activity after surgery is very critical to your successful recovery. You will need some form of assistive device (i.e. walker or crutches) to provide support when you walk.
While you are in the hospital, you will have frequent visits by the rehabilitation staff. You will have assistance with your walking and you will have progressive increases in the distance you will walk.
Patients benefit greatly with physical therapy once discharged from the hospital. Therapy will help you strengthen your muscles and will increase the mobility of your joints. Outpatient therapy will be arranged for you by the Joint Center staff. Your surgeon and therapist will determine how long you will need this assistance.
Will I need help once I return home?
Most joint replacement patients can return to their homes while needing only a few hours of assistance per day. You may need help with dressing changes and routine activities around the house. Many patients will become independent quickly as the joint heals from surgery. Some patients benefit from a Home Health Nurse or Therapist or take advantage of an extended care/rehabilitation facility. This can be arranged for you when you are still in the hospital. It's suggested that patients visit facilities in their neighborhoods before the day of surgery in the event such care is necessary.
When do I see the surgeon after I leave the hospital?
You will have your first office appointment scheduled for you before you leave the hospital. You should expect to visit the surgeon within 2 weeks after being discharged so that he/she can check your incision and to assess your rehabilitation progress. Additional visits will be scheduled during that first office visit.
Will my joint feel different than before surgery?
At first you will experience pain which will then progressively reduce to milder discomfort. Some patients feel numbness around the surgical incision. You may hear or feel clicking noises - this is just the artificial surfaces moving against each other, and is not something that should cause you concern. You will have a scar at the surgical site, and your care team will give you instructions on how to care for the site. Over time, the redness and swelling at the site will diminish, but there will always be some evidence of a surgical incision.
When will I be able to drive?
Your surgeon will provide this instruction prior to your discharge, but in general, you will have some restrictions for a month or longer.
What activities will be restricted?
You will not be able to do activities that are high-impact (running, jumping), and it will be recommended to avoid lifting heavy objects. Cycling, walking, swimming and other activities of daily living are encouraged, but speak with your physician or therapist if you have specific questions. You will be given more detailed instructions before you leave the hospital and also during your outpatient therapy sessions.
When will I be able to return to work?
In general, it is recommended to be off of work for one month. Of course, this is dependent on your occupation (i.e. active or sedentary) and your own personal recovery. You will get more specific information after your surgery and as you work with your surgeon and therapists.