Joint Replacement Surgery
Joint Replacement Surgery
Hip and Knee Joint Replacement
Although I am primarily a hip surgeon, I also still do knee replacement surgery and procedures aimed at preserving the knee joint prior to replacement. As such I have insight into both procedures.
Hip replacements do not only relieve pain, but also improve function and range of motion to near normality. Knee replacements however, are for pain mainly. They do not come anywhere close to given you the knee you were born with. Knee replacements are more painful operations and take longer to recover from. Knee replacements have a higher complication rate and their mechanical nature is more evident to the patient.
Basically, you have to earn a knee replacement more than you do a hip replacement. Hence, knee replacements are preferably done mostly over the age of 60 versus hip replacements which are often done in the late 40's or 50's.
Joint replacements are done because the cartilage has disintegrated or worn out to a point of no return. By return, I mean any form of conservative joint preservation surgery or non-surgical intervention. Most importantly the cartilage loss has resulted in pain and disability that has negatively impacted your quality of life or indeed your health. On occasion the joint destruction may have resulted in deformity or loss of movement that negatively impacts other joints, like the spine, without generating pain directly. This too is a reason to replace the joint.
The modern joint replacement procedure, hip or knee, has improved a lot on many fronts. With these improvements we have been able to minimise the complication rates and lessen the overall pain and suffering experienced by the patient. The implant materials have also improved to lower the wear rates and thus hopefully the lifespan of the implant.
The approach to joint replacement surgery has become more soft tissue friendly and more accurate. The latter relates to better translation of preoperative planning to the actual surgery by making use of the digital age.
Modern medication allows for safer anaesthesia and better post operative pain control. We encourage all my patients to move the surgical limb on the day of surgery. Some even manage to walk around the bed. On average the hospital stay is 2 to 4 days and no one is discharged on addictive pain controlling opioids. They do not need them by the time they go home. By no means is joint replacement surgery pain free initially, but the outcomes are great within a very short space of time in the majority of patients.
Before and after X-rays for a left total hip replacement