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Expert Opinion
From the professionals at East Jefferson General Hospital 

From the Professionals at East Jefferson General Hospital

One of the fastest growing surgical procedures in the United States is joint replacement. The number of surgeries performed is expected to rise rapidly in the coming years as more and more Americans seek hip and knee joint replacement surgery as a way to alleviate pain and to regain the ability to do certain activities.

Although replacing the entire joint is not the first line of treatment physicians recommend, it is becoming more widely used as medical procedures advance and materials used to make the prosthetic joints improve.

When choosing a physician or hospital for the procedure, it is recommended that you inquire about patient volumes for both the physician and the facility as well as their success rates. Research shows that there is a direct correlation between the number of procedures performed and the amount of post-operative complications. The Journal of Bone and Joint Surgery reported that patients of surgeons and hospitals that do higher volumes of joint replacements had a lower risk of post-operative complications. This leads to lower incidents of infections and other serious adverse effects.

Several studies recommend that patients choose a hospital that has performed more than 100 hip replacements and more than 200 knee replacements a year and a physician who performs more than 50 procedures a year.

Causes of joint pain vary from person to person and are not specific to age groups. Oftentimes the surgery is viewed as something primarily geared to remedy an injury from sports or an accident. However, patients with arthritis, degenerative joint diseases and just normal wear and tear on the joints over time require replacement the most.

An alarming trend orthopedic surgeons have noticed is the number of surgeries necessitated by obesity. The Centers for Disease Control and Prevention estimates that obesity in the United States has risen 23 percent in the last decade. The extra weight puts increased pressure on the knees and hips, leading to a breakdown of the joints.

"The result of the joint replacement surgery is a dramatic reduction, or even elimination, of pain these individuals may experience on a daily basis," says Laurie Norman, a registered nurse and the Orthopaedic Clinical Educator for East Jefferson General Hospital. "The quality of life goes up and they can participate in activities they haven't been able to do in years."

More than 400,000 hip and knee replacements are performed annually. Before surgery is recommended, however, your physician should closely examine the joint to determine the cause of the pain or the reason you have a limited range of motion. The examination may include taking X-rays of your joint and performing an arthroscope procedure to look for damage to the joint and tissue. To alleviate pain, your physician may also recommend certain anti-inflammatory drugs, physical therapy or walking aids.

If these treatments are not effective, a total or partial replacement may be the next step. The procedure usually lasts about two hours and requires the patient to stay in the hospital three to five days after the surgery. The prosthetic joint that will replace the natural joint usually is made of certain types of plastics or metal.

"Many patients recover from the surgery beautifully," says Norman. "Over the past two years we have done over 1,100 procedures, and the success rate is over 90 percent. Patients are out of the bed and starting to walk the next day, and some doctors are getting patients out of bed the day of surgery. After discharge from the hospital, it is important to continue performing the rehabilitation exercises and follow the schedule set by the doctors."

As with any surgery, complications can occur, Norman says. Patients should notify their doctor if they experience increased pain, develop an infection or dislocate the joint. A more serious complication is the potential for blood clots. To help reduce the risk of blood clots, your doctor may recommend that you get back on your feet as soon as possible, take prescription blood-thinning medication or exercise to increase blood flow to the lower extremities.

The prosthetic joints being used today can last between 15 and 20 years and may need to be replaced, especially since patients today tend to be younger when they undergo the surgery than those in the past were.


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