Signs You’re Ready for Knee Replacement

If you’re thinking about having knee replacement surgery, you’re in good company. Every year, more than a half-million Americans opt for the procedure.

Many people have knee replacements (also called knee arthroplasty) because they have osteoarthritis. This condition occurs when the cartilage (tissue) that cushions the knee joint wears away. As a result, bone rubs against bone, which is quite painful. Other people may need a new knee because they have rheumatoid arthritis, a disease that causes chronic joint inflammation. Still others may have had an injury causing knee pain and limiting function. These conditions are known to cause gradual worsening of knee pain over a long period of time. It’s not always easy to know when knee replacement surgery is necessary. You and our doctors will take several factors into account in deciding if (or when) joint replacement is right for you. These factors include your X-ray or MRI results, pain level, physical function, personal health history, and weight.

Here are high-level guidelines that can help you prepare for a conversation with your our doctors about moving forward with knee replacement.

Why You Might Say “Now’s the Time” 

Here are seven signs that the time might be right for a knee replacement:

  1. Medications—even stronger anti-inflammatory drugs—don’t help, or no longer help ease your pain. 
  2. Other less invasive treatment options don’t effectively reduce your pain and inflammation. These may include cortisone injections, lubricating injections, rest, and physical therapy. 
  3. You have lots of difficulty and pain performing everyday tasks, such dressing, bathing, getting out of bed or a chair, or climbing stairs.
  4. You need the aid of a cane or walker to get around. 
  5. Your pain is severe day and night. The pain is there even when you’re not using your knee, such as when you’re sitting still or lying down. 
  6. Your knee has become deformed from injury or arthritis. It bows in or out. (However, in some cases, severe deformity can make surgery more difficult. If you start to feel severe deformity, talk with our doctors sooner than later.) 
  7. You are between 50 and 80 years old. Most people who get knees replaced are in this age range. (However, age is not necessarily a deciding factor. Surgeons successfully perform knee replacements on patients of all ages.)

Why You Might Say “Not Yet” 

Here are a five reasons knee replacement might not be right for you—at least for now:

  1. You still have time to give more conservative treatments a chance to work. These options include rest, ice, heat, muscle-strengthening exercises, and pain medications. 
  2. Your pain is bearable, and medications are helping. 
  3. You can still get around and do your normal activities without much difficulty. 
  4. You have weak thigh muscles that wouldn’t be able to support a new knee joint. Or, you have open sores or ulcers in the area that could easily become infected after surgery. 
  5. You are very overweight. Extra weight puts more pressure on your knees, and may move parts of the artificial knee joint. This can lead to pain or further surgery.

Have a Conversation With Our Doctors

Before you make up your mind about having your knee replaced, talk with our doctors about the possible risks of surgery. These can include infection, loosening of the knee replacement parts, and movement limitations. Also, talk about any health conditions you might have that could make the operation and your recovery more difficult.

It’s also important to have realistic expectations for how quickly you will recover from the surgery. It can take several weeks to several months to feel back to normal after a knee replacement. You’ll also need to commit to physical therapy and exercise. Your doctor can talk through the factors that can speed up or slow down recovery, and help you decide if the timing is right.

Under the right circumstances, a knee replacement can significantly boost your quality of life. More than 90% of people who get new knees are able to resume their normal activities shortly afterward and are happy with the results, according to the American Academy of Orthopaedic Surgeons. And pinpointing a good time to have a knee replacement is a key part of having success with the procedure.

When it comes to hip replacement surgery, not all surgeries are created equal

The options you need to know before deciding to have hip replacement surgery

Author: Dr. James Loging, MD, MBA, FAAOS

   You have always enjoyed an active lifestyle until that one day when you start to notice an unusual pain in your hip. You tried to manage the pain hoping it would get better, only to find that over time it has progressively gotten worse. As the pain worsens you find yourself avoiding activities you once enjoyed.  After realizing that the pain will not get better on its own, you decide to see your doctor to see what may be going on.  It’s then that you find out that the pain your experiencing is related to severe arthritis in your hip and that you need a hip replacement to resolve your pain.  This can be a scary and very stressful situation.  But it doesn’t have to be if you know that there are options available to help you recover faster and experience less pain after surgery.

   Most people don’t realize that there are multiple ways that the hip can be replaced by an orthopedic surgeon.  Unfortunately, not all orthopedic surgeons are trained on all the different options available and tend to only offer one approach to patients. They also usually don’t even discuss the approach they will perform with the patient.  The reason for this is because of the type of training the doctor received typically only involves one approach, which is why the orthopedic surgeon only performs that one option for patients.  However, not all the different approaches are created equal and certain ones have significant benefits over others.  The approach that has the most benefits is called the Anterior Approach.

   Anterior Hip Replacement surgery means that the surgeon replaces a patient’s hip by coming from the front (anterior) of the hip. The benefit of coming from the front is that the doctor doesn’t have to cut muscles to replace the hip which makes for a significantly faster recovery compared to all the other methods of replacing a hip. All other approaches, which include posterior, lateral, and anterolateral all must cut muscles and disrupt vital tissues to replace the hip. Other benefits of anterior approach and not cutting muscles include less pain, less blood loss, less risk for dislocation, and more equal restoration of leg lengths. But the biggest thing most patients care about is the faster recovery which allows you to get back to living life without the pain and not having a prolonged recovery process.  Anterior hip replacement is also so less invasive that lots of patients are candidates to have their surgery done outpatient and able to recover in the comfort of their own home with out the need for a costly hospital stay.

Some physicians may recommend a hip resurfacing surgery instead of a hip replacement. A hip resurfacing is essentially a hip replacement but instead of replacing the ball, a cap is placed over the patients existing ball and the hip socket is still replaced as in a hip replacement. Be cautious when considering this as hip resurfacings has lots of potential downfalls. First, for most surgeons to resurface a hip, a posterior approach is performed which cuts most all muscles away from the hip and leads to permanent damage to the muscle that can have detrimental consequences in the future. Second, hip resurfacings are all metal on metal components which have significant well known complications including implant failure, local hip tissue and muscle damage, and absorption of metal fragments that are generated from the metal components rubbing together into the blood stream and traveling throughout the body. This absorption of metal ions has been suggested to lead to numerus health problems including cancer. Hip resurfacings all have a very short and limited lifespan and will all eventually have to be revised to a full hip replacement. For these serious concerns mentioned, hip replacement performed by anterior approach is much preferred to hip resurfacing. Patients also experience a faster and easier recovery compared to hip resurfacing.

   When it comes to anterior hip replacement, experience also matters. If your surgeon hasn’t been performing anterior hip replacement for very long or doesn’t perform it regularly, then you should consider looking for a surgeon who has more experience in the surgery. Surgeons with limited experience have a much higher complication rate and can lead to decreased success of the surgery. Thus, experience matters. Palmetto Bone and Joint has the most experienced surgeon in anterior hip replacement and has been performing this procedure longer and performed more anterior hip replacements than any surgeon in South Carolina.

So, if your contemplating hip replacement surgery, know that you have options and don’t settle for an approach that will affect your recovery and outcome. Call Palmetto Bone and Joint to discuss these options and what’s best for you.

Hip Replacement Facts You May Not Know

Hip replacement is one of the most successful surgeries in all of medicine. Fact or fiction? According to the American Academy of Orthopaedic Surgeons, it’s true. And doctors perform the surgery on more than 300,000 Americans every year. That’s a lot of people who find relief from hip pain and return to their active lives. If this surgery might be in your future, here are some hip replacement facts you should know. 

1. Hip replacement isn’t just for ‘old people.’

Hip replacement surgery relieves pain and improves mobility in people with diseased or damaged hip joints. Arthritis and hip joint injuries are common causes of these hip problems. And these conditions aren’t limited to older adults. In fact, the rate of total hip replacement in middle-aged adults—45 to 54 years—more than doubled between 2000 and 2010. This age group also accounts for an increasing percentage of total hip replacements. What’s more, adults in this age group had a shorter average hospital stay compared to older adults.

2. Hip replacement takes preparation.

Hip replacement surgery will require some preparation. If you’re overweight, you should try to shed some extra pounds before surgery. It will reduce stress on your new joint. Regardless of your weight, you can improve your safety and comfort during your recovery by preparing your home as well. Remove tripping hazards, such as cords and rugs. Make things convenient by getting a reacher, dressing stick, and long-handled bathing sponge. Your doctor can give you other ideas. Check with your insurance company too, to arrange coverage of a walker or toilet seat ahead of surgery.

3. Hip replacement can be minimally invasive.

New techniques allow doctors to perform hip replacement using minimally invasive surgery. This means you will have a smaller incision instead of one large one. It also means you may recover quicker and with less pain than traditional surgery. In general, ideal candidates are thin, young and healthy although you can still be a candidate for hip replacement regardless of weight or age. You also need to be committed to a thorough rehab program. Dr. James Loging, MD at Palmetto Bone and Joint was the first surgeon in South Carolina to perform Anterior Hip Replacement and is the most skilled and trusted surgeon in South Carolina when it comes to this minimally invasive hip replacement surgery. Dr. Loging believes all patients deserve the benefit of anterior hip replacement and patients come from all over to have him replace their hip. 

4. Hip replacement recovery used to be lengthy, but it doesn’t have to be anymore. 

In the past, it would take numerous weeks to return to normal activities, including work. You would need a lot of assistance during this time. You wouldn’t be able to drive. Daily activities would be challenging, especially during the first six weeks. Some people would have benefited from staying in a rehabilitation center before returning home. However, now with Anterior Hip Replacement surgery, you will be able to perform more daily activities quicker and have a much faster recovery compared to traditional posterior approach hip replacements and even faster compared to hip resurfacings. Hip replacements are now even done outpatient and you’re able to recover in the comfort of your own home with a personal nurse and therapist coming to your house to work with you. 

5. You’ll be walking within a few hours of surgery.

Walking will be a high priority during recovery, even right after surgery. In the hospital, your nurse will get you up and moving within a day of surgery. However, you won’t be walking on your own. You will use a walker or other support for a few weeks. Gradually, you will be able walk longer, farther, and with more stability. Walking helps prevent blood clots and strengthens your hip as you heal. Walking and rehab exercises will be a daily part of your recovery and your team will give you goals. Meeting those goals will speed your recovery.

6. Health insurance usually covers hip replacement.

Many people wonder about hip replacement cost. Check with your insurance company to find out about your coverage. Most plans will cover a medically necessary hip replacement. This includes Medicare and Medicaid. Palmetto Bone and Joint will work with you to provide any necessary paperwork before surgery. Your insurance provider will have information about your out-of-pocket costs. This may include copays, deductibles and co-insurance (your portion of the expense after your copay and meeting your deductible).

7. Life will be different after a hip replacement.

A hip replacement can greatly improve your quality of life. Most people return to an active lifestyle with little or no pain and stiffness. But life can be different in other ways as well. High-impact activities are not good for your new hip. If you are a runner or play basketball, you may need to find alternatives however this can be discussed with our doctors. You may also find that your walking gait is different or you have a limp. Physical therapy rehab exercises can help correct this. Being diligent about your exercises will strengthen the supporting muscles and improve your flexibility. Eventually, your gait will feel normal again.

8. Hip replacements can last for decades.

Hip implants are mechanical devices, so they can and do wear out. But the implants used by our surgeons have been reported to last up to 30 years. And you can take steps to prolong the life of your hip implant. Maintaining a healthy weight will keep extra stress off the implant. Avoiding high-impact and contact sports will protect the implant from damage. Staying active and exercising will strengthen your hip muscles and stabilize the implant. It’s also important to see your orthopedic surgeon regularly to monitor the health of the implant.

Make an appointment

If you’ve been suffering from hip pain and are curious if hip replacement including minimally invasive anterior hip replacement is right for you, contact us to make an appointment with Dr, James Loging to discuss what options are best for you. 803-321-6254 or 803-941-8095

Hip Replacement Testimonal