If you have been told you need hip or knee surgery, you are not alone. The Centers for Disease Control (CDC) reports that, in 2010, the number of total hip replacements was over 300,000, while the number of total knee replacements was almost 700,000. While a bit dated, this data was from the most recent survey conducted by the CDC — and research since then has shown that the number of joint surgeries performed in the U.S. is rising quickly.
Even with numbers that high, needing a knee or hip replacement yourself can be scary. From choosing a surgeon to planning your recovery time, there is a lot to think about.
Keep reading to learn more about what total joint replacement surgery is, who needs it, how to qualify for total knee or total hip replacement surgery, and what you can expect before, during, and after your surgery.
What is total joint replacement surgery?
A total joint replacement is a type of surgery that replaces the hip or knee joint with artificial parts, called prostheses. These surgeries are generally only recommended if physical therapy and medications alone are not helping you control the pain or restore mobility to your knee or hip. Though the last resort, total joint replacements are highly effective at eliminating joint pain, correcting deformities, and increasing mobility.
What causes joint issues?
Joint issues can arise for a variety of reasons but, most commonly, are caused by osteoarthritis and rheumatoid arthritis. Arthritis is a very common condition affecting more than 3 million people in the U.S. each year. It is an inflammation of your joints that can cause pain and stiffness. People older than 40 are most prone to arthritis, though younger people can develop it, especially due to joint injury.
What is osteoarthritis?
Osteoarthritis, or OA, is a chronic joint condition that causes the cartilage of the joint to break down, which causes swelling, pain, and difficulty moving the joint. Osteoarthritis is the most common type of arthritis and usually affects people over age 65. Unlike other types of arthritis, it does not affect any internal organs — only joints.
The National Institute of Health points to some common causes of osteoarthritis:
- Being overweight
- Getting older
- Joint injury
- Joints that are not properly formed
- A genetic defect in joint cartilage
- Stresses on the joints from certain jobs and playing sports
What is rheumatoid arthritis?
Rheumatoid arthritis is an autoimmune disease that causes your body’s immune system to attack the lining of your joints, thinking that they are a foreign bacterial or viral substance. Inflammation then causes the joint lining to thicken, causing swelling and pain in the joints. If not treated early enough, the cartilage and the bones can become damaged.
While doctors aren’t entirely sure what causes rheumatoid arthritis, they believe that it can be caused by:
- Environmental factors
When is knee or hip replacement surgery recommended?
There are several factors that go into determining whether you qualify for a total knee or total hip replacement surgery. As outlined by the National Institutes of Health, the qualifications for knee and hip replacements include:
- Joint disease has been identified through an MRI or X-ray
- Pain caused by the joint disease that affects your ability to walk or care for yourself
- Unsuccessful attempts at treating the disease with non-surgical methods for a minimum of 3 months
As with most surgeries, comorbidities, or the presence of more than one chronic conditions, can also play a role in your eligibility for joint replacement surgery. For example, if you’re obese with a body mass index (BMI) higher than 45, your care team may recommend a weight loss program before you can qualify for a knee or hip replacement. Obesity can negatively affect the success of joint replacements. Other comorbidities that could impact your eligibility for a total knee or hip replacement include:
- Cardiovascular disease
- Endocrine disease
- Gastrointestinal disease
Your doctor or a Carrum Health Concierge can help you determine whether you qualify for a knee or hip replacement.
How do I prepare for my knee or hip surgery?
Once you have been qualified for joint surgery, you will schedule your surgery and begin preparing — for both your surgery and life after. Taking the time to plan before you have your surgery will go a long way in making the procedure safer and more effective.
While exercise can be challenging if you have hip or knee pain, it is a good idea to talk to your doctor or the Carrum Concierge about activities that you can do. Exercise, which you can usually do until the day before your surgery, can help you build strength, endurance, and range of motion in your joint. When done consistently before your total knee or hip surgery, these things can make the surgery — and your recovery — more successful. Keep in mind: you do not have to run a marathon; simple water exercises and walking are just fine.
Make necessary lifestyle changes
In addition to starting an exercise routine, if you have not done so already, you will want to start thinking about your lifestyle. If you smoke cigarettes, you should try to stop as soon as possible. Smoking can increase the risk of medical complications such as blood clots and make a recovery more difficult.
Monitor your blood glucose levels
While studies have debunked the idea that uncontrolled diabetes could cause problems during joint surgery, monitoring your blood glucose levels before (and after) surgery is a good idea. Having your blood glucose at an optimal, managed level could help prevent infected wounds.
Talk to your doctor about any medications you’re taking
Any blood thinning medication, including arthritis medication, Aspirin, and other anti-inflammatory drugs, should be stopped before surgery. They can affect both blood thinning and blood clotting — two things that could complicate your knee or hip replacement. Your doctor will tell you exactly when you should stop taking these, and any other, medications.
Create a plan for after your joint replacement
Once your total knee or hip replacement surgery is complete, you will start recovery. But the weeks following any surgery can be stressful, especially without a plan in place. Your Carrum Concierge will be able to help you create a specific plan, suited for your life. In the meantime, some ideas to get you started include:
- Make (or have a friend make) meals you can freeze and eat later
- Make arrangements for transportation to and from the hospital for your surgery
- Arrange for child care or pet walking services, if you need them
- Talk with your employer about the time you’ll need off work
- Get your house set up so you can safely and easily get around
It sounds like a lot of steps but planning ahead of time will help. It can ensure that your surgery is successful and give you peace of mind that everything in your life is taken care of. When you use the Carrum Health benefit offered through your employer, you’ll have a care concierge available to help with each step.
Carrum Health’s covered surgeries include total hip replacements and total knee replacements. Let’s take a look at each.
What happens during a total knee replacement?
Total knee replacements usually take between 1 and 2 hours, as long as there are no complications. During a total knee replacement, also called total knee arthroplasty, your surgeon will make an incision across the front of your knee. The next steps in a total knee replacement are as follows:
- Your patella (or kneecap) is rotated so your surgeon can see the area they are operating on.
- Your surgeon will precisely cut away the damaged bone and cartilage from the ends of your thigh bone and shinbone.
- Metal implants will be fitted onto the ends of your thigh and shin bones.
- If needed, your surgeon will fit your patella with a plastic piece that will fit your new knee.
- Finally, the incision will be closed, and you will be ready for recovery.
What are the potential risks of a total knee replacement?
While total knee replacements are among the safest and most effective surgeries available, no surgery is free from risk. Studies have found that, on average, total knee replacement surgeries have a mortality rate of only 0.25%. Another study identified that the readmission rate after surgery was 4% at 30 days and 8% at 90 days, with three-quarters of readmissions due to surgical causes, like an infection.
Carrum Health’s hospitals and surgeons must meet stringent quality criteria. For them, the rate of all complications related to joint replacement surgery is 0.1%. The readmission rate 30 days after surgery is 1.7%.
Some of the potential risks of a total knee replacement include:
- Complications from anesthesia
- Blood clots
- Allergy to metal components
- Bleeding complications
- Artery damage
- Nerve damage
- Loss of motion in the knee
- Implant failure
Most complications are rare; knee replacements are generally safe surgeries that can help relieve you of knee pain, restore mobility to your joints, and increase the quality of your life. You should always talk to your doctor if you have any questions before or after your surgery, or if you think something might be wrong.
What happens during a total hip replacement?
During a hip replacement surgery, your surgeon will make an incision on the side of your hip and move the muscles connected to the top of your thigh bone aside so they can view your hip bones. From that point, the next steps are:
● The ball portion of your hip joint is removed from your thigh bone with a medical saw.
● An artificial joint is then attached to the thigh bone.
● Your surgeon will cut away the damaged cartilage and bone from your hip bone and attach an artificial socket.
● The artificial ball joint and socket are attached to each other.
● Finally, your doctor moves the muscle before closing your incision.
What are the potential risks of a total hip replacement?
Much like total knee replacements, hip replacements are a common and very safe surgery. One study identified the 30- and 90-day mortality rates as 0.30% and 0.65%, respectively. The readmission rates after a total hip replacement were 4% at 30 days and 7% at 90 days. Patients who were readmitted were most often done so due to dislocation, surgical site infection, and postoperative hematoma (an abnormal collection of blood outside of the blood vessels).
Through Carrum Health, you can access only the highest quality hospitals and surgeons. For them, the rate of all complications related to joint replacement surgery is 0.1%. The readmission rate 30 days after surgery is 1.7%.
Some of the potential risks of a total hip replacement include:
- Blood clots
- Change in leg length
- Loosening of the implant
Again, hip surgeries are very common and are highly effective at reducing hip pain and decreasing immobility caused by injury, rheumatoid arthritis, and osteoarthritis.
What happens after I have knee or hip surgery?
Once your knee or hip replacement surgery is over, you typically stay in the hospital for 2 to 3 days. After you are discharged from hospital, your recovery at home can take up to 12 weeks. Most people will begin rehabilitation the day after surgery and continue until your doctor gives you the all clear.
Keep in mind, your surgeon and care team will give you specific recovery instructions, tailored to your health needs. You willll need to follow the exercise and rehabilitation guidelines given by your care team — this will help ensure you have a quick, effective recovery.
As with any medical procedure, there are risks involved. However, total knee and hip replacement surgeries have relatively low risks with high success rates. If you are a candidate for knee or hip surgery, your next step is to schedule a free consultation.