The facts to know about hip and knee replacements
Surgery to replace worn out joints is now an everyday option to treat arthritis, particularly of the hips and knees. It's popular because it is so very effective, but that doesn't stop my patients from worrying about it.
What are joint replacements made from?
Replacement joints can be made from metal or plastic (or occasionally ceramic). They may be held in place with a special cement. Otherwise, they may be coated with a chemical which encourages your own bone to grow around them, holding them in place.
What does the operation involve?
Both joint replacements are usually done under general anaesthetic (where you are put to sleep) but they can be done under spinal or epidural anaesthetic. With these, you are awake but completely numb from the waist down. Which one you have usually depends on other medical conditions you have, such as heart or breathing problems.
Your surgeon will make a single cut (four to 12 inches long for knee replacements, eight to 12 inches long for hip replacements) over the joint. The hip joint is a 'ball and socket' joint. The worn out socket in your pelvic bone will be replaced and the ball at the top of your thigh bone will be replaced with an artificial ball. The knee joint is a 'hinge' and the end of both bones will be replaced with an artificial joint which fits over both bones.
What's the time frame?
You will usually need an assessment to check you're fit for surgery some time before your operation. The actual operations for both knee and hip replacements usually take about two hours. After surgery you will feel drowsy for a few hours from the anaesthetic. From the day after surgery, a physiotherapist will help you to start getting up and about and doing exercises to strengthen your muscles. You will usually be in hospital for about three to five days. However, if you're otherwise fit and well, you may be allowed to go home sooner. If you have dissolvable stitches, you won't need them removed. If you have non-dissolvable stitches or clips, they will need to be removed 10-14 days after your operation.
By the time you get home, you should be able to get around inside including managing stairs. You should be off crutches within four to six weeks and can usually return to light work, and start driving again, after about six weeks. You may need to be off work for longer if you have a strenuous job or do a lot of standing.
What are the risks?
Both operations are generally safe and complications are uncommon. The risk of a clot on the leg or the lung can be greatly reduced by wearing compression stockings and possibly with medicine. Other uncommon complications include infection (antibiotics during and after surgery cut this risk); unstable joint; scar tissue; and with hip replacement, a difference in leg length. But don't forget that most people who have this kind of surgery recover completely and are delighted with the outcome.
How long will my new joint last?
Most hip and knee replacements last for 10-15, and sometimes for 20 years. Keeping your weight down, doing exercises to strengthen your muscles and avoiding certain movements for the first few weeks (your physiotherapist will show you how) will help keep your brand new joint in good shape for years.
Non-surgical treatments for arthritis
Osteoarthritis - wear and tear of the joints - is extremely common, especially as you get older. In the short term, simple painkillers may be enough to control any pain. Regular exercise helps relieve pain and stiffness, and you may be referred to a physiotherapist for exercises. Depending on which joints are affected, shoe insoles, knee braces and walking aids may all help.
Although you may be tempted not to exercise if your joints ache, it's important to keep active to stop your arthritis getting worse. Swimming is ideal, because it doesn't strain the joints but keeps you mobile. It also helps keep your weight down, which is crucial for your joints.
With thanks to 'My Weekly' magazine where this article was originally published.