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Patient Education: You Don't Have to Live With Joint Pain Recent Advances in Total Joint Replacement 
Nearly half a million hip and knee replacements are performed each year in the U.S. using conventional metal/plastic prostheses. As successful as most of these procedures are, over the years, the artificial joints can become loose and unstable, requiring a revision (repeat) surgery. These issues—together with the fact that increasing numbers of younger and more active patients are receiving total joint replacements, and older patients are living longer—have challenged the orthopaedic industry to try to extend the life cycle of total joint replacements. Recent improvements in surgical techniques and instrumentation will help to further the success of your treatment. The availability of advanced materials, such as titanium and ceramic prostheses and new plastic joint liners, provides orthopaedic surgeons with options that may help to increase the longevity of the prosthesis. Preparing for Joint Replacement Surgery Preparing for a total joint replacement begins weeks before the actual surgery date. In general, patients may be told to: Consider autologous blood donation—while some total joint procedures do not require blood transfusion, it is possible that a patient may need blood during or after surgery. To avoid using donor blood, patients may donate their own blood ahead of time (autologous donation). Begin exercising under a physician’s supervision—it is important to be in the best possible overall health to help promote the best possible surgical experience. Increasing upper body strength is important because of the need to use a walker or crutches after hip or knee replacement. Strengthening the lower body is also key because increasing leg strength before surgery can reduce recovery time. Have a general physical examination—patients who are considering total joint replacement should be evaluated by their primary care physician to assess overall health and identify any medical conditions that could interfere with surgery or recovery. Have a dental examination—although infections after joint replacement are not common, an infection can occur if bacteria enter the bloodstream. Therefore, dental procedures such as extractions and periodontal work should be completed before joint replacement surgery. Stop taking certain medications—your orthopaedic surgeon can advise you which over-the-counter and prescription medications should not be taken before surgery. Stop smoking—a good idea at any time, but particularly before major surgery in order to help reduce the risk of post-operative lung problems and improve healing. Lose weight—in patients who are obese, losing weight will help reduce stress on the new joint. Arrange a pre-op visit—an important opportunity to meet with healthcare professionals at the hospital to discuss your personal hospital care plan, including anesthesia, preventing complications, pain control, and diet. Have routine laboratory tests—blood tests, urine tests, an EKG or cardiogram, and chest X-ray may be prescribed to confirm that you are fit for surgery. Evaluate post-surgical needs for at-home care—every patient who undergoes total joint replacement will need help at home for the first few weeks, including assistance with preparing meals and transportation. |
