Hip replacement is a surgical procedure that removes damaged parts of the hip joint and replaces it with artificial parts. This treatment option is usually considered after all other treatment options have failed to provide pain relief. The extent as to how much of the hip joint is replaced with artificial parts will depend on the severity of the damaged joint.
Hip replacement is recommended for severe osteoarthritis, rheumatoid arthritis, or ankylosing spondylitis. Hip surgery may be also required for fractures of the hip secondary to osteoporosis. Depending on the cause of the damage, the surgeon will assess the extent of the damage and recommend the best treatment option possible. Possible non-surgical treatments include the use of painkillers, steroid injections, walking aids, or physiotherapy. Total hip arthroplasty, (also known as hip replacement surgery) is usually recommended if the hip pain already interferes with the patient’s daily activities and conventional treatments have not worked. In majority of the cases, arthritis damage is the most common reason for hip replacement.
Conditions that might require hip replacement surgery:
- Osteonecrosis – Inadequate blood supply to the ball portion of the hip joint, resulting in deformity and breakdown.
- Rheumatoid arthritis – Inflammation in the joints is often attributed to an overactive immune system and result in painful deformity.
- Osteoarthritis – Also called wear-and-tear arthritis, refers to the breakdown of joint cartilage and results in pain, stiffness and swelling.
Patients are advised to observe some precautions for the first 6 weeks after surgery.
As there is increased risk of blood clots developing in the legs after surgery, the following measures are observed to prevent complications:
- Pressure application – During and after surgery, inflatable air sleeves or elastic compression stockings will be worn on the lower leg. The pressure will prevent the blood from pooling in the leg veins, minimizing the chance of blood clots from forming.
- Early mobilization – Patients are encouraged to try walking using a walker or crutches soon after the operation.
- Blood-thinning medications – The surgeon may prescribe an oral blood thinner right after the surgery to reduce likely blood clot formations from developing.
Early intervention of physical therapy is encouraged to help speed up recovery. The physical therapist will teach patients some strengthening and mobility exercises to help regain the use of their muscles and joints. These exercises should also be done at home.
A follow-up appointment is usually scheduled about six to eight weeks later to assess if the hip is healing properly. If there are no complications, patients can resume their day-to-day routines. In most cases, full recovery and improved strength occurs after 6 to 12 months.
Knee replacement is a surgical procedure that removes damaged-parts of the knee joint and replaces it with artificial parts.
The most common condition that results in the need for knee replacement is osteoarthritis. Osteoarthritis is common in the knees because the knees bear the weight of the body and can severely impact a person’s lifestyle including walking and climbing stairs. A knee replacement surgery is a major surgical procedure that should be considered only after all other conservative treatment options (physiotherapy therapy, injections, arthroscopic debridement) have failed.
Similar to any surgery, knee replacement surgeries can come with certain risks including, stroke, nerve damage, heart attack, infections or blood clots (in the lungs or leg veins).
While the risk of infection is very minimal, the doctor should be notified immediately if the following symptoms manifest:
- High fever
- Severe swelling, pain, tenderness, and redness in the affected area
- Drainage from the site of surgery
The surgeon will conduct a physical examination to gauge the knee’s strength, stability and range of motion, and taking into account the patient’s medical history before recommending surgery for the patient. The surgeon will explain how the surgery will be carried out and also give post-surgery care advices so that the patient will be able to make informed decisions. Prior to surgery, patients will be required to fast up to six hours before the surgery and patients will be advised if they need to stop any medication or dietary supplements during the fasting period.
In most cases, the patient will need to stay in the hospital for two days after the surgery. Moving the ankle and foot will be encouraged in order to prevent the formation of blood clots and swelling and to increase blood flow to the legs.
Oftentimes, a day after the surgery, patient will be taught exercises for the new knee. Recovery is also faster if patient will adhere to all the instructions the doctor will give pertaining to exercise, diet, and wound care.
A typical physical activity program often includes:
- Gradual walking program (indoors first, then outdoors) in order to increase mobility
- Knee-strengthening exercises (taught by the physical therapist), to be done several times daily
- Slow return to everyday routine (including walking up and down the stairs)
For majority of patients, knee replacement surgery provides improved mobility, pain relief, and better quality of life.
After three to six weeks, patients who have had the surgery can already perform activities like light housekeeping and shopping. Low-impact activities like biking, golfing, walking, and swimming can also be enjoyed. However, high-impact activities like skiing, tennis, and jogging would be prohibited. To play safe, recommended limitations are best discussed with the doctor.