Frequently Asked Questions
Ans : Problems with major joints like the hip and knee are most frequently are due to arthritis. Osteoarthritis is the most common form of arthritis. It is most often related to wear and tear that has been placed on the joints over the years. Its onset is usually after age 50. Factors that predispose this condition include family history, obesity, previous surgery to the joint where a large piece of cartilage (cushion between the bones) was removed, or previous fractures in the area of the joint. Rheumatoid Arthritis is one of the more common kinds of inflammatory arthritis. It is a chronic inflammatory disorder affecting all the joints of the body, which are lined with a membrane called synovium. These joints include the hip, knee, shoulder, elbow, wrist, hands and feet. Rheumatoid arthritis is likely of autoimmune origin, which means the body produces cells that irritate the synovium in the joint leading to destruction of the cartilage. This form of arthritis occurs in all age groups. Stiffness, joint swelling, and laxity of the ligaments, pain, and decreased range of motion characterize it.
Ans : In the early stages of arthritis, successful alternative treatments may include medication, exercise and arthroscopic surgery. However, since anti-inflammatory medications and cortisone injections do not change the progression of the disease, these conservative options eventually become ineffective. Joint replacement is a long-term answer for pain relief and returning to an active lifestyle.
Ans : When pain in the knee or hip severely limits the ability to walk, work or perform even simple activities, a joint replacement may be an excellent option. In some cases, when an individual has the problem in both knees (and both hips), fixing one can reduce the stress on the opposite joint, thus putting off having the second surgery for several years.
Ans : The knee joint is composed of three parts: the end of the femur (thigh bone), the top of the tibia (shin bone), and the patella (knee cap). In a normal knee, these three bones are covered with a smooth cartilage that cushions the bones and enables them to move easily. In the arthritic knee, the cartilage layers are destroyed resulting in bone rubbing against bone, which causes pain, muscle weakness and limited motion. Total knee replacement surgery involves the resurfacing of the knee joint. Metal components are cemented to the ends of the bones and a plastic liner is inserted between them. The knee cap is also resurfaced with a plastic liner. When in place, these components move together to allow normal motion of the knee joint.
Ans : The hip joint is composed of two parts: the round head of the femur (the ball) and the acetabulum (the cup or socket in pelvis). In a normal hip joint these two bones are coated with smooth articular cartilage that allows them to move against each other without friction or pain. In an arthritic hip, the cartilage layers are destroyed, and bone rubs against bone causing pain and limiting motion. Hip replacement surgery replaces arthritic hip joint with an artificial joint composed of a ball component and a socket component. The metal ball is attached to a stem that fits into thigh bone. This component can be cemented or non-cemented depending on age and the condition of bone. A plastic liner with an outer metal shell is secured into pelvis. A combination of a cemented ball and a non-cemented socket also may be used. I choose the type of prosthesis that best meets individual patient's needs. Once in place, the artificial ball and socket function in essentially the same manner as natural hip.
Ans : An artificial joint lasts about ten to fifteen years, depending on your activity level. If the new joint allows you to return to pre-surgery activities that place stress on the joint (running, tennis, etc.) and you are fairly young at the time of joint replacement, a second joint replacement may become necessary later in your life.
Ans : Hospital stay is three days for total knee replacement and total hip replacement. The new minimally invasive procedures being done by I relieve patients out of the hospital sooner, with less pain and a faster overall recovery. Through the preoperative education, combined with physical therapy my most of the patients return to everyday activities within two months.
Ans : Thanks to advances in medication technology, we are able to keep you very comfortable after surgery. After surgery, any temporary discomfort does not compare to the pain of arthritis endured by most people in months and years before surgery. I pay considerable attention to pain management. Your pain will be treated with PCA pump (patient controlled analgesia) by keeping epidural catheter in the back and post-operative pain management protocol. Our goal is to manage your pain effectively and maximize your comfort.
Ans : Recovery varies with each person. Generally, patients begin physical therapy the day after surgery. Once home, some patients use a walker for two weeks to protect the new joint while it heals. It usually takes two to four weeks to get back behind the wheel. Most people gradually increase their activities during the next six to eight weeks.
Ans : Generally, total joint replacement is successful. Pain is relieved, deformity corrected, and patients resume former activities and enjoy an active lifestyle. Long-term success rates vary from 15 to 20 years, depending on age, weight, and activity level.
Ans : Both knee and hip joint replacements are recognized as miracles of modern surgery. Most orthopedic specialists consider it the best way to treat the pain and restore the loss of mobility from severe arthritis. It has allowed hundreds of thousands of people with arthritis to get back on their feet and resume an active lifestyle.
Ans : Joint replacement is considered to be major surgery. It is important that you are aware of potential risks and complications. These include problems from anesthesia, infection, surgical bleeding, blood clots, and damage to nerves or blood vessels, dislocation with hip replacement. Although these complications are rare, they are possible. Every precaution is taken by my team and me to avoid these complications.
Ans : Today most artificial joints last 15 to 20 years under normal wear, but they can wear out sooner if subjected to vigorous activity. When a joint wears out, loosens or develops a problem, it can be resurfaced or replaced as a redo or revision joint replacement.