Brooke Kline, PA-C, Orthopaedic Associates
When someone is considering joint replacement, many questions come to mind about what to expect from the overall process—before surgery, during the hospital stay, and afterwards.
Each year, Deaconess and Orthopaedic Associates www.oaevansville.com perform more than 1,200 joint replacement surgeries. The majority of those are hip and knee replacements, but we also offer shoulder replacements as well. Because joint issues are so common, lots of people have probably had the same questions you do. Below is a Q&A of those common questions.
What type of patient typically has a joint replacement?
Total joint replacement is usually for patients who have severe arthritic conditions. Most patients who need joint replacement are over 55 years of age, but the operation is being performed in greater numbers on younger patients thanks to advances in artificial joint technology.
Does every patient who has a severe arthritic condition automatically qualify for joint replacement?
Circumstances vary, but generally patients are considered for total joint replacement if:
- The pain and loss of mobility affect them all the time. They can’t function in their daily lives.
- Pain is not relieved by other conservative methods, such as oral antiflammatory medication, joint injection therapy, physical therapy, using a cane, etc.
- X-rays show advanced arthritis or other joint problems
- Patients must be healthy enough to undergo surgery and participate in their own recovery.
What is the first step in the joint replacement surgery process?
Once your doctor has determined that you should have joint replacement surgery, you’ll begin the process by participating in pre-testing and education.
Pre-testing is done at the physician office, and at the hospital, where we do an EKG. The patient also consults with the physician assistant to determine if there are any medical issues to address prior to surgery. After pre-testing comes education. We know that patients who attend educational sessions (sometimes called Joint Camp) before surgery have better outcomes after surgery, and are less anxious about the recovery process. In the education session, you will learn more about the surgery, your hospital stay, as well as what to expect after discharge.
What should I expect from the surgery and hospital stay?
The average hospital stay for a joint replacement patient is two days after surgery. If you have your surgery Monday morning, you will likely go home on Wednesday. On the day of your surgery, you’ll check in at Deaconess Gateway Hospital two hours before surgery time, and then you’ll be prepped for surgery. The surgery itself takes between one and two hours. After surgery, you’ll be in recovery for a little while, then moved to your room on the fifth floor, tower B at Deaconess Gateway. Later that day, you’ll likely be taking your first steps with your new joint–almost everyone is up and moving the day of their surgery.
After surgery, what is the physical therapy schedule?
While hospitalized, patients go to group therapy twice a day with other joint replacement patients. This group approach works well, as people feel encouraged and motivated by being with each other–there’s a “we’re all in this together” feeling. Most patients have a partner or coach with them during their therapy sessions. This is often a spouse or other family member or friend. Your time here will be well-spent, because you’ll be kept busy getting stronger and preparing to recover after your hospital stay.
Time to go home…now what?
On your final day of hospitalization, you are released after lunch and a group therapy session. Prior to this release, many arrangements will have been made with a case manager who makes sure all the plans are in place for your recovery outside the hospital. The vast majority of our patients are able to go home after surgery; a smaller number need to go to in-patient rehabilitation for a period of time.
Once a patient has been released to go home, he/she will have outpatient therapy about three days per week. This is usually arranged at a facility close to where the patient lives, even if he or she lives outside of Evansville. It varies from patient to patient, but this outpatient therapy will last for 6-8 weeks.
Patients will have an appointment at Orthopaedic Associates www.oaevansville.com two weeks after surgery, and then again at intervals based upon progress.
Will I need a lot of help at home, and how quickly will I return to my normal activities?
This will vary from person to person, and is even different depending on what type of joint was replaced. I can definitely tell you that every patient should plan to have help around-the-clock for a full week after surgery.
Shoulder replacement patients have more difficulty with dressing and activities of daily living. Knee and hip replacement patients do tend to be more independent, and get back to daily life earlier.
Someone who is in better physical condition will recover more quickly, but overall, we explain to patients that they are typically 90% recovered at 90 days post-surgery.
Pain and swelling can be expected up to 6 months after surgery, and some patients may not feel fully recovered for up to a year.
However, as patients have commented…. Every day before surgery the pain gets worse, but in the days, weeks and months after surgery, the pain gets better.
What are some of the biggest misconceptions about joint replacement surgery?
Among our most common questions, there are two that would probably be the biggest misconceptions.
“I heard you can only have a joint replaced once in your life, so doctors wait as long as possible to do it so that you won’t outlive the joint.”
FALSE. Joint replacements generally last a couple of decades, and then they can be revised if needed. Joint replacements have come a long way, so the surgery isn’t nearly as extensive.
Joint replacements don’t involve removing large areas of joint and bone. The focus of the surgery is on removing small amounts of damaged bone and then resurfacing that area of the joint.
“I’m scared to get this surgery done because I’ll have to miss months and months of work.”
FALSE. If you have a sedentary (sitting) job, you can go back as early as a few weeks to a month after surgery. If you have a job on your feet all day, it may be longer, but almost everyone is back to work in a period of time covered by FMLA, which is 12 weeks.
In conclusion If you are considering joint replacement, or know someone who is, we hope this has been a helpful Q&A session for you.
For more information, you can visit the following websites:
If you have joint pain or want to learn more about joint replacement, you can also call the Orthopaedic Associates office at 812-424-9291 to request an appointment.
As a physician assistant at Orthopaedic Associates for 14 years, Brooke Kline has assisted with joint replacement surgeries and provided care to thousands of joint replacement patients both before and after surgery.