Johns Hopkins Health Alert
What Should You Expect from Joint Replacement Surgery?
When joint problems become overwhelmingly uncomfortable and debilitating, many people opt to have their old, achy joints replaced with artificial ones. Having realistic ideas about what joint replacement will accomplish -- including what the recovery process is like and how much a new joint can enhance quality of life -- is important. Researchers at Toronto Western Hospital in Canada found that those patients who went into surgery with realistic expectations for recovery given their age, health, and joint function before the replacement were the most satisfied a year later.
The majority of joint replacements performed involve the knee, hip, and, to a lesser extent, shoulder. A joint replacement is often the answer if you have pain that won't subside and you are unable to move the joint well, even after your doctor has prescribed exercise, physical therapy, medicines, or vitamin supplements. This type of discomfort is usually the result of osteoarthritis, in which the cushioning cartilage between joints gets worn away over time.
Joint replacement surgeries are quite effective in most people. But a patient's expectations don't always match up with the results. Misinformation on the Internet and, sometimes, a physician's own advertisements about quicker recovery, smaller incisions, and faster rehabilitation can create unrealistic expectations for the patient, says David Hungerford, M.D., a professor of orthopedic surgery at Johns Hopkins and a joint replacement specialist.
According to one report, presented at the last annual conference of the American Academy of Orthopaedic Surgeons, researchers from the Hospital for Special Surgery in New York City found that more than half of the patients surveyed as part of a small pilot study had expectations that exceeded those of their surgeons for tasks of daily living. These tasks included the ability to stand from a sitting position, to go up and down stairs, and to walk without a limp.
Joint replacement patients come into the operation from a wide spectrum of starting places. The most important thing to remember, says Dr. Hungerford: "Each patient needs to have a frank discussion with the treating surgeon to develop realistic expectations."
Posted in Arthritis on September 20, 2010
Medical Disclaimer: This information is not intended to substitute for the advice of a physician. Click here for additional information: Johns Hopkins Health Alerts Disclaimer
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I am two months out from having a total knee replacement. My doctor ordered aggressive physical therapy ( I was up and walking with a walker the morning after my surgery). I still go to physical therapy twice a week and undergo PT sessions that progressively increase resistance. My progress has been very good although not as good as I had hoped. I can walk without any aids (have been since 1 week after surgery). Still have a slight limp and have pain in the joint after being on my feet for an hour or so. Also have Restless Leg Syndrome, the effects of which seem to be amplified in the new knee. Pain medication has no effect on the Restless Leg. However taking medication for restless leg syndrome (ropinrole) does reduce the level of pain to manageable. My expepctations and those of my surgeon, are that I will be walking normally by spring. I am glad that I finally decided to get the knee fixed. I am already able to walk better than I could the last year before the knee replacement and hope to be pain free and walking normally within a month or so.
Posted by: royd | February 2, 2011 8:06 AM
Revision tka after failed partial, medial replacement (Oxford style). Second surgery (Revision to TKA) was performed by well-regarded ortho surgeon--validated by the fact that many drs. go to him for orthopedic surgery. Nevertheless, my experience with purported outstanding ortho surgeon has been negative--after 4 months I have unbearable night pain, meaning that pain wakes me up after 1 to 4 hours of sleep. Usually, to get 8 hours sleep, I have to endure being woken up several times. Because I take one medication that makes me very drowsy, although not designed for sleep, and also taking clonazepam, prescribed to help me sleep and for anxiety during the day, I am able to get back to sleep usually without having to take pain med, but this is not true every night. Sometimes 1/4 nights I must apply cold pack , take additional clonazepam, and pain med to get back to sleep. During day, I have pain but I take pain med and use cold pack frequently, which helps with the pain. However, inability to enjoy life (I know cliche) and inability to function in a productive, adequate
Posted by: newport12 | October 10, 2011 10:14 PM
As a recipient of a shoulder replacement at 59 yrs old, I am able to after 4 months of 3 times a week PT therapy and 7 months of re-vamping my continued fitness training, can execute 3 sets of push-ups, between 30-40 reps per set.
I'd call that successful for the replacement arm but am looking forward to the other arm within the next 8 months.
If you have considered it, do it. Quality of life and drug free!
Posted by: captainowow | October 12, 2011 3:20 PM
FYI- the key to any planned surgery is FITNESS. If you are out of shape i.e. overweight, unhealthy eating, not properly resting, your recovery/post op PT will be the worst.
Know this from a man fit n over 50 (actually 60), ex-fitness instructor with 54 major surgeries on both shoulders before getting my left shoulder replacement.
A complete success.
Posted by: captainowow | October 12, 2011 3:24 PM
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Hello-I realize I may be the exception to the rule, but for the past 5 years I have been having continuing ankle surgeries as a result of a very serious compound fracture. By left justifying my left leg to take all of my body weight I ended up blowing out my left knee and sped up the breakdown of osteoartihritis. A few months ago I had a total knee replacement on that knee. After all the horror stories about having this done, I was scared to death! Because of that fear, I did not do well during the 3 day hospital stay. Once home, in doing home therapy I did exceptional and within two weeks was released. Why, Mental Attitude! I was so glad to be at home, less pain than before the surgery and could walk ideally. Alot of my strength was the result of PT for my ankle, which left me quite fit. I did not realize how far I came until I went back to the Dr. for the 4wk visit and saw some of the same people who had the surgery done the same day in wheel chairs, walkers, etc. They were shocked to see me walking around, and with no limp! My strength was not quite 100%, but it is now. Right now it is 3 months and there are times I have totally forgotten the ankle and knee surgeries because of no discomfort and all my friends are shocked at how well I do. Absolutely no indication at all I had it done, except when I am tired. There was nothing magical about what the surgeon did for me, he did the same thing on all of his patients. Mental attitude and realistic expections as the article suggests is so important. It is with God's blessing that we all have the option to fix our knees. It is with your own capacities, mental and physical, that we heal. God's Blessing to all. Kathy
Posted by: flkathy | September 20, 2010 9:59 AM