Frequently Asked Questions
Hip and Knee Replacements
- What are hip and knee replacement implants made of?
- How long will they last?
- How big is the incision?
- Will there be stitches?
- How long is the surgery?
- What kind of anesthesia is used?
- What about pain?
- When do I start therapy?
- How long is the hospital stay?
- When can I return to regular activities?
The metal in modern hip replacement implants is most often titanium. The material is strong, lightweight, and hypoallergenic, so it will be tolerated by the body. The surrounding bone will grow onto it, eliminating the need to cement the total hip to the surrounding bone.
Most knee replacement implants are made of cobalt chrome. This metal works better than titanium as a gliding surface with the complex motions of a total knee. Patients with metal allergies may have specially treated titanium designs.
Laboratory reports suggest that hip replacements employing newer technology may last anywhere from 30-100 years. Clinical experience includes people with hip replacements that are more than 10 years old and have no signs of wear. Knee replacements are functioning just as well.
In both cases, current technology offers the hope of a lifetime of durability.
The incision is 4-5 inches long for uncomplicated hips and slightly longer for uncomplicated knees.
Most operations can be performed using plastic surgery techniques. There are no stitches in the skin. The incision is covered with a medical glue that holds the edges together and is impermeable to water, allowing the patient to shower within 3-4 days after surgery.
Routine hip or knee replacement procedures generally average an hour and a half.
For most patients, spinal anesthesia is the preferred choice. It is safer than general anesthesia and may lead to a lower risk of blood clots and less blood loss. It also provides better pain relief. Anesthesiologists and patients work together to determine which form of anesthesia is best. For patients with certain medical conditions, the kind of anesthesia and its method of delivery must be modified for individual needs.
Arthritis is painful, sometimes with every step, getting out of a chair, or climbing stairs. Most people know that total joint replacement will put an end to this pain and restore freedom of motion and activities, but people also fear that surgery will hurt.
Things have changed.
The goal is PAIN PREVENTION, not pain relief.
Surgical pain can now be addressed with a new medication and new surgical techniques.
The drug EXPAREL instilled into the surgical site can alleviate pain for two to three days after surgery. This drug is similar to the Novocaine a dentist may use to make the mouth numb. It is delivered in slow release droplets making for the prolonged effect.
Current surgical techniques: Minimally invasive surgery for the hip including Anterior Approach and mini Posterior Approach, and mini Midvastus Approach for the knee yield smaller incisions and far less muscle injury than older techniques.
Pain management specialists see patients several times a day to change and adjust medications to maximize comfort and relief while keeping in mind patients’ individual responses and reactions to pain medications.
Patients return to their daily lives sooner and with a smoother recovery than in the past.
Trained physical therapists begin walking, muscle strengthening, and range of motion exercises as soon as possible, often beginning day of surgery, and no later than the following day.
The average length of stay is 2-3 days. Patients may have a shorter or longer stay, depending on their physical and medical condition. Some people go home and some go to a rehabilitation facility.
Patients may return to regular activities within 3-4 weeks following surgery, although that may vary for each individual patient. Return of full muscle function and range of motion may take longer. It is not uncommon after hip replacement to limp for 2-3 months while the muscles are strengthening. Knees may feel stiff at first, even if they have a good range of motion.