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The Truth About Joint Replacements

My name is Michael Wagner and I am an Orthopedic Surgeon specializing in hip and knee replacements. The vast majority of my operative practice is spent performing these two procedures. When I am not in the operating room the rest of my work life is spent in my clinical office talking about hip and knee replacements, and what I have found is that everyone knows someone that has had one of these procedures done. This really isn’t surprising as hip and knee replacements are some of the most common procedures done in the United States today. Knees out number hips almost two to one, and in total, roughly 1.5 million of these procedures are done every year. As our population gets older it is projected 3.5 million procedures will be done per year by 2030. With this comes the all-too-common buzz word of misinformation. In medicine we call it anecdotal evidence, and that coupled with Dr. Google, means a good portion of my day is spent setting the record straight. Which is what I am going to attempt to do today.

Before Surgery:

This is the time when the patient has the biggest say of what gets done. In my opinion, the authoritarian model of “you must have a surgery” doesn’t work here, and those are words I don’t use in my practice. Barring a few exceptions, joint replacements are and always will be an elective procedure. Yes, is it true, often times more conservative measures may fail to provide long term relief, but the right time to get the surgery done is when you are physically and mentally ready for it.

Surgery:

Posterior vs anterior, robotic or not, general anesthesia vs spinal. These are all options and all have their place. Most importantly, is that once you’ve found the surgeon you are comfortable with you trust your surgeon and trust their process.

After Surgery:

Twenty years ago, the average joint stayed five days in the hospital. Ten years ago, almost every joint replacement stayed three days in the hospital. Today, the typical patient goes home the next day, and soon they will routinely be outpatient procedures. Patients walk with the use of a walker the same day of surgery and most are surprised at how independent they can be. Pain is controlled through a multi-modal approach which starts before surgery and continues to the postoperative phase. Narcotics have essentially become an afterthought; many don’t take any at all. After surgery, your doctor will transition from surgeon to cheerleader. Physical therapy is a must. Most patients are now going right to out patient therapy. It is easier to bring you to the gym rather than to bring the gym to you. “How long will my recovery be?” is a very common question, the answer to which is based on more variables than you can count. Typically, in the first six to eight weeks your joint is a priority, and at this time most patients found they are 90% of the way to recovery.

At the end of the day the decision to proceed with a joint replacement is a personal one, and this is a difficult topic to break down to one page. Don’t be afraid to ask questions and make sure you get your answers. For more information, or to continue a conversation with me please visit our website at MacombOrthopedics.com

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