Show #394 Airing Sunday, 7/15/07
Is severe arthritis or joint pain taking the joy out of your favorite activities, like golf, tennis or just walking around? It may be time to consider a joint replacement. Here to keep us hip to the latest information is Dr. Raymond Horwood, chairman of the department of orthopedics at Fairview Hospital.
Question:Which joints are the most likely to wear out or break and need replacement?
Answer:The primary joints that need to be replaced are hips, knees, and shoulders. About 12,000 shoulder replacements were done last year in the United States. However, 700,000-800,000 hip replacements were performed.
Question:Why would we need a joint replacement?
Answer:Severe arthritis that wears out the cartilage of the joint. It is very painful when it progresses to the stage when the cartilage is gone and there is a bone-on-bone situation. Degenerative arthritis affects adults of all ages, but is more common in the elderly. Women are more prone to the disease than men. By 2030, it is estimated that over 40 million people will be affected. Or a fall or a break.
Question:When is the right time to get a total joint replacement?
Answer:A sore hop or knee will bring a person into their doctor's office at which time treatment will begin with anti-inflammatory medication, rest, and perhaps physical therapy. However as the disease progresses, the pain and disability will progress to the point that it's no longer tolerable. The patient will know when it's time.
We have patients come into the office for a work-up. Their primary care physician will evaluate their overall health. We'll take x-rays and talk about the procedures and risks (this is an operation, with all the typical risks for surgery).
Question:You've brought some examples of hip and knee replacements. Tell us about them.
Answer:There are many myths and misunderstandings surrounding joint replacements. First, people think that they are heavy. They are not. Whether the implant is made of titanium or a chrome-cobalt steel alloy, they weigh only about 1-2 pounds.
People think that they will no longer have their own kneecap. That is incorrect as well—we just resurface the kneecap.
Perhaps the most misleading opinion is that after 10 years you will need to have that procedure repeated because your original implant wore out. Many studies have shown that after 15 years, over 90% of total hips and knees are functioning well with no significant signs of failure.
Question:What happens after a joint replacement?
Answer:The patient will be gotten out of bed and walking the next day. They will have to stay in the hospital for 4-10 days depending on their age, the help they'll have at home, the number of stairs at home, etc.
Most improvement occurs within 6 weeks, although you will continue to see improvement for up to 6 months. Most people will be back on the golf course, for example, in a couple months.
Most people really can go back to doing all low-impact activities: biking, dancing, bowling, golfing, swimming. I even have some patients with hip replacements who go skiing. Running, however, is discouraged, because it tends to beat up the replacements.
I really believe that hip replacements, for example, are one of the best things we do in medicine to improve a person's quality of life.
The time you lose to pain can=t be replaced. But painful joints can be. To learn more, call Fairview Hospital at the number that=s next. My thanks to Dr. Horwood.
