Frequently Asked Questions About Joint Replacement
At the Henry Ford Center for Joint Replacement, we are committed to giving you the best orthopedic care. We believe that educating and informing our patients empowers them to heal and live their best lives. Whether you are just starting to experience joint related pain or are ready to schedule joint replacement surgery our doctors are here to help.
This list of answers to frequently asked questions is a good place to begin when you want to learn more about joint replacement surgery at Henry Ford.
- Do I need to lose weight or stop smoking before I can have surgery?
- Why does my surgeon recommend going home after surgery instead of to a rehab facility?
- What does it mean for me and my surgery?
- I am having second thoughts. Should I get another opinion?
- How successful are joint replacements for most patients?
- How long will my joint replacement last?
- Is the anterior approach to my hip replacement the best approach for me?
- Will my new joint replacement trigger the alarms at the airport?
- Will I need therapy after my joint replacement? When can I return to work and drive?
- Will I need to take prophylactic antibiotics prior to seeing a dentist after my joint replacement?
- Why does my surgeon use a robot? Are there any advantages to the robot?
- What questions should I ask my joint replacement surgeon?
- What implants will my doctor use?
- Are there alternative methods of pain relief to opioids
Do I need to lose weight or stop smoking before I can have surgery?
There has been a concerted effort in the orthopedic community to improve the safety and efficacy of joint replacement. This includes the identification and improvement of modifiable risk factors prior to surgery.
Although some people have surgery without modification- it places them at much higher risk and jeopardizes the long-term outcome of the replacement and patient satisfaction. Insurance can also play a role in the decision making process.
Why does my surgeon recommend going home after surgery instead of to a rehab facility?
Patients who go directly home after surgery instead of a rehabilitation or skilled nursing facility often achieve a faster recovery (a bit shocking, but true)! Additionally, there are lower risks of adverse events, such as infection, wound healing problems and readmission to the hospital if people go home, instead of to a rehabilitation center, after their hospital stay. It may be appropriate for a small percentage of patients to go to a rehabilitation center for safety concerns.
What does this mean for me and my surgery?
Research shows that most patients can safely return home after shoulder, hip or knee replacement surgery. It is very important to discuss your home environment with your doctor and care team to formulate your optimal postoperative plan before you have surgery. Preparing your home before surgery for when you return after your surgery is a key step to success. This could include preparing meals in advance, placing supplies in easily accessible areas and removing clutter that could cause you to trip and fall. Most people can be confident that they will be able to return home after surgery and have a lower risk of complications by going directly home.
I am having second thoughts. Should I get another opinion?
A second opinion is always an option that we support. Your surgeon is obligated to inform you of the possible complications related to the surgery. Although the risks are small, you may be at higher risk due to diabetes, hypertension, obesity, or cardiac issues; they can be significant. You should understand these risks and discuss them with your family and primary care physician prior to agreeing to the procedure. Total hip and total knee surgeries are elective surgeries to improve the quality of your life.
How successful are joint replacements for most patients?
Both total hip replacement and total knee replacement are very successful operations that change patient’s lives. It is important to discuss success rates with your surgeon prior to surgery as well as your expectations following surgery.
How long will my joint replacement last?
Any hip or knee implant is a mechanical device that wears with each movement. They undergo rigorous testing and must pass FDA standards. They can wear out based on the amount of use over an extended period. Like new tires on your car, they may be made to last a certain number of miles but can show premature wear in some situations. The good news is that the current implant generation has made advances that should outlast the need of most patients.
Each individual patient is different and how you use your hip or knee, your activity level, your overall health can influence the longevity. A warranty is nice on a set of tires if they wear out prematurely, but for patients, it is unclear what advantage the patient gains from this. Redo surgeries (revision surgery) is covered under almost all health insurance policies should the implant fail prematurely.
Is the anterior approach to my hip replacement the best approach for me?
Anterior hip surgery is one of the first hip approaches used over a century ago and has been re-popularized by some surgeons. There are several approaches popular for total hip replacement.
Whether anterior, posterior, lateral, or superior all approaches have advantages and disadvantages. The goal of less muscle damage and quicker recovery is common to all modern approaches to the hip, and knee, joint and there is no clearly better approach in most studies. The most important part of the hip operation is putting the implants in correctly and securely. The size of the incision is based on the individual patient’s anatomy and the surgeon’s ability to gain adequate view during surgery to do the operation safely and efficiently. Discuss with your surgeon his/her preferred approach and your desire to minimize the size of your incision.
Will my new joint replacement trigger the alarms at the airport?
There are currently 1.2 million joint replacements performed per year in the United States and patients can fly around the world without problems. You no longer need a card but you should let the agents know you have an artificial joint. Yes, they will trigger the alarms and then they will scan the area per TSA protocol.
Will I need therapy after my joint replacement? When can I return to work and drive?
Most patients after hip replacement need only a small amount of physical therapy unless there were preexisting issues before the surgery. You may progress from a walker, to a cane to no assisted device in only a few weeks. Each patient is different, and therapy should be individualized based on your progress. Knee replacements generally require more physical therapy and this can last up to 6 weeks.
Return to work and driving is individualized based on your own progress, demands of your job and your overall health. Some patients return to work/driving in 3 weeks while others take longer. Discuss this with your surgeon so you are both clear about expectations.
Will I need to take prophylactic antibiotics prior to seeing a dentist after my joint replacement?
Yes, you should take short-term oral antibiotics prior to any dental work including a simple cleaning during the earlier part of your recovery. During dental work, there is a transient spread of bacteria from the oral cavity that potentially could infect your joint replacement. As this also occurs when eating, there is only limited evidence to support the antibiotic prevents infection. However, an infected total joint is a devastating problem. It is currently recommended this for 2 years only if you are healthy. We recommend this for your lifetime for major dental work.
Why does my surgeon use a robot? Are there any advantages to the robot?
The use of computer navigation and robotic surgery was developed to provide more accurate placement of the components and make the operation more reproducible. The surgeon is still doing the surgery, while the computerized portion allows for some additional controls and is functioning as more of an advanced tool. There is data to suggest these technologies may improve the positioning of the implants or some early clinical outcomes. However, to date there is nothing to suggest that they are of any significant benefit over the standard approach over the long term. You should discuss this with your surgeon for recommendations.
Visit our robotic knee replacement page for more information.
What questions should I ask my joint replacement surgeon?
Most total joint replacements are being performed by general orthopedic surgeons including sports surgeons. Some surgeons concentrate on total joints and may have a larger volume of total joint patients in their practice. Don’t be afraid to ask how many hip or knee replacement your surgeon does a week/year. You want a surgeon who does at least 25-50 joint replacements per year.
Fellowship trained total joint surgeons often limit their practice to just hip and knee replacement as well as re-do surgery called revisions. Most fellowship-trained surgeons perform 300-500 surgeries per year. Uncomplicated hip and knee replacement surgeries are very successful in the hands of most orthopedic surgeons in the community hospital setting. For patients with complex hip or knee problems, another opinion from a fellowship trained surgeon may be of benefit.
What implants will my doctor use?
There is a plethora of implant brands available for both hip and knee replacements. Most of the implant brands and styles are quite similar regardless of the manufacturer. An important question to ask year surgeon would be if there are any recalls on the implants planned for your surgery. Your surgeon will plan to use implants that are most suited to your anatomy and fit you the best.
Are there alternative methods of pain relief to opioids?
Opioid medication will likely be prescribed following your hip or knee replacement surgery. There are some patients who do not require any narcotics after surgery. The most appropriate timing for opiate use after surgery is in the early postoperative period when surgical pain is at its worst. This duration may be as short as a few weeks.
At Henry Ford Hospital we employ many non-narcotic options to minimize pain and discomfort following these major surgeries. This “multimodal approach” reduces the amount of narcotic needed following surgery. A multimodal approach includes things such as preoperative non-narcotic medications, special anesthetic techniques and early mobilization following surgery, all of which have been shown to minimize postoperative pain and discomfort following joint replacement surgery