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Total joint replacement, including knee and hip replacement, is rapidly becoming one of the most commonly performed procedures in orthopedics. The most common indication for joint replacement is debilitating joint pain from underlying osteoarthritis. Osteoarthritis develops when cartilage (the “cushion” in the joint) wears away, which can eventually result in bones rubbing against one another. This can lead to joint pain and stiffness. If nonsurgical treatments, such as anti-inflammatory medications, physical therapy, and joint injections, do not provide adequate pain relief, joint replacement may be a viable option.
Before considering joint replacement, I believe that it is important to understand what the procedure can and cannot do. Greater than 90% of people who have joint replacements report a dramatic reduction in joint pain and a significant improvement in the ability to perform common activities of daily living. Joint replacement, however, will not allow you to do more than you could before you developed arthritis.
It is also important to recognize that every joint replacement will develop some wear in its plastic cushion with normal use. Excessive activity or body weight may place high stresses on the implant and lead to early failure. This could result in the need for further surgery. For this reason, I recommend avoiding high-impact activities, such as jogging or jumping. Realistic activities following joint replacement include unlimited walking, swimming, golf, driving, biking, and other low-impact sports. With appropriate activity modification, joint replacements can be long-lasting. Currently, more than 90% of modern joint replacements are still functioning well for 15 years after surgery. In my opinion, joint replacement is a surgery performed to improve quality of life, and low-impact activities such as those listed above may be performed without restriction. Sports and fitness activities should be individualized to each patient.
Before considering joint replacement, I believe that it is important to discuss postoperative expectations with your surgeon. Having a realistic understanding of what a joint replacement can and cannot do is essential to having an excellent postoperative outcome.
