By Dr. John Kumar, Orthopedic Surgeon @ Kaiser Permanente, Downey
Operation Walk Board Member & Team Surgeon
Q:I was advised to get a hip/ knee replacement- how long will the implant last?
A:You should expect the current implants to last 20 years or more.
Q:How do I know WHEN I need to get a joint replaced?
A:Consider a joint replacement when your pain is limiting your ability to function on a day-to-day basis. If you have arthritis, find yourself avoiding activities because of pain, and no other treatments are working you should consider joint replacement surgery.
Q:Should I try physical therapy first?
A: It would be recommended to try multiple modalities to decrease your pain prior to surgery. These will be based on your individual medical condition. Treatment options include medications like Tylenol, nonsteroidal anti-inflammatories (Motrin, Alleve and prescription variations of the same and similar drugs), physical therapy, topical ointments (icy hot, Ben-Gay or Voltaren gel for example), bracing and injections are all modalities that can be used prior to surgery. Common injections include corticosteroids and visco-supplementation with hyaluronic acid. Other injections like platelet rich plasma, aka PRP, and stem cell injections are being offered by some providers. There is limited data on the efficacy of these injections. Injections in the knee can often be done in your surgeon’s office, injections in the hip may require fluoroscopic guidance and are usually performed less frequently.
Some patients do well with alternative medications like glucosamine, chondroitin, MSM another “natural medications” these have not been studied and are not regulated by the FDA. They are usually safe, but you should consult your primary care physician prior to trying these to make sure they will not interact with another medical condition you may have.
Q:How do I choose the right surgeon? Where can I check his/her qualifications?
A: You should choose a surgeon who does a high volume of cases. Many reports suggest that the complication rate is lower in surgeons that do more than 200 implant cases per year. The surgeon should be orthopedic board eligible or certified. Websites you can use to check the surgeon’ credentials are healthgrades.com, vitals.com, and webmd.com. You can also check your state medical board website.
Q:What happens after my surgery? How long do I stay in the hospital?
A:The length of stay after the surgery will depend on your medical condition, and your recovery. Many patients can go home the same day after routine primary hip or knee replacement. Some patients have medical conditions that require them to stay longer. You should be safe getting in and out of bed by yourself, walking at least 50 ft with an ambulatory aid, traversing stairs, and getting on and off the toilet.
Q:How long until I can return to work? Will I need a walker? cane? crutches?
A:The time return to work will vary based on what type of job you perform. Some patients can work from home and return to work sooner. Some patients work in high demand fields like construction and may need longer before returning to work. Your surgeon can guide you and give you a reasonable expectation on when you can return to work. If you drive a long distance to work, you will need to be safe driving before you can return to work.
Q:How much does a typical surgery cost if I have Medicare?
A:The cost of the surgery can vary depending on your insurance plan, length of stay in the hospital, and whether you will are in or out of network. Someone in your surgeon’s office, or at the hospital where you are having surgery should be able to estimate the costs for you.