Although the pain of arthritis is a major factor in having joint replacement, the majority of joint surgeries are elective, says Art Schoenstadt, MD, founder of the health information Web site eMedTV.com, which features more than 30 articles on joint-replacement surgeries. That means you – and only you – make the ultimate decision as to whether you will have joint surgery, he says. It also means you have the luxury of time to make the decision and to plan, once you do.
People reach the decision at different times and for different reasons. For some, joint pain becomes unbearable and is no longer relieved by exercise, medication or other conservative methods. For others, stiffness or immobility affects their ability to do their jobs, care for their homes and families or enjoy their favorite activities.
Waiting a month – or even a year or two – to pursue surgery probably won’t have lifelong effects (although many people who have waited much longer say they wish they had had it sooner). And waiting for even a short time can enable you to learn all you can about the procedure and then prepare for it – mentally, physically and financially.
In this three-part series, Arthritis Today will guide you through all the steps – from decision making to recovery.
Although joint surgery is rarely life-saving, many people can attest it can be life-changing. Preparing for surgery properly can help ensure the change is a positive one.
Know thyself
Just as there are many forms of arthritis, there are many types of arthritis surgeries.
Understanding your precise problem – torn cartilage, worn cartilage, a limb-length discrepancy or osteonecrosis (death) of the bone adjacent to the joint, for example – as well as the treatment options, is important as you consider surgery.
1. What part of the body is most common to arthuitis?
2. how much does it hurt?
3.is there help availab;e to you?
4.do you believe charities are helping?
5.do you think that doctors and nurses are doing enough to help find a cure?
6.How are you affected?
7.what is you hinest opinion about it alll?
Thankyou very much, you are helping me greatly as now i will be able to particiapate in convosations about the disesase and i will understnad how i affects you.
Developmental Dysplasia of the Hip (DDH) is the most common cause of OA of the hip (though I do not see you discuss dysplasia at all anywhere on this website), and indeed is present in 1 out of every 1,000 live births. 80% of those diagnosed with DDH are female, and most are first born. Most diagnoses of hip OA are generally accepted to be SECONDARY to a developmental deformity (such as dysplasia) in North America today: surgeons at prestigious Harvard Medical School state that 43% of all hip OA cases are associated with hip dysplasia. Only 20% of hip OA cases are believed to be primary. Source is here at the Journal of Orthopedics, Harvard Medical School:
http://www.orthojournalhms.org/volume11/manuscripts/PDF/V11_om_13.pdf
The periacetabular osteotomy surgery (PAO, for short) is considered to be the preferred surgical correction of hip dysplasia, a much better option than a total hip replacement for those patients who are deemed good candidates (and for whom OA has not progressed too much, yet.) Though it has an initial recovery period that is somewhat more difficult than that of a hip replacement, it is worth it: this procedure preserves and improves the function of the patient's own hip joint rather than replacing it with an artificial one. The goal of the PAO is to reduce or eliminate pain, restore function, and maximize the functional life of the dysplastic hip. More often than not, no additional surgeries are needed with no limitations whatsoever on the patient's activities, post-op. I know, because I had a PAO on each of my hips this year with excellent results. It was tough, but it was so, so worth it. I look forward to returning to all of my activities, likely without another surgery for the rest of my life. Thank goodness I found out about this incredible surgical option before it was too late.
**I urge anyone who is experiencing hip pain (particularly women) to research periacetabular osteotomy (PAO) surgery to see if you might be a candidate, and hip dysplasia. An excellent place to start is to check out the "Hip Chicks Unite" hip dysplasia and impingement support group online: www.hipchicksunite.org. There is a staggering lack of education in the public (and among medical practitioners, unfortunately, as evidenced perhaps by a complete lack of information on the Arthritis Foundation's website, here) on developmental dysplasia of the hip and the corrective surgeries that can FIX this problem completely, thus eliminating the need for hip replacement surgery and subsequent painful, technical revision replacements. For more information on hip dysplasia, you can also check out the very informative website for Children's Hospital Boston's Adolescent and Young Adult Hip Unit:
http://www.childrenshospital.org/clinicalservices/Site1163/mainpageS1163P7. html
YOU WILL BE SO THANKFUL YOU DID.
I injured my left knee lifting text books and now that knee needs to be replaced. I'm postponing surgery by water exercise and strengthening.
Is it likely that that knee injury years ago has led to the necessity of a knee replacement? Thank you. Dana
I waited awhile with the first replacement of the left hip, as I was 'only' 54 at the time and felt I was too young. I tried therapy, etc., but eventually the therapist said there was no more she could do to improve and, IF THE ARTHRITIS WAS INTERFERING WITH THE WAY I WISHED TO LIVE MY LIFE that I should consider the replacement surgery. That made a lot of sense to me, and is basically the thinking I have used to decide on the other two surgeries.
I certainly hope this next surgery will be the last, at least for awhile, and I will be able to take walks with my wife and granddaughter and play golf without pain!
By the way, someone asked about working out after surgery, and it is not only possible, but is encouraged by the doctors and therapists so that you maintain strength around ALL of your joints and reduce stress and wear and tear around your original and new joints.
As far as pain and recovery from the surgeries, I have been blessed that surgical pain was very minimal after both surgeries and recovery/rehab went well and was fairly easy. The rehab is, of course, easier if you are used to exercising before your surgery.
I have also worked in the medical field for many, many years.
Keep what you have, what you were born with until you can no longer stand it. I have taken this approach with each of my fusions, and so far have had really good results. In both instances the doctor did not retrieve any cartilage out of either joint. I used it all up!
I think planning ahead of time for any time of joint surgery is important. You have to think of the time you have to be in bed, going back and forth to doctor appointments, and in many issues physical therapy appointments multiple times a week. These can be time consuming and cumbersome, especially on the caregiver.
Give thought to who your caregiver will be, and if they are physically and emotionally able to do so. I am very lucky to have that type of support.
If you do not have that type of support, I suggest looking into rehab facilities for a short period of time. Having joint surgery is a matter of following doctor's orders to a T and not staying from them just because you can't take care of yourself properly.
If you cannot make the committment to the healing process, joint surgery may not be an option for you. You can cause more harm than good by doing what you feel is best for you than what the prescribed treatment and recovery is. It's easy to finally become pain free and think that it's okay to do something, when it's not indicated.
Get a second and third opinion if possible. If the first doctor is offended by you doing that, is that really the doctor you want working on your joint? Any type of joint surgery is not easy on a patient,and should not be taken lightly.
The internet is never ending. You can read medical studies, watch you tube videos, and learn so much from other people who have gone down the path that you are getting ready to go on. The best advice and information I have found has been from message board that cater exclusively to MY SPECIFIC AILMENT. I don't look to knee replacement or hip replacement patients to give me an outlook on what an ankle surgery will be like. I look to others with ankle fusions.
Good luck to everyone who has gone through or is going through the process. Take it serious, believe in yourself, and most of all, follow doctor's orders.
I have had two hips and one knee so far and all three were different experiences but dragging it out living in pain was a mistake. Best advise, prepare mentally and get the best surgeon and therapy afterwards that you can.
I have RA and have had 5 joint replacements,
both knees, both shoulders and my right ring finger pip joint. I DO recommend knee replacement surgery, my knees are 15 and 14 years old and still do well.
As for fingers...it's best to talk with your hand doctor and then take it from there...they can come out of joint early after surgery and I'm really not sure about after because my new finger joint is only 9 weeks old. May God bless you all.
I AM NOT WHAT MOST WOULD CALL ELDERLY...I STILL RIDE A 2008 HONDA GOLDWING MOTORCYCLE AND GET AROUND VERY GOOD.
MY QUESTION IS THIS: IF I HAD THE THUMBS AND FINGERS OPERATED ON, WOULD I BE ABLE TO USE THEM BETTER WITHOUT PAIN AND WITH SOME STRENGTH IN THEM??
THANK YOU FOR THIS OPPORTUNITY TO ASK THIS QUESTION.
SINCERELY,
billy jack surles
Any advise?
deedee
Thank you so much for your suggestions,
Marilyn
I am looking for a Surgeon at Vanderbilt! Who was your incredible surgeon?
Thank you,
Marilyn
Laura
Even after that surgery i am having prob with my backbone. Its not letting me to sleep. For God sake no one should get a prob in backbone. That is more dangerous than any other i feel. This is all my experience..
I thank the site for having such gud innovative work and content dispalyed is also gud. And also i thank the people who are all posting there comments. Byee
Re|"should I have both knees done @ once?"
ABSOLUTLEY NOT! one at a time is more than enough to deal with, especially with PT and the pain...you don't know how mobile you will be, so from personal experience, I'm glad I had the other knee to rely on for some support, even though that one was very painful as well... but different pain than surgical pain. By the way, if you ever have to have hip surgery...it's a breeze after knee replacement! Had left hip done in July, 09 and next Tuesday, 01-19-10 I become the "bionic woman" both knees, both hips replaced, I can't wait for my "life" to return to me pain free! Best of luck and have faith in your surgeon (very important) and of course, GOD!
I just went through arthoscopy surgery on my right knee. Mainly to repair a tear in my miniscus and of course arthritis. My surgery was two weeks ago. In recovery the doctor mentioned we need to talk about your right hip. My hip I said in confusion. My pain has been in the groin area as well as the buttox. I am wonderfing if I need a second opinion whether I might need a hip replacement. I can not take anymore pain
I am 45 with PA, (psoriatic arthritis) and had 1 knee replacement and a 2 nd one coming up on June 30th. I have had 2 metal braces at one time and now just 1. The surgery is not fun but really I was feeling very good aft 2 weeks. I am looking forward to walking without a brace and swimming too without one. I cannot even walk through a store now, I hate it as I was so active, the surgery is worth it. I cannot help the damage the disease has done, and this is an option for me to go on with my life as an active person. I did the hyalagan shots, 5 in each knee, and I saw no relief. I am thankful for the surgery, I will be able to be more active. Go for it! If you want someone to talk to feel free to contact me.
Hang in there, it gets better.
She too took xrays and said it was obvious to her that I did need hip replacement and that the hip giving me the most pain was not as bad as the other one. She was not practicing as a surgeon and had no "incentive" on her part for me to have surgery.
In the past six months I have had both hips replaced and haven't felt better for years. BUT I totally agree, be careful who you get as a surgeon because there are many horror stories out there like my friend who fell and broker her hip (or visa versa) and the surgeon on call at the closest hospital was a "foot doctor" who messed things up for her and next week she will have her third surgery on the same hip in less than a year to repair what TWO orthopaedic surgeons did to her.
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