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Aging knees and hips

Is it time to consider joint replacement?

Created date

November 22nd, 2011

Bones are alive. Like other parts of your body, they need a good blood supply to stay healthy. When blood flow becomes limited due to damage, your bones can no longer repair themselves and may deteriorate. The bones in your joints are especially vulnerable. Years of wear and tear can contribute to damage, says Henry Boucher, M.D., orthopedic surgeon and joint replacement specialist at Union Memorial Hospital in Baltimore, Md. But arthritis is by far the most common cause of joint problems. Injury or trauma to a joint, especially fractures, can also harm joints, says Myla Carpenter, M.D., medical director at Charlestown, an Erickson Living community in Catonsville, Md. So can a condition called aseptic necrosis which is when bone dies due to decreased blood supply. No matter the cause, pain, stiffness, and swelling may mean that the joint is worn down. Persistent pain at rest, trouble walking, or difficulty performing your daily activities might mean it s time to consider having a joint replaced, Carpenter adds. But before recommending surgery, your doctor may try other treatment options, including medications, cortisone injections, physical therapy, or assistive devices such as canes or walkers.

Surgery and complications

Knees are the most common joints that need replacement, Boucher says. The second most common are hips. Sir John Charnely, a British orthopedic surgeon, pioneered the modern hip joint replacement in the 1960s. Modern knee replacements were also developed in the 1960s. Since then, improvements in surgical materials and techniques have increased the longevity of new joints. With today s technology, we can expect joint replacements to last up to 20 years in many cases, Boucher says. There are many reliable and safe implants we can use. Research has helped us hone in on some previous problems such as materials that were failing at an earlier rate than expected. Part or all of a joint can be replaced, depending on the severity of damage. A new joint can be made of plastic, metal, or a combination of materials. It may be cemented into place or not cemented, which allows your bone to grow into it. Problems can occur with joint replacements but most are treatable. Serious complications such as infections are rare, as are heart attacks or strokes after surgery, Carpenter says. Blood clots in the veins are a common complication, but if you re going to have surgery, your doctor will order medications or treatments to help prevent them from forming. Other complications include nerve or blood vessel injury, and loosening or dislocation of the joint.

Optimize your recovery

After surgery, you may be able to go home in a few days, or you may need to spend several weeks in a rehabilitation facility. But forget about weeks of bed rest. You will most likely stand or walk the same day you have surgery, usually with the aid of crutches or a walker. Physical therapy typically begins within a day or two. The best thing you can do after surgery is to be active, he adds. Low-impact exercise is best, such as walking, swimming, or using a stationary bicycle. You may not reach your best level of functioning until three months after surgery it s mostly about increasing your strength and stamina, Boucher explains. The more you use your new joint, the more flexible you become. With today s medications and treatments, most people have good pain relief so they can be active sooner. People with chronic medical conditions such as diabetes may have a prolonged recovery period, Carpenter adds. Don t let your age deter you from considering a joint replacement. Age does not limit you from having surgery, Boucher explains. If your health is fairly good and you want to stay active and independent, talk to your doctor about your options for joint replacement.