Hip and knee replacements are fairly common in the United States. Nearly 1.3 million knee replacements and up to 760,000 hip replacements are performed on Americans each year. Those numbers are expected to slowly grow as the number of older Americans increases.
Joint replacement is an elective surgery that often helps patients who have a lot of pain. The decision to have a joint replacement is left up to you, along with guidance from your specialist.
But how do you know if it's right for you? What should you expect after joint replacement?
There are lots of things to consider. Speaking with your orthopaedic surgeon may help guide you in making the best choice for you. Here are some answers to top questions about knee and hip replacement surgery.
How do you know if you need a hip or knee replacement?
This is one of the most asked questions in orthopaedic clinics. Specialists consider a variety of things before making a recommendation to their patients.
The main two things specialists use determine whether joint replacement is recommended include:
- Pain level: Is your pain interfering with basic functions, like getting good sleep or living a healthy lifestyle? Ask yourself if your pain is affecting your mood or if you're avoiding activities that you enjoy. And be honest with your specialist.
- X-rays: Orthopaedic surgeons will examine the x-rays to see if there is bone-on-bone joint space narrowing or arthritis.
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To make an appointment with our orthopaedic surgeons, you can call 800-2-UCDAVIS (800-282-3284).
Are there alternatives to try before joint replacement surgery?
Most orthopaedic specialists will recommend trying other treatments before surgery. This includes over-the-counter pain medications, physical therapy, a brace and injections.
If those measures don't work after a period of time, then you may want to discuss surgery.
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How long does a knee or hip replacement last?
As medicine has improved, so has the lifespan of artificial knees and hips. A knee implant may last between 15-20 years. Hip implants are typically good for 10-15 years. However, much of this depends on the activity level and other patient factors.
Preparing before your surgery with specific exercises, losing weight and living a healthy lifestyle could improve your outcome.
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How painful is joint replacement?
Hip replacement is usually less painful after surgery. Patients typically feel a difference in the type of pain almost immediately. The hip pain they felt from arthritis will be almost gone after surgery. That pain is replaced with surgical pain that goes away quickly.
Knee replacement surgery involves a little more pain for most patients. There is more swelling and stiffness, as well, compared to hip replacements.
Remember that everybody is different. Just because you have pain and your friend didn't, doesn't mean the surgery did not go as planned. That's just how your body recovers. This can even be the case between your left or right side. One side might be more painful or less painful than the other after surgery. No joint, even on the same person, is the same.
As patients expand activities after surgery, they may have aches and pains. This is similar to when you haven't been in the gym in a while, and you feel sore after.
Learn about orthopaedic complications after surgery
How long does it take to recover from a hip replacement?
Hip replacements are much more predictable than knee replacements. In the first two weeks, there will still be some soreness. Generally, if you have bad arthritis, you'll notice a lot of improvement in the first few days. After surgery, patients can walk immediately and put full weight on it (there can be some precautions).
You may go to physical therapy for about six weeks. However, some surgeons opt for no physical therapy for hip replacement. Patients typically return to normal life and are moving well by about six weeks. At about three months, patients are usually feeling better than they were before surgery.
Between three and 12 months, patients are picking up strength, endurance and more activities. Overall recovery from all symptoms after surgery is about a year.
How long does it take to recover from a total knee replacement?
The first few weeks of a total knee replacement are more work, more rehab and more painful. After knee replacement surgery, patients can walk right away and put full weight on their knee.
Patients stay in physical therapy for about six to eight weeks after surgery. Up until about three months, there is a lot of stiffness when patients sit for long periods of time. The skin near the incision might feel numb and the knee may click occasionally. That's all normal.
By about three months, patients are able to move pretty well and aren't in as much pain. They are usually back in their normal routine. Full recovery after surgery can be about one or even two years.
Some people are unable to kneel after surgery. Also, your range of motion might not be back to the way it was when you were a young adult. Even after a year, you might not be able to touch your heel to your buttocks when stretching. Still, your range of motion is usually better than before surgery. At the one year mark, your knee that has the replacement might still be bigger than the other.
After joint replacement, can you return to normal physical activities?
Most surgeons don't have restrictions for you after joint replacement. However, your knee or hip may restrict you.
If you were playing a sport, running or exercising before surgery, you should be fine to do those after surgery. Specialists recommend that if you weren't doing it before, you shouldn't try it after your replacement.
It's important to note that you are having your joint replaced, but the soft tissue is still yours. You can still have tendonitis, bursitis or other soft tissue issues.
Should some patients undergo joint replacement surgery sooner than later?
Specialists used to encourage people to wait as long as possible to have surgery. Much of that was because implants didn't last as long, especially in younger patients.
Now, orthopaedists still tell patients to wait if they can. However, they don't want them to wait until they're not very mobile. That will make the recovery much more difficult.
If your symptoms and x-rays match, your specialist may encourage you to have surgery while you're healthy. This typically allows for a faster recovery. Our providers at UC Davis Health believe it's more important to enjoy more years of a pain-free hip or knee.
See how we partner with you for routine or complex joint replacements
Are there certain people who shouldn't get a hip or knee replacement?
For many providers, mental state plays a role in the decision of recommending surgery. A patient's older age isn't as much of a factor.
People who have dementia or other cognitive decline usually have an easier time recovering from a hip replacement than a knee replacement. They don't have to be as involved in their rehab to have a successful outcome. However, there is a worry that they won't stick to post-operation precautions or that they'll fall and dislocate their hip.
Cognitive decline in people who may need a knee replacement is a bigger factor. That's because they often don't understand that they need physical therapy and may forget to do the rehabilitation exercises. These patients can often get stiff and aren't as mobile as they were before surgery.
What else should you know before joint replacement surgery?
One thing you might not realize is that your sleep may be disrupted for a while. People often say that their sleep routine is very disturbed. This can play a role in your mood and even your physical therapy progress.
Sleep interruptions can be caused by the way you turn in bed, causing pain, or the pain medications you're taking. You typically return to a normal sleep pattern soon after surgery as part of your recovery.
Get some tips for better sleep and why it's important for your health
How can you make an appointment for joint replacement surgery at UC Davis Health?
Our orthopaedic care is ranked among the nation's best. Located across Northern California, our orthopaedic surgeons bring together expertise, research and education for patients of all ages.
To request an appointment, you can call 800-2-UCDAVIS (800-282-3284).
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This blog was medically reviewed by orthopaedic surgeon Zachary Lum.