Knee and hip replacements are major surgery so be sure you go for a skilled surgeon who is experienced at performing these operations.
When faced with the need to choose a surgeon for your joint replacement, it can be overwhelming. How do you choose? How do you know?
You might ask friends, family, your GP or the local NHS hospital who will say to you “Mr X is highly/well respected in our area” or “Mr X is the ‘top’ surgeon”. You might ask and be told by others who had Mr X do their hip/knee and were delighted and found him “approachable, understanding and such a nice person”.
In time there is a tendency for hip replacements to become loose. In general there is about a 90-95% chance that the hip replacement will continue to function well for 15 years.
The upshot is that hips and knees are pretty much tried and tested. Most have been around for years and although they have been ‘re-designed’ and refashioned from time to time, they are basically the same prosthesis. They have stood the test of time. Your surgeon will advise you on what is best for you.
The vast majority of individuals who undergo hip replacement surgery experience a dramatic reduction of hip pain and a significant improvement in their ability to perform the common activities of daily living. Following surgery, you may be advised to limit certain activities such as jogging and high-impact sports.
In general there are few restrictions following recovery from a hip replacement. For the first 3 months there will be certain restrictions to allow the soft tissues around the hip to heal and to reduce the risk of dislocation. After that patients can get back to the activities they wish although it is probably unwise to partake in a lot of impact exercise.
When a hip replacement becomes loose it usually leads to pain. We are now aware that the main factor causing hip replacements to loosen relate to wear particles released from the moving articulation. Once this process starts to happen the bone can start to be damaged and effectively eaten away (osteolysis). The effect of this is to make revision surgery more difficult because there is simply less bone to anchor an implant into. This requires a variety of techniques to restore bone and to re-gain strong fixation of the implant to the skeleton. The surgery is undoubtedly more complex and lengthy than a primary operation on the joint and does carry with it a higher complication rate. It does depend a lot on how damaged the bone has become. However, in the majority of cases it is possible to achieve a good result with good fixation of implants and the prospect of the hip continuing to function well.
Your new knee does have a shelf life and will wear in time. It’s important to look after the new knee joint after the operation. You shouldn’t need another knee replacement (or revision) for the next 10-15 years.
Get as fit as you can before the operation. Lose weight, stop smoking and tackle any infections that you have.
Visit your GP for assessment and if necessary he may refer you to an orthopaedic surgeon for an evaluation to determine whether you could benefit from arthroscopy.
Signs that you may be a candidate for this procedure include swelling, persistent pain, catching, giving-way, locking and loss of confidence in your knee. When other treatments such as the regular use of medications, knee supports, and physiotherapy have provided minimal or no improvement, arthroscopy may be necessary.
This really depends on the type of surgery you have had, previous level of fitness, type of work, travelling involved, etc. This is therefore best discussed with your surgeon before and after surgery.