Frequently Asked Questions About Joint Replacement

At the Henry Ford Center for Joint Replacement, we are committed to giving you the best orthopedic care. We believe that educating and informing our patients empowers them to heal and live their best lives. Whether you are just starting to experience joint related pain or are ready to schedule joint replacement surgery our doctors are here to help. This list of answers to frequently asked questions is a good place to begin when you want to learn more about joint replacement surgery at Henry Ford.

• Who is a candidate for joint replacement surgery?
• Why does my surgeon recommend going home after surgery instead of to a rehab facility?
• What does it mean for me and my surgery?
• How successful are joint replacements for most patients?
• How long will my joint replacement last?
• Is the anterior approach to my hip replacement the best approach for me?
• Will my new joint replacement trigger the alarms at the airport?
• Will I need therapy after my joint replacement? When can I return to work and drive?
• Why does my surgeon use a robot? Are there any advantages?
• What questions should I ask my joint replacement surgeon?
• What implants will my doctor use?
• Are there alternative methods of pain relief to opioids?

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Who is a candidate for joint replacement surgery?

Why does my surgeon recommend going home after surgery instead of to a rehab facility?

Many patients can go home the same day as surgery. Some patients who stay overnight in the hospital go home instead of to a rehabilitation center. These patients often achieve a faster recovery than those who go to a rehabilitation center or skilled nursing facility. Additionally, there are lower risks of adverse events, such as infection, wound healing problems and readmission to the hospital if people go home, instead of to a rehabilitation center. It may be appropriate for a small percentage of patients to go to a rehabilitation center for safety concerns.

What does this mean for me and my surgery? 

Research shows that most patients can safely return home after shoulder, hip or knee replacement surgery. It is very important to discuss your home environment with your doctor and care team to formulate your optimal postoperative plan before you have surgery. Preparing your home before surgery for when you return after your surgery is a key step to success. This could include preparing meals in advance, placing supplies in easily accessible areas and removing clutter that could cause you to trip and fall. Most people can be confident that they will be able to return home after surgery and have a lower risk of complications by going directly home.

How successful are joint replacements for most patients?

Both total hip replacement and total knee replacement are very successful operations that change patient’s lives. It is important to discuss success rates with your surgeon prior to surgery as well as your expectations following surgery. Many joint replacement procedures change patients’ lives, and our goal is to get you back to the lifestyle and activities that mean the most to you.

How long will my joint replacement last? 

With today’s technology, the expectation is that your joint replacement will last you the rest of your life.

Is the anterior approach to my hip replacement the best approach for me?

Anterior hip surgery is one of the first hip approaches used over a century ago and has been re-popularized by some surgeons. There are several approaches popular for total hip replacement.

Whether anterior, posterior, lateral or superior, all approaches have advantages and disadvantages. The goal of less muscle damage and quicker recovery is common to all modern approaches to the hip, and knee, joint and there is no clearly better approach in most studies. The most important part of the hip operation is putting the implants in correctly and securely. The size of the incision is based on the individual patient’s anatomy and the surgeon’s ability to gain adequate view during surgery to do the operation safely and efficiently. Discuss with your surgeon his/her preferred approach and your desire to minimize the size of your incision.

Will my new joint replacement trigger the alarms at the airport? 

There are currently 1.2 million joint replacements performed per year in the United States and patients can fly around the world without problems. You no longer need a card, but you should let the agents know you have an artificial joint. Yes, they will trigger the alarms and then they will scan the area per TSA protocol.

Will I need therapy after my joint replacement? When can I return to work and drive?

Most patients after hip replacement need only a small amount of physical therapy unless there were preexisting issues before the surgery. You may progress from a walker, to a cane, to no assisted device in only a few weeks. Each patient is different, and therapy should be individualized based on your progress. Knee replacements generally require more physical therapy and this can last up to 6 weeks.

Return to work and driving is personalized based on your own progress, demands of your job and your overall health. Some patients return to work/driving within a few weeks while others take longer. Discuss this with your surgeon so you are both clear about expectations.

Why does my surgeon use a robot? Are there any advantages to the robot?

The use of computer navigation and robotic surgery was developed to provide more accurate placement of the components and make the operation more reproducible. The surgeon is still doing the surgery, while the computerized portion allows for some additional controls and is functioning as more of an advanced tool. There is data to suggest these technologies may improve the positioning of the implants or some early clinical outcomes. However, to date there is nothing to suggest that they are of any significant benefit over the standard approach over the long term. You should discuss this with your surgeon for recommendations.

What questions should I ask my joint replacement surgeon?

Most total joint replacements are being performed by general orthopedic surgeons including sports surgeons. Some surgeons concentrate on total joints and may have a larger volume of total joint patients in their practice. Don’t be afraid to ask how many hip or knee replacements your surgeon does a week/year. You want a surgeon who does at least 25-50 joint replacements per year.

Fellowship-trained total joint surgeons often limit their practice to just hip and knee replacement as well as re-do surgery called revisions. Most fellowship-trained surgeons perform 300-500 surgeries per year.

Uncomplicated hip and knee replacement surgeries are very successful in the hands of most orthopedic surgeons in the community hospital setting. For patients with complex hip or knee problems, another opinion from a fellowship-trained surgeon may be of benefit.

What implants will my doctor use? 

There is a plethora of implant brands available for both hip and knee replacements. Most of the implant brands and styles are quite similar regardless of the manufacturer. Your surgeon will plan to use implants that are most suited to your anatomy and fit you the best.

Are there alternative methods of pain relief to opioids?

Opioid medication will likely be prescribed following your hip or knee replacement surgery. There are some patients who do not require any narcotics after surgery. The most appropriate timing for opiate use after surgery is in the early postoperative period when surgical pain is at its worst. This duration may be as short as a few weeks.

At Henry Ford Hospital we employ many non-narcotic options to minimize pain and discomfort following these major surgeries. This “multimodal approach” reduces the amount of narcotic needed following surgery. A multimodal approach includes things such as preoperative non-narcotic medications, special anesthetic techniques and early mobilization following surgery, all of which have been shown to minimize postoperative pain and discomfort following joint replacement surgery.