There are many items throughout life that need to be replaced. Old tennis shoes, light bulbs. Maybe even a wardrobe. When one talks of replacement, it is not often that people discuss parts of their body. However, for hundreds of thousands of Americans, it’s a different story. According to the American Academy of Orthopaedic Surgeons (AAOS), 267,000 people undergo knee replacement, and 160,000 undergo hip replacement surgery each year.

Joint replacement is surgery done to replace all or part of the diseased portions of the joint with an artificial device (prosthesis) to restore joint movement. The most common reason why patients undergo hip or knee replacement is from the natural wearing down of the joint. This is known as osteoarthritis. For this reason, it’s logical to understand that most patients who have the surgery are older. The more the joints are used, the more they wear down. Possible reasons for replacement of the hip or knee joint may include:

• Pain that has failed to respond to conservative therapy (medications, steroid injections, physical therapy, lifestyle and activity adjustments, rest)
• Osteoarthritis or arthritis confirmed by X-ray
• Inability to work, sleep or move because of pain
• Loose prosthesis
• Joint fractures, tumors or deformities

While joint replacement is ideal for some patients, it’s not for all. Joint replacement surgery is not recommended for those with current joint infection, poor skin coverage around the joint, paralysis of the muscles surrounding the joint, severe vessel, nerve or physical disease or those who are morbidly obese (over 300 pounds). It is also not typically recommended for those who are young because of the strain that can be put on the prosthesis.

If you’re considering joint replacement, talk with your physician about seeing an orthopaedic surgeon for an evaluation. This evaluation usually consists of taking a medical history, doing a physical examination of the joint and surrounding areas and taking X-rays of the joint. Occasionally, blood tests, an MRI (Magnetic Resonance Imaging) or a bone scan may be done to assess the condition of the bone and tissues around the joint. In addition, the surgeon will ask about the patient’s expectations of the surgery and talk about the risks involved and the possible outcomes for recovery.

Rehabilitation is an important part of getting the maximum benefits out of joint replacement surgery. Typically, therapy begins the day after surgery. While the initial exercises are extremely basic, the goal is to get the joint moving. Physical therapy increases daily until the patient can perform daily care activities unassisted and is ready to be released from the hospital. Before going home, a patient should have a plan mapped out for aftercare: wound care, physical therapy and occupational therapy, if needed. The patient should also have a clear understanding of what can and cannot be done after surgery, in order to allow for proper healing and recovery.

It’s important to realize that joint replacement surgery is not a magical cure. It may, however, help many of the patients who undergo the surgery to live in less pain with the ability to carry on with normal, daily activities that many take for granted - such as replacing items that are not part of the body, like tennis shoes and light bulbs.