WHO NEEDS JOINT REPLACEMENT SURGERY?

Are you

• Unable to sleep at night because of the joint pain.
• Tried a series of different medications that don't help
• The pain or prior medication no longer works.
• Pain from your arthritic joint keeps you away from regular outing such as visiting friends, going shopping or taking a vacation.
• Activity is restricted to the point where you have trouble getting out of chair, going up stairs, getting off the toilet or getting up from the floor.
• Reduced walking distance and unable to stand long hours.

WHAT DOES THE SURGERY INVOLVE?

• Joint Replacement actually involves only changing the worn out joint surfaces with artificial material to restore the joint space and correct deformity.
• It also offers pain relief in all daily activities like walking, climbing stairs, using the toilet.
• Materials and Design of the artificial joint used will vary on the need of the patient and extend of damage, which you need to discuss with the treating surgeon.

RECOVERY PERIOD

• Patients are usually made to stand and take a few steps the same evening or next day of the surgery. Walking will progress to stair climbing by 4th day and allowed to use the toilet after 2-3 days.
• Discharge is planed after 4-5 days and walking is allowed to tolerance with walker for a week or two. Stitches or Clips are removed on 10-12th days after surgery.
• Resuming work and driving usually takes 4-6 weeks.
• Overseas patient can fly back after 2 weeks.
• Both knees can undergo joint replacement at the same sitting in selected patients.

PAIN MANAGEMENT

• Most surgeries are done under spinal Epidural combination and General anesthesia is used less frequently.
• As you recover from the anesthesia, the catheter in your back will control post-operative pain with good efficiency, hence allowing early movement.
• Some discomfort can be expected which gets better with time.
• Pain after exercise can be managed with ice pack and may need to take an occasional painkiller for a few days.

POSSIBLE COMPLICATIONS OF JOINT REPLACEMENT SURGERY.

• Infection of the operated joint can be early or a delayed complication which can be treated by changing the implant after control of infection. Incidence is 1-2 percent and this can happen despite all precautions.
• Loosening of the implant occurs over months or year if not well aligned or due to poor bone quality.
• Deep vein clots and injury to blood vessel or nerves may occur very infrequently.
• Stiffness and Residual pain generally improves but may persist in few patients.

IS AGE AND ASSOCIATED ILLNESS LIKE DIABETES AND HYPERTENTION A BARRIER FOR JOINT REPLACEMENT SURGERY?

Age is no barrier for joint replacement as anesthesia techniques are safer and more precise and improved surgical techniques and minimal blood loss.
Yet good control of sugar and blood pressure is imperative before any surgery.

DO I NEED TO ALTER OR STOP ANY MEDICATION BEFORE SURGERY?

• Blood thinners like Aspirin, Clopidogrel needs to be stopped a week prior to the day of surgery.
• Other medication for Blood pressure, Diabetes, Epilepsy, Bronchial asthma need to be continued as per the physician advice.
• Any Skin, Dental, Urinary or chest infection need to be controlled with antibiotics before deciding on day of surgery.

BENEFITS FOR JOINT REPLACEMENT SURGERY

• Predictable pain relief.
• Good range of movement to allow stair climbing. Driving a car, Riding a bicycle, playing golf or tennis.
• Return to improved quality of life, without worrying about pain is the ultimate benefit of this surgery and which lasts for 15-20 year in 90% of the patients.
• With better designs, better materials and better techniques they will last longer in the future.