Nathaniel Stewart, MD

Have a painful, disabling joint disease of the hip resulting from a severe form of arthritis

• Are not likely to achieve satisfactory results from less invasive procedures, medication, physical therapy, or joint fluid supplements
• Have bone stock that is of poor quality or inadequate for other reconstructive techniques
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  Your Knee Joint

  Femur – thigh bone
  Cartilage – tissue between bones that provides cushioning
  Patella – knee cap
  Tibia – shin bone
  Synovium – tissue that provides lubricating fluid to joint
  Ligament – flexible tissue that holds knee joint together

  What Causes Knee Joint Pain?
  One of the most common causes of joint pain is arthritis. The most common types of arthritis are:

  • Osteoarthritis (OA)
  • Rheumatoid Arthritis (RA)
  • Post-traumatic Arthritis

  Knee Surgery
  May be suitable for patients who:

  • Have a painful, disabling joint disease of the knee resulting from a severe form of arthritis
  • Are not likely to achieve satisfactory results from less invasive procedures, medication, physical therapy, or joint fluid supplements
  • Have bone stock that is of poor quality or inadequate for other reconstructive techniques

  Total Knee Joint Replacement

  • End surface of femur replaced with metal
  • End surface of tibia replaced with metal
  • Plastic liner is inserted between femur and tibia to reduce wear
  • Patella is resurfaced with plastic

  Recovery
  Every individual is different and every treatment plan is different. The length of hospital stay after joint replacement varies and depends on many factors including age and physical ability.

  Estimated Recovery Schedule

  • In-hospital Recovery: 2 – 5 days
  • Significant Functional Improvement: 6 weeks – 3 months
  • Maximal Improvement: 6 – 12 months

  Recovery — Rehabilitation 
  Following joint replacement the physical therapist begins an exercise program to be performed in bed and in the therapy department. The physical therapist or another member of the staff works with the patient to help the patient:

  • Regain muscle strength
  • Increase range of motion
  • 
    

    When will I be able to go back to a normal daily routine?

    This is a decision only you and your surgeon can make. Every patient’s experience is different.

    However, there are some general guidelines your doctor may give you:

    • You'll practice stair — climbing in the hospital and should be able to do this by the time you leave
    • You should have no restrictions on leaving your home as long as your safety and comfort are assured. Just don't tire yourself out; a good balance of exercise, rest, and relaxation is best for helping your body heal and gain strength
    • When to resume driving a car, going to work, and/or participating in sports activities are all highly individualized decisions. Be sure to follow your doctor's or orthopaedic surgeon's advice and recommendations

    After Surgery — Limitations

    For approximately 12 weeks after surgery certain limitations are placed on your activities. When fully recovered, most patients can return to work. However, some types of work may not be advisable for individuals with a joint replacement. These types of work include:

    • Construction work
    • Certain types of carpentry
    • Occupations that involve repeated high climbing

    Athletic activities that place excessive stress on the joint replacement will need to be avoided. Examples of these activities include:

    • Skiing (snow or water)
    • Basketball
    • Baseball
    • Contact sports
    • Running
    • Frequent jumping

    Realistic Expectations

    Physical Activities
    After joint replacement, acceptable physical activities should:

    • Not cause pain — including pain felt later
    • Not jar the joint — running and jumping should be avoided
    • Not place the joint in the extremes of its range of motion
    • Be pleasurable

    Longevity of Joint Replacement
    It is impossible to predict in individual cases how long a joint replacement will last. Many factors determine the outcome including:

    • Age
    • Weight
    • Activity level
    • Bone strength

Your Hip Joint

A joint is formed by the ends of 2 or more bones. The hip must bear the full force of your weight and consists of two main parts:

• A ball (femoral head) at the top of your thigh bone (femur)
• A rounded socket (acetabulum) in your pelvis

What Causes Hip Joint Pain?
One of the most common causes of joint pain is arthritis. The most common types of arthritis are:

• Osteoarthritis (OA)
• Rheumatoid Arthritis (RA)
• Post-traumatic Arthritis
• Avascular Necrosis

Hip Surgery
May be suitable for patients who:

Partial Joint Replacement

Partial joint replacement is a surgical procedure in which only the damaged or diseased surfaces of the joint are replaced, leaving much of the natural bone and soft tissue in place.

Total Joint Replacement

Total joint replacement is a surgical procedure in which certain parts of an arthritic or damaged joint are removed and replaced with a plastic or metal device or an artificial joint. The artificial joint is designed to move just like a healthy joint.

Joint Replacement

Joint replacement is a treatment option when pain:

• Is severe
• Interferes with daily activities
• Interferes with work

Joint replacement is a decision that should include:

• You
• Your primary care provider
• Your orthopaedic surgeon

Did you know?
Total joint replacements of the hip and knee have been performed since the 1960s. Today, these procedures have been found to result in significant restoration of function and reduction of pain in 90% to 95% of patients.

Source: National Development Conference, National Institutes of Health, December 2003

 Joint Replacement Preoperative

Preparing for a joint replacement procedure begins weeks before the actual day of surgery. 
In general, patients may need:

• Routine blood tests
• Urinalysis
• Physical examination
• Exercise
• Quit smoking
• Stop certain medications
• Donate blood

Joint Replacement Preoperative

• A general physical examination
• Dental procedures
• Skin condition
• Smoking
• Weight
• Medications