Whether the pain and stiffness in your knee is getting worse, or your hip has been achier than usual, you may be wondering if joint-replacement surgery is in your future.
Although joint replacement (arthroplasty) usually is associated with older people, the decision to pursue this procedure isn’t based on age alone. Instead, there are a number of factors to consider when you’re in the doctor’s office asking, “Should I have a joint replacement?”
Who Is a Candidate for Joint-Replacement Surgery?
Joint replacement is a major procedure that takes time to recover from. You will have limitations in movement for a couple of weeks and will need to several months of exercises and therapy to resume full activities.
For that reason, it’s important to weigh the risks and benefits involved. Here’s a look at the issues you and your doctor should discuss before you decide.
- Your general health. You must be in good health to undergo this elective surgery. Certain health conditions, such as heart disease, lung problems, blood-clotting disorders, and diabetes will put you at increased risk of complications if they are not under control. Obesity and tobacco use also are associated with increased complications after joint-replacement surgery. Your physician will help guide you in getting these aspects of your health in check before recommending surgery.
- Your level of pain. Joint pain that has gotten so severe that it interferes with your sleep and isn’t adequately relieved by medication may signal it’s time to pursue surgery.
- Your ability to function. If pain keeps you from performing daily activities (such as bathing, dressing, or preparing meals), you should talk to your doctor about your options. Likewise, joint pain and stiffness that prevents you from climbing stairs or requires you to use a cane or a walker to get around is a sign that surgery could be necessary.
- Your age. Although the number of people undergoing joint replacement surgery in their 40s and 50s is increasing, most people having these procedures are age 60 or older.
Who Is A Candidate for Same-Day Discharge?
Some patients having total joint arthroplasty are eligible to be discharged on the same day as their surgery. Same-day discharges for ideal candidates have increased steadily over the last few years. As with all hip- and knee-replacement surgeries at UPMC, patients who are same-day discharge surgery candidates receive preoperative education, testing, and consultation with their orthopaedic surgeon. These patients also must complete standardized prehabilitation protocols before surgery and take part in the same amount of physical therapy and rehabilitation after surgery as other patients.
More patients are choosing same-day discharge thanks to advances in anesthesia protocols and pain-reduction strategies. Keep in mind that just because a patient is designated same-day discharge prior to surgery, it does not mean they automatically will go home that day. Patients still will need to meet discharge requirements, including being able to move about with no or only minimal assistance before going home.
In general, patients who are 75 years of age or younger, and who are in generally good health, are candidates for same-day hip- or knee-replacement procedures. Other criteria for a patient to be considered for a same-day discharge include:
- Body mass index of < 40 kg/m2
- Ability to walk without assistance or with limited assistance (cane only) prior to surgery
- Assistance at home during the recovery and rehabilitation period
- No cardiac or respiratory disease for which monitoring is necessary
- No untreated sleep apnea
- No chronic opioid use or opioid addiction
- No health condition that would prevent a same-day discharge
Time to Call a Doctor for Joint Replacement?
If nonsurgical approaches to joint pain and stiffness — including medication, physical or occupational therapy, and braces — haven’t worked, joint-replacement surgery may be right for you.
Talk to your doctor—not just about the procedure and whether it is right for you, but also about the recovery time and physical therapy you’ll need afterward. Ask whether they perform same-day discharge joint replacement and about the surgery-day details. If you’ve been deemed ready for joint-replacement surgery, your orthopaedic surgeon will discuss whether same-day discharge is right for you.
When deciding whether to have joint-replacement surgery, consider choosing a doctor who is experienced in the procedure. The more experience a surgeon or department has with joint procedures, the more likely it is that your procedure will be a success, with a lower risk of complications.
To learn more about whether joint-replacement surgery is right for you, contact UPMC Orthopaedic Care at 1-866-987-6784.
Editor's Note: This article was originally published on , and was last reviewed on .