Hip or knee replacement: 5 things to know before surgery

The number of hip and knee replacements performed each year in the United States continues to climb, with more than 2 million patients undergoing total joint replacements annually.

Advances in surgical techniques and expertise continue to drive improved outcomes and these procedures dramatically improve quality of life for a growing group of adults.

Yet, many patients often wish they had known exactly what to expect before undergoing the procedure. Endeavor Health orthopaedic surgeon and total joint replacement specialist Hristo Piponov, MD, highlights some key details to understand before surgery.

“It’s important for patients to understand the scope of their procedure, potential length of recovery and their vital role in achieving the best possible recovery and long-term health and wellness,” said Dr. Piponov.

Here are five important things to know before joint replacement surgery:

1. Full recovery can take 6-12 months. “Most people expect to be fine in 6-8 weeks, but in reality full recovery, meaning returning to full speed, endurance, balance, coordination and muscle strength, can take 6-12 months,” said Dr. Piponov.
2. The new joint might not feel “normal” right away. Especially in the first weeks and months after surgery people often worry that something doesn’t feel “right” or “normal,” explained Dr. Piponov. Extra stiffness in the morning, particularly the first 10-15 minutes after getting out of bed is to be expected, some numbness around the incision is also normal, as is a clicking sound. People sometimes worry when they hear their new joint clicking, and that too is a normal function of the new metal and plastic in your joint, said Dr. Piponov.
3. Recovery is not linear. Patients will have good days and bad days in the first few months after surgery as recovery is not totally linear, said Dr. Piponov. “Every week overall you should feel a little better than the week before,” he said. “But having a day that feels worse is not cause for alarm.”

4. There are options for pain management. Using a combination of non-opioid medications to control pain is now the norm. Some patients may need narcotics for breakthrough pain in the first 4-6 weeks, said Dr. Piponov, but in general non-opioid medications work very well. 

   “New drugs have emerged in the last few years to block pain receptors and they work well for so many people,” said Dr. Piponov. “We prioritize working with patients to help reduce their pain with safe and effective medications.”

5. Be as healthy and fit as possible before surgery. Make sure you are up to date with all your dental work, you definitely don’t want to go into surgery with any kind of tooth or other infection, said Dr. Piponov. 

   Similarly, staying on top of any chronic conditions is vital in the time leading up to surgery. “We don’t want patients to be dealing with any active infections, including common conditions like urinary tract or upper respiratory infections,” he added. Maintaining a healthy weight and normal body mass index (BMI) is also important for surgery and recovery. “Having excess weight puts people at additional risk for complications as well as negatively impacting the longevity of the implant,” said Dr. Piponov. “We want patients to come into the surgery as healthy and fit as possible.”