Is It Time for Joint Replacement Surgery?

According to the Arthritis Foundation, approximately 60 million people in the U.S. have arthritis.

Although there are many types and causes of arthritis, osteoarthritis is the most common. Sometimes known as “wear and tear” arthritis or degenerative joint disease, it is the progressive breakdown of cartilage, our joints’ shock absorbers.

People with osteoarthritis often experience one or more of the following symptoms:

  • Pain that increases over time
  • Stiffness
  • Limping
  • Weakness
  • Swelling
  • Poor range of motion
  • Problems walking or doing other everyday activities

Treating Arthritis

“There are several approaches your health care provider may recommend to ease the pain of arthritis and restore mobility,” says Matthew Brown, MD, orthopedic surgeon at Cooper University Health Care. “Recommendations usually depend on how advanced your arthritis is and the intensity of your symptoms.”

Over-the-counter medications, such as acetaminophen (Tylenol), NSAIDs (nonsteroidal anti-inflammatory drugs) like ibuprofen (Motrin), and naproxen (Aleve), are among the first lines of defense to relieve pain. Stronger NSAIDs are also available by prescription.

Topical pain relievers and analgesics reduce pain in several ways. Some have ingredients such as menthol and eucalyptus oil that create a cooling or warming sensation that can ease discomfort. Creams that contain salicylates decrease inflammation. Products that contain capsaicin temporarily block a chemical called substance P that delivers pain messages to the brain.

Injections. Your health care provider may suggest injecting corticosteroids (cortisone) or hyaluronic acid directly into the joint to provide relief. Cortisone fights inflammation, acts quickly, and may last several months. Hyaluronic acid boosts the natural joint fluid, making movement easier. It acts slowly and can take a couple of months to be fully effective, but the effects can last six months or longer.

Exercise and physical therapy can help improve mobility and strengthen the muscles that support joints.

Supportive braces, splints, or canes provide more direct support.

Weight loss can provide relief of arthritis symptoms for those who are overweight because dropping pounds reduces pressure on joints.

When to Consider Joint Replacement Surgery

It can be hard to identify the best time for surgery. Health care providers often recommend waiting as long as possible. Waiting too long, however, could limit recovery. On the other hand, having surgery too soon might increase the need for an additional procedure later.

“Prosthetic joints being produced today are expected to last up to 20 years,” says Dr. Brown. “If you’re 70 or 75, that might be fine. But if you have your knee replaced when you’re 50, there’s a chance you might need to have that joint repaired or replaced at some point.”

So, when is the best time to have joint replacement?

“When other, less invasive options no longer provide relief,” Dr. Brown says. “That’s usually when your health care provider will suggest joint replacement surgery.”

You may be a candidate for joint replacement surgery if you are experiencing the following:

  • Severe pain that limits your ability to participate in daily activities
  • Moderate or severe pain while resting, day or night, especially if pain wakes you up
  • Long-lasting inflammation or swelling that doesn’t improve with rest or medications
  • Inability to tolerate NSAIDs
  • Limited range of motion that makes it hard for you to climb stairs, get out of a chair, reach over your head, or get in and out of the car
  • X-rays that show your bones are touching (known as “bone-on-bone”), with no cartilage to cushion them

“Advanced arthritis can also impact emotional well-being, as increasing pain reduces quality of life,” Dr. Brown says. “Chronic pain has been linked to depression and anxiety, even in people with no history of mental illness.”

What Is Joint Replacement Surgery?

Although knee and hip replacement procedures are the most common, shoulder replacement is also possible for those with advanced arthritis in the upper extremities.

An orthopedic surgeon will remove all or part of the joint and replace the damaged part with an artificial joint made of plastics and metal. Although the procedure is common, it’s also considered major surgery.

Someone having joint replacement surgery can expect several months of recovery, including physical therapy, before they achieve their highest level of functionality. However, the investment pays off in relief that may last a lifetime.

“All medical procedures have their risks,” Dr. Brown says. “And other health issues may factor into recovery.”

Dr. Brown adds that following your health care provider’s instructions can play a significant role in your recovery.

“Keep all your follow-up appointments, go for all ordered tests, take your medication as prescribed, complete your physical therapy program, and stay active as recommended,” Dr. Brown explains. “Patients who do so usually have the best outcomes and live much improved lives.”

If you are experiencing joint pain that interferes with your daily activities, make an appointment with a specialist at the Cooper Bone and Joint Institute by calling 800.8.COOPER (800.826.6737), or use our online appointment request form.

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