Ben (Moderator) - 1:50 PM:
Greetings everyone and welcome to the NorthShore University HealthSystem's latest chat: Active Life After Joint Replacement with Dr. Alexander Tauchen. The chat will not begin for another 10 minutes, but please start submitting your questions now and the doctor will start answering them shortly.
Alexander Tauchen - 1:59 PM:
Thank you for joining. I look forward to answering your questions about hip and knee replacement!
Julia (Buffalo Grove) - 2:00 PM:
Is there a benefit to doing a partial knee replacement using MAKO vs the conventional way?
Recovery time for both? How long does a replacement last (usually)?
While the "conventional way" is tried and true and works very well, there is now published data to show that Mako can assist with more accurate component positioning and can help to minimize soft tissue trauma. Recovery time with Mako may also be a bit quicker. I prefer Mako as I feel like it helps me to do a better job technically and gives more reproducible results.
Nick (Mt. Prospect) - 2:04 PM:
I was an avid Racquetball player, even after a new hip in 2012. I just had lower lumbar spinal fusion this past July, due to 6 months of spinal stenosis and nerve pain. My question is, will I be able to run again? Sprint? Play RB like I used to? It seems my nerves won't let me. Do I have nerve damage?
Unfortunately, this is hard for me to comment on without knowing all of the details. Typically, people can recover quite well after this type of spine surgery. On rare occasions, if there was prolonged nerve compression before surgery, recovery of the nerves can take longer and be more unpredictable. I would defer more detailed questions to your spine surgeon. With regard to the hip replacement itself, the answer would be yes. While I don't formally recommend prolonged running after a hip replacement, people get back to all sorts of activities, including RB, cycling, swimming, golf, tennis, and hiking.
Sergio Correa (Chicago iL) - 2:09 PM:
Is it true, that after a knee replacement, after a certain time, people ended having a hip replacement also?
While this can certainly happen, I would say this is not true. Having a knee replacement does not mean you will some day need a hip replacement, and vice versa. However, there are a number of people who happen to have arthritis in multiple joints that requires replacement of multiple joints. Many people go thru their entire lives without having either hip or knee replacement, while some end up having both hips and both knees done at some point - it is highly variable.
Susie (Chicago) - 2:14 PM:
How much pain can I expect after total knee arthroplasty, what will I get for pain after surgery?
I also wonder, what is mako?
Knee replacement can be a very painful surgery, particularly in the first 1-2 weeks post-op. Your surgeon will provide pain medications to get you thru this time - some common medications include Tylenol, norco, tramadol, celebrex, and sometimes stronger narcotics like extended release morphine or oxycontin. We try to minimize the use of narcotics as much as possible. Not everyone experiences pain the same way so the amount of pain experienced is highly variable between patients.
Mako is newer technology that allows surgeons to perform robotic-assisted knee and hip replacement.
Mariola (Des Plaines, Illinois) - 2:19 PM:
What is the average lifespan of the replacement hip joint? What happens when joint goes "bad"
When people talk about joint replacements "wearing out," they are usually referring to the plastic liner used wearing out. Historically - prior to around 2003-2004, this plastic was expected to last 15-20 years. "Newer" plastic, the kind used today, is expected to last much longer than that although it is hard to know an exact time frame since it has only been used since the early 2000s. If a hip or knee replacement "goes bad," it often requires revision surgery, or a "re-do" of the joint. It is more complicated than a primary surgery in most cases but not always depending on the reason for the revision. My partners and I perform both primary and revision hip/knee replacement regularly.
Kathy (Wintrhop Harbor, IL) - 2:25 PM:
After hip replacement surgery, I was restricted to only 50% weight bearing on the surgical leg to allow bone growth and healing around a screw holding the prosthesis in place. The restriction has been removed and this is week 7. Gaining strength in the leg every day. When can I reasonably expect to be caught up to the activity level I'd have been without the 6-week restriction? I was pretty active pre-op, even with the hip pan. No other mobility issues.
If you were an active person pre-op, I would guess maybe within a month or 6 weeks. This type of restriction can be placed on patients for a number of reasons after surgery based on intra-operative findings. The most important part is being compliant with this to help minimize the risk of complications. While this may prolong the overall early recovery period, the long term result will be the same - hopefully a surgery that provides good pain relief and lasts for many many years.
Susie (Chicago) - 2:30 PM:
Is there anything being done at NorthShore that is less invasive for knee surgery, ie. stem cell etc.?
On the knee replacement side, my partners and I all perform knee replacement surgery that is as minimally invasive as possible. Certain patients require more exposure to do a proper job, which leads to a larger incision. When possible, soft tissue disruption and overall "invasiveness" is kept to a minimum. Prior to knee replacement, there are a number of non-surgical options - stem cell being one of them for a select group of patients. We do have providers at NorthShore who do stem cell injections. This is a newer treatment option for certain patients with early arthritis that has shown some promise. I would recommend consulting with one of our providers who perform this procedure if you want to learn more specifics.
Stephanie (Wilmette, IL) - 2:35 PM:
Dr. Tauchen, I had DAA hip replacement 4 years ago, at the age of 46. I have a lot of issues with the scar tissue, which deep tissue massages have helped, but it is constant. Is this normal? Any recommendations or concerns? Worst is when I'm walking on level ground my quad tends to knot, then it pulls my SI joint, which then leads pain and limping. My PT has another patient with the same issues, but I cannot seem to find anything online about these issues in relationship to DAA.
I am sorry to hear that you are having this experience. As a hip surgeon who does about 99% of my primary hips via the anterior approach, I would say your experience is quite uncommon. Patients can have continued pain for a number of different reasons and this would be best addressed by either your primary surgeon or a 2nd opinion. In many cases, there is an identifiable cause, but sometimes there is not. I wish you the best and would be happy to see you in the office to provide a better evaluation.
Sam (Evanston, IL) - 2:40 PM:
Should I wait as long as I can before getting a joint replacement? How long is too long?
This is a good and very common question and I would say it is a fine line and everyone is different. While joint replacement isn't something to "rush" into, you also shouldn't wait so long that you are totally debilitated prior to considering surgery. Many patients have a hip or knee replacement and say "I wish I did this 5 years ago!" This is also dependent on a patient's age. If you're 40, I would say wait as long as you can. If you're 75, I would say any time would be fine.
Tyler (Skokie, IL) - 2:44 PM:
I’ve heard you can have joint replacement surgery and go home the same day. What are the benefits of recovering at home vs. a rehab facility?
For the "right" patient, this is 100% true. Outpatient joint replacement has been demonstrated over the past 5-7 years to be a safe practice. Candidates are typically on the younger side and are overall healthy without major medical problems. Regardless of going home the same day or going home after a night in the hospital, going home vs going to a rehab facility is strongly preferred and is the best option for nearly everyone aside from older patients without social support at home. Patients recover better and quicker at home in their own environment. Nationwide, rehab facilities tent to have a higher rate of overall complications and readmission rates. Personally, I believe home is the better option for the overwhelming majority of patients having hip or knee replacement surgery.
Deja (Chicago, IL) - 2:51 PM:
I’ve been told I need knee replacement surgery. What are the best questions to ask when meeting with different surgeons in order to find the best fit for me?
From a purely objective standpoint, I would recommend asking how many knee replacements the surgeon has done and how many he/she typically does in a year. If the surgeon has done a few hundred at least, this is reassuring. While certainly not a requirement to do knee replacement surgery, choosing a surgeon who is fellowship-trained may make you feel more comfortable. Maybe more important than questions may be your overall rapport with the surgeon - how well you tend to get along and feel that the surgeon listens and answers your questions. Being a good technician is only part of being a good doctor/surgeon. There are lists of questions published online that may provide some guidance as well.
Ernest (North Chgo. Il.) - 2:57 PM:
My question is how long does a knee replacement last? Also, what would the pain level and what types of meds they will have you on and the time it will take to recover? Now like in my case I'm 50 years old and I do have two jobs that require a lot of standing and walking. I just like to know what the life expectancy of a total joint replacement any answers please let me know will leave my email address.
With modern implants, we think they will last much longer than the classic "15-20 years" you may read online. We do not have long term outcomes data with these new implants, so it is a tough question to answer. If you are 50, there is a chance a total knee replacement will last you forever, but you should understand that your risk of needing a revision surgery for any reason is going to be higher than a 85 year old who is minimally active. In terms of pain, knee replacement can be very painful initially but there a number of medications we use to help control this. If you do a lot of standing and walking at work and cannot do your job due to pain, considering knee replacement is not an unreasonable idea, even if you're on the younger side at 50 years old.
Ben (Moderator) - 3:01 PM:
Thank you, everyone, for your great questions and participation. Thank you, Dr. Tauchen for your time and expertise. A complete transcript of the chat will be available on northshore.org shortly.
Alexander Tauchen - 3:03 PM:
Thank you all for joining and for your excellent questions. I appreciate it!