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Total Joint Replacement: Questions About Joint Pain, Knee and Hip Surgery Answered

December 10, 2018 1:00 PM with Dr. Anand Srinivasan

Today, people are living longer with optimistic expectations to remain active, productive and physically fit—at any age. NorthShore's Total Joint Replacement Center understands these expectations. Anand Srinivasan, MD, Orthopaedic Surgery Division, answers your questions about joint pain, knee and hip surgery, and same day total joint replacement.

Doctor with joint replacement models

Michael (Moderator) - 12:59 PM:
Welcome to the Total Joint Replacement chat. The chat is now open and you can submit your questions at any time.

  Tim (Evanston, IL) - 1:02 PM:
I had knee joint replacement surgery (not at NorthShore) and I had pain in my ankle that was a 9. It was due to fluid settling in that area. Is this common? I had three physical therapists who had not seen this. My surgery was Oct. 10 and the pain is still there but minimal and getting better.
Anand Srinivasan
Sometimes ankle swelling is common after knee replacement surgery and can persist for months without elevation/compression. Pain at a high level is less common but may be secondary to "re-aligning" your leg from the knee replacement. Often, we don't realize the deformity and tightness in our arthritic knees. I would suggest that if it's getting better, continue with observation and therapy and follow up with your surgeon.

  Sally (Evanston, IL) - 1:06 PM:
I'm having my hip replaced in a few months. My Dr. mentioned a possible anterior approach might have better recovery times. What are the advantages and disadvantages of this anterior approach?
Anand Srinivasan
The anterior approach is a less invasive approach to the hip that does not incise through the largest muscles of our hip, the gluteal muscles. The recovery time tends to be shorter, although no outcome differences are noted at three months from surgery. The surgical time and risk are slightly higher in that because the hip is not dislocated and no muscle is cut, exposure is harder. At the end of the day, I would ask your surgeon how experienced they are with the approach in that a "well-done" total hip arthroplasty will provide a great outcome, regardless of approach.

  Brian (Skokie, IL) - 1:12 PM:
I travel a lot. Will my new joint set off metal detectors? Do I need some sort of documentation to show the TSA when I travel?
Anand Srinivasan
Your new joint may set off a metal detector but with modern body scanners, generally, the TSA is aware of implants pretty quickly. You may be subject to secondary screening. Documentation generally does not help in these cases. You may want to account for 10-15 extra minutes going through security.

  Crystal (Northbrook, IL) - 1:20 PM:
We have a history of addiction in my family and I’m terrified of getting hooked on pain pills after my surgery. Are there other options for pain management than pills?
Anand Srinivasan
Opioid addiction is a valid concern. Generally, we would recommend seeing our pain management team (anesthesia) before surgery to determine if you can be a candidate for regional blocks and even devices that reduce the need for pain medication after surgery. Generally, we can control moderate pain with non-narcotic medication (tramadol/Tylenol/NSAIDs).

  June (Glencoe, IL) - 1:25 PM:
I'm 68-years-old, how long will my hip replacement last? What is the likelihood that I will need a replacement/second surgery?
Anand Srinivasan
At 68, the chance of needing a second surgery is low assuming a good result. Hip replacements generally last 20 years with modern technology. Generally, your demand is lower as you age so even if it is "starting to fail" at 85, you may not need revision surgery.

  Dave (Highland Park, IL) - 1:30 PM:
I have a knee replacement coming up and have read that doing Physical Therapy beforehand is necessary. My Dr. has NOT required me to do any PT. When is PT required before a knee replacement and when is it not?
Anand Srinivasan
PT is not required before surgery if you have good strength and range of motion. If stiff with a limited range of motion or if severely deconditioned, then therapy would be required. In general, doing a home exercise regimen a few times a week leading up to your surgery is sufficient at obtaining a good result.

  Tom (Skokie, IL) - 1:35 PM:
What materials are the joint replacements made of? Will they degrade inside my body over time?
Anand Srinivasan
Knee replacements are generally made from titanium, cobalt chrome and polyethylene (plastic). Hip replacements are generally made of similar materials, although a ceramic head (ball) can be used in place of a cobalt chrome ball. In general, these implants do not degrade, unless there is debris in the hip causing abrasion. Sometimes, only in hips, corrosion can occur at the taper junction but this situation is rare with all implants on the market.

  Sarah (Evanston, IL) - 1:41 PM:
My Dr. mentioned I should get all my routine dental work done before my surgery. What’s the deal with that? Why does dental cleaning have anything to do with my joint replacement?
Anand Srinivasan
There is a small chance that infections from the mouth can travel to your artificial hip/knee. So we advise patients to get their dental work completed before hip and knee replacement. Certainly, if you have known infections etc. in your roots, you would have to get these addressed beforehand. If you go twice a year to the dentist with no issues, generally you are in good shape and may not "need" dental clearance. It is up to the surgeon, however.

  Chris (Morton Grove, IL) - 1:47 PM:
When is it time to get a knee replacement? Like...what other options do I have before I resort to surgery to fix a degrading knee?
Anand Srinivasan
Great question, but the answer varies. Generally, you first have to confirm that your knee is the source of pain and quality of life concerns. Generally, injections and therapy are the mainstays of non-surgical treatment. There are some newer options in regenerative medicine that are promising but not covered by insurance. Medicines can also help with alleviating pain. But if you fail these options, generally knee replacement is the most definitive way to treat knee pain

  Stan (Niles, IL) - 1:53 PM:
Are there any new procedures that may replace this surgery anticipated in the next few years?
Anand Srinivasan
For the time being, there are no new procedures that have the track record of joint replacement surgery. Also, if people have significant knee or hip disease already, it may be hard to reverse pathology. There are more advances in regenerative medicine each year, and it is possible in the future that healing and restoration of tissue may happen. Perhaps, there may be prophylactic treatment in the future, but we are at least a decade away from concrete technologies that work.

Michael (Moderator) - 2:00 PM:
That is the end of our chat. Thank you, Dr. Srinivasan, for all your expertise.

This chat has ended.

Thank you very much for your participation.