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 Northshore) and had pain in my ankle that was a 9. It was due to fluid settling in that area. Is this common? I had 3 physical therapists who had not seen this. My surgery was Oct. 10 and the pain is still there but minimal and getting better.
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 getting better, continue with observation and therapy and f/u 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?
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 3 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? Would I need some sort of documentation to show the TSA when I travel?
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?
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 likely hood that I will need a replacement/second surgery?
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?
PT is not required before a 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?
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 that 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?
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?
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 at 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?
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.