Tulane Medical Center - April 21, 2021
X-ray like drawing of knee and hip bones.

Joint replacement for hip or knee osteoarthritis

Pain, constant debilitating pain, is the hallmark of knee and hip osteoarthritis and other forms of degenerative joint disease. Medications and change in activity can help manage symptoms with varying amounts of pain relief. But at the end of the day, you just can’t be as active and self-sufficient as you want to be when you have severe joint pain.

Luckily, medicine has advanced significantly in recent years to offer hip and knee joint pain sufferers more advanced, and more successful, partial or total joint replacement procedures. For instance, the Mako Robotic Arm-Assisted Surgery program at Tulane Lakeside Hospital improves the alignment and placement of implants for total hip, total knee and partial knee procedures.

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Person holding knee.

Partial joint replacement for knee pain

A partial knee replacement procedure is sometimes called "unicompartmental knee arthroplasty" or "uni" because only one of the three knee compartments is replaced. It is most commonly the joint between the thigh bone and the shin, but it can also be the joint between the knee cap and thigh bone that is replaced.

There is new technology to aid with joint replacement. At Tulane Lakeside Hospital, the Mako robot-assisted technique allows the orthopedic surgeon to better position the implant, which is a factor in how long implants last.

Partial-joint replacement is very appealing to patients because it tends to have shorter recovery times. However, there are many factors that make total knee replacement a better option for most patients, including the amount of disease and how badly the joint is damaged.

X-ray of knee replacement

Total knee replacement

When it comes to knee joint surgery for severe knee osteoarthritis – total knee replacement (TKR) is the gold standard. The procedure involves removing the surface of the bones damaged by osteoarthritis. The bone is cut away so that the knee joint can be replaced with an artificial joint.

There are a variety of technologies to help patients get the best possible fit for their artificial knee. The use of hand-held navigation devices and/or robotic technology allow surgeons to make precise bone cuts without the use of invasive guides. Additionally, implants are utilized to match the size and shape of the patient’s knee to ensure the best position and fit. Specialty trained orthopedic surgeons can help you decide which type of surgery, technique and implant is best for your individual knee.

Image showing step-by-step of hip replacement (1 - cutting of joint bone. 2 - replacement with artificial hip and 3 - Joining together of artificial hip.

Total hip replacement

Total hip replacement (THR) is the most common procedure to relieve hip pain associated with advanced osteoarthritis and other degenerative hip joint disease. In the procedure, any damaged or worn-out cartilage on the top of the thigh bone and in the hip socket is removed. The natural joint is cut away and the artificial hip is implanted.

Traditional hip replacement involves a 10-12 inch incision on the side of the hip. There are minimally invasive techniques as well which vary in the number and the size of incisions. Robotic surgery may also be an option—in which the surgeon controls very precise robotic arms to complete the surgery. The robotic-arm-assisted surgery at Tulane Lakeside Hospital allows your physician to create a personalized preoperative plan and to make adjustments to that plan in real time during your hip surgery. This improves the alignment and placement of the hip implant.

With another approach, called the anterior approach, surgeons access the hip joint from the front, instead of the side. This may allow them to avoid cutting major muscles. Less trauma to surrounding tissue could mean less pain and a faster recovery, along with less risk of hip dislocation.

Multiple methods and advanced technology allows physicians to design a surgery and recovery plan that will best meet the needs of each patient.

Hip replacement is successful in treating disabling degenerative hip pain in people of all ages.

Patient working with physical therapist.

Joint replacement rehabilitation

Rehabilitation after knee or hip replacement is vital to the process of returning to normal activity. Inpatient Rehabilitation Centers provide intensive therapy following release from the hospital and aid in the transition to home. Outpatient therapy can help you continue to build strength and skills after your return home.

Orthopedic rehabilitation typically involves a combination of:

  • Physical therapy—to build strength, endurance and coordination through exercise with programs tailored to individual patients and directed by physical therapists.
  • Occupational therapy—to help you build or relearn skills needed for daily living, including helping you cope with any pain or loss of function.
Women holding hip and knees.

Your joint replacement plan

We asked our orthopedic specialists what are the most common questions their patients ask when considering a joint replacement procedure. Most revolve around how long the recovery process takes. Here is a general timeline:

  • Day 1: In general, joint replacement surgeries take about 60 to 90 minutes and patients will remain in the hospital from 1 to 3 days.
  • Week 1 & 2: A time for healing and learning how to use your new joint, such as walking with some sort of assistance device.
  • Weeks 3 to 8 (2 months) after surgery: Getting back to normal. You’ll lose the assisted devices and start to return to your routine activities. You’ll also be doing physical therapy to strengthen your new joint. At this stage, most people are around 85% recovered.
  • Months 3 to 24 (2 years) after surgery: Building strength, endurance and confidence in your new joint.

Most replacement joints continue to function for decades. About 10 to 15 percent of joint replacements need an additional intervention within the first 20 years of the initial implant.

For other common questions, the answers will depending on the procedure and the patient, so make sure you are discussing them with your doctor. It can help take notes at your appointments or even to bring a friend or loved one to help you recall all the answers.