Joint replacement: recovery, satisfaction and risks of joint replacement surgery
Hip joint replacement: recovery
Mr Tony Dunin, orthopaedic surgeon
That's slightly different between hip and knee replacements. Let's start with hip replacements first. For a lot of those patients have been in severe pain beforehand and often very stiff hips. Many of those patients are surprised as to how little pain they have postoperatively it's still a major procedure and they may feel all sorts of temporary symptoms in the immediate post-operative period, they may be off their food, they may feel nauseated they may feel giddy or dizzy the first time they get up, that's very common. They're minor symptoms that they will I pleasant experiences that they will have lost in hospital, but they will all pass. For most people they will notice with hip replacement that their mobility is much better very soon after the operation and they'll be able to get up walk either the same day or the next day after their procedure. However, it still takes several weeks to really get over the operation and the body has to heal itself so it's not a bad idea that when you go home it should have some siestas and breaks to allow for the body to heal itself.
Knee joint replacement: recovery
Mr Tony Dunin, orthopaedic surgeon
The knee replacement surgery it's a little more gruelling. The knee is the more sensitive area of the body it tends to swell up dramatically after the surgery and so some patients may experience quite a deal of pain. We'll help the patients well they’re in hospital with a cocktail of drugs, but it's still not going to be an easy comfortable ride. Every patient is different and don't compare yourself with someone else, some people find it relatively easy other people are in pain for quite some weeks afterwards. In addition with a knee replacement you have to work hard to get the need to bend and to straighten, so you'll need some physiotherapy and you'll need to work harder when you get home, more so to keep working on exercises that you would have been given whilst you're in the hospital. So, with knee replacement surgery it is harder and you'll need to weigh up whether you willing to undergo what can be a difficult operation but which has good long-term results.
Joint replacement: satisfaction and risk
Mr Tony Dunin, orthopaedic surgeon
Knee replacement surgery for most patients is a very successful operation. When we do a hip replacement we often tell patients that they may not even remember that how the hip replacement feels so good that's for the majority. However, when you look at the forgotten joint in the replacement surgery it's only about fifteen percent so some people experience some clicking, some discomfort and some other little difficulties that they would rather not have.
There was an interesting study done in Ontario in Canada where they asked the patient's how satisfied, they were, and they did find that seventeen percent of patients are not completely satisfied within their replacement surgery.
Professor David Hunter, rheumatologist
So, about 95 percent of people that have a hip replacement can expect good relief of their pain and improvement in their function about 12 months after the procedure. About 75 to 80 percent of people have a knee replacement can expect a satisfactory outcome in terms of relief of their pain and improvement in function again about 12 months after the procedure it takes a while for them to recover from the surgery this is significant surgery and it also carries with it substantial risk. About 1 to 2 percent of people are likely to get an infection in the joint after the procedure they may also develop a clot in the limb that they've been operated on that may also have other effects in terms of being dislodged and going elsewhere. About 1 in 200 people die perioperatively as a consequence of their joint replacement and this is more likely to occur in older people with other comorbidities, particularly heart and lung related disease.
So, for a knee replacement about 1 in 3 people may not necessarily redeem an improvement in their pain and it may actually either stay the same will get worse. That commonly occurs in the context of an inappropriate diagnosis being made in the first instance and the pain related to what you thought was knee osteoarthritis may be a referred pain from somewhere else and/or you have substantial comorbidity particularly depression that interferes with your ability to respond appropriately to a joint replacement. So, in the context where you're unsure whether the pain in your knees coming from knee osteoarthritis and all your depressed really go out and try and find the best treatment option that's suitable for you before you go down at surgical treatment option.
