Hip and Knee Replacement
The Total Joint Services program at Spring Valley Hospital Medical Center focuses on hip and knee replacement surgery. Total hip or knee replacement involves replacing diseased joint cartilage with artificial materials. Joint cartilage is a tough, smooth tissue that covers the ends of bones where the joints are located. It allows joints to move with minimal friction.
Total hip or knee replacement procedures are most commonly performed in people who have a severe form of osteoarthritis, a common degenerative condition of the joints that is usually associated with aging (age 45 and up). Other indications for joint replacement are trauma or injury, rheumatoid arthritis (in which the body's immune system attacks joint membranes), and bone deformities.
Hip and Knee Problems on the Rise
About one million hip and knee replacement procedures are performed in the US each year, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, part of the National Institutes of Health (NIH); this is expected to increase in the coming years due to an aging population. Nearly 70 million people in the US have some form of arthritis or chronic joint symptoms, according to the NIH. Nearly 21 million US adults have osteoarthritis, and most people over 65 have osteoarthritis in at least one joint.
Wear and Tear of Osteoarthritis
In osteoarthritis, wear and tear over time, trauma, repetitive movement, or for no apparent reason, joint cartilage wears down, exposing the ends of bone. It is not known why some people with osteoarthritis go on to develop a severe form of the condition while others live for years with the condition and do not experience the type of severe pain or disability that requires joint replacement.
Before joint replacement is recommended, doctors usually try the following therapies and recommendations:
- Acetaminophen or anti-inflammatory pain relievers on a daily or regular basis (hip or knee pain)
- Exercise and/or physical therapy (hip or knee pain)
- Weight reduction - for those overweight (hip or knee pain)
- Walking devices (hip pain)
- Knee braces (knee pain)
- Rest or activity modification (hip or knee pain)
- Ice following certain activities (hip or knee pain)
- Intra-articular pain managing injections (hip or knee pain)
In a total hip replacement, also known as total hip arthroplasty, the damaged bone and cartilage is replaced with prosthetic (artificial) components. The damaged head of the femur (thigh bone) is replaced with a metal stem that is placed into the hollow center of the femur; this stem may either be cemented or pressed into the bone. A metal or ceramic ball replaces the damaged femoral head. The damaged cartilage surface of the socket (acetabulum) is replaced with a metal socket and screws or cement are used to hold the socket in place. A spacer, made of plastic, ceramic or metal, is placed between the new ball and the socket to allow for smooth gliding similar to that of a natural joint.
There are three approaches for hip replacement: anterior, lateral and posterior. Your physician will choose the approach that is best for you based on your condition and his or her experience. Each approach requires specific precautions to prevent hip dislocation. Our therapist will work with your during your sessions to reinforce the movements that are safe for you to do to promote the best outcomes.
A knee replacement, also known as knee arthroplasty, involves building up the surface of bones where cartilage damage has occurred. The damaged cartilage surfaces at the ends of the femur (thigh bone) are removed along with a small amount of bone. The surgeon replaces the removed cartilage and bone with materials made of metal that mimics the surface of the joint. These may be cemented or pressed to fit the bone. The undersurface of the patella (kneecap) is resurfaced with a plastic material in some cases. A plastic device called a spacer is inserted between the metal material and the bone to create a smooth, gliding surface that is similar to that of a real joint.
Our goal at Spring Valley Hospital is to discharge you home safely. The best therapy is to get your new joint moving as quickly as possible. Our physical and occupational therapists will see you the day of surgery. You will walk with a walker and be given additional equipment as deemed necessary by the therapy team. We offer a group therapy “Joint Camp” for patients a day or two after surgery. This is an opportunity to get together with other people who have had a joint replacement and have a similar experience.
Walk. Walk. Walk. Proper walking in the best way to help your new joint heal. Walk as rhythmically and smoothly as you can using your walker. Don’t hurry. Adjust the length of your step and speed as necessary to walk with an even pattern. As your muscle strength and endurance improve, you may spend more time walking. Most people use their walker for two-three weeks after surgery.
Joint Camp Presurgery Class
There is no cost to attend this class.
Join us for a one-hour class designed for patients who are about to undergo joint surgery for hip or knee replacement. Instructors will define common terms, explain procedures and answer questions.
- How to prepare for surgery
- What to expect during your hospital stay
- Physical and occupational therapy
- Discharge information
- Tips for home
Following orthopedic procedures, patients may need therapy and rehabilitation to help relieve pain and increase function. Spring Valley Hospital offers rehabilitation services to assist those recovering from surgery and other injuries.
For more information about our orthopedic services, please contact:
Jenna Spalding, RN, MSN
Orthopedic Nurse Navigator