Keeping the body in motion

Sunday, May 31, 2015 | 2 a.m.

Joint replacement surgery has become an essential procedure for aging bodies on the move.

Our bodies are built to carry us through the many stages of our lives, but as the average lifespan continues to increase and our lifestyles become more complicated, many of us will end up needing a little extra support. Joint replacement surgery is an inpatient procedure that drastically changes the quality of life for nearly 1 million people in the United States every year.

“Hip replacement surgery continues to have the No. 1 satisfaction rating of all elective surgeries,” said Dr. Xin Liu, an orthopedic surgeon at Southern Hills Hospital and Medical Center.

Joint replacement surgeries are performed most often on elderly patients, but many younger people are candidates as well.

What is joint replacement?

Joint replacement occurs when a patient’s troubled joint is surgically replaced with a prosthetic joint. Depending on the patient, the surgeon could replace the entire joint or only a section of it. Prosthetic joints typically are made from titanium and often are coated in ceramic, which replicates bone. The man-made “bone” is situated on plastic disks, which replicate joint cartilage.

“Hip and knee replacements are definitely the most common, followed by shoulder replacements, but we can replace any joint,” Liu said.

Options include ankles, elbows and even fingers.

Who might need a joint replaced?

Anyone with arthritis could be eligible for a joint replacement. While many people think of arthritis only in terms of rheumatoid arthritis — an autoimmune disorder — arthritis describes any inflammation of one or more joints, and comes in many different forms.

“As we age, everyone will get some degree of arthritis,” Liu said. “It could present in an 80-year-old woman who hardly has any symptoms, or it could present in a 50-year-old man who needs a full hip replacement. It just depends on the person. Past medical history, genetic composition, even just basic anatomy — there are many factors.”

Injury, or even some rare diseases, also could lead to arthritis.

“Regardless of the onset, once the cartilage in the joint breaks down, it’s arthritis,” Liu said. “That’s when the joint replacement is necessary, because otherwise, the patient just has bone grinding on bone.”

Is joint replacement the last resort?

Many times, yes. While a joint replacement is a fairly standard, inpatient procedure, it’s still surgery. Complications are very rare, but the surgery comes with substantial downtime.

“All patients will be able to walk the day after a hip or knee replacement, but they will need crutches or a walker for a few weeks,” Liu said. “Getting back to work after a knee replacement could take six weeks to three months. The hip is usually a little bit faster.”

For people who suffer from joint pain, anti-inflammatories are the first line of treatment. Steroid injections also may help, and physical therapy could make a huge difference. It’s only when those options have been exhausted and someone remains in constant pain and/or is unable to move the joint well that he or she would be considered for replacement surgery. New joints last only 10 to 15 years, so younger patients may have to have more than more replacement in their lifetime.

How to ensure ongoing success after surgery

After joint replacement surgery, physical therapy is extremely important. While the body likely will adapt easily to the prosthetic joint, patients will need to redevelop muscle mass surrounding the joint.

How to keep joints healthy and prevent joint replacement

The two most important things people can do to maintain healthy joints is keep their weight low and maintain an exercise routine. “The more weight you carry, the faster the cartilage in the joint breaks down,” Liu said. A moderate, but regular, exercise routine is key because it helps keep cartilage strong and inspires good blood flow, which is necessary for bone health.