Monday Medical: Hip and knee replacement can restore active lifestyle
For Steamboat Pilot & Today
The hip and knee are two of the largest joints in the human body and vital to movement, so it makes sense that wear and tear can take a toll that sometimes requires replacement surgery.
Each year, one million hip and knee replacement surgeries are performed in the United States, making it one of the most common orthopedic procedures performed, according to the American Academy of Orthopedic Surgeons. That number grows each year as people live longer and are more active into later years.
“I think Steamboat is an extremely healthy community,” said Dr. Bobby Howarth, an orthopedic surgeon who specializes in hip and knee replacement in Steamboat Springs and is a member of the medical staff at UCHealth Yampa Valley Medical Center. “So many people here are fit well into their 70s, and they want to continue to do the things they love. We want that for them as well.”
Hip and knee replacement surgeries share some similar traits. They both:
- Can be completed on an outpatient basis.
- Take less than an hour.
- Have patients receiving local anesthesia, not general anesthesia.
- Include minimal tissue damage.
- Involve limited narcotic use during recovery to control pain.
Recovering from a hip replacement
Because it is a simpler joint, the recovery for a hip replacement is usually easier and less painful.
“A lot of patients ask, ‘Can I ski after a hip replacement?’” Howarth said. “The answer is yes. We want you to resume your normal life and get back to the activities you love now that you’re not in pain.”
A hip joint is like a basic ball and socket. So, when replacement surgery is needed, usually for osteoarthritis or rheumatoid arthritis, implant parts replace the joint in a straightforward procedure.
“The majority of our patients are walking within three hours of surgery, and about 60 percent of them go home that day,” said Howarth. “They meet with physical therapists immediately after they get out of surgery.”
According to Howarth, most patients leave on crutches or with a walker, but graduate to a cane within a few days or weeks and are soon walking independently. They can expect some soreness, but for the most part, are able to resume all the physical activities they once enjoyed within four to six weeks after surgery. Physical therapy is not always necessary, he said, as long as patients are moving and walking. And, for most patients, pain medication is not needed after the first few days.
“Sports like tennis and pickleball that include short bursts of speed are fine, as well as hiking and biking,” he said. “The only thing we ask is no motorcycle riding or getting up on a horse for at least six weeks.”
Recovering from a knee replacement
The knee is a much more complicated joint as it has wider range of motion and flexibility, moves side to side and balances off-center loads. A replacement involves cutting out the arthritis and putting the hardware onto the bone, and then making sure that the knee is stable and that the joint can flex and rotate.
During surgery, more tissue and bone are removed than in a hip replacement. Also, soft tissue must stretch further around the knee than with soft tissue around the hip, which is why patients usually have more pain after as the knee can swell and feel tight.
“Physical therapy is a must after knee replacement,” Howarth said. “A lot of these patients do extremely well, but the more they follow the instructions from their surgeon and their physical therapist, the better off they’ll be.”
Recovery time depends upon the age and overall health of the patient and can range from a few months to a year. Howarth said his hope is that patients are able to bend their knee to a 90-degree angle at two weeks.
No matter which surgery a patient has, Howarth recommends talking with your primary care physician and coming up with a post-surgery plan that considers physical therapy, exercise, nutrition and home modification, if necessary.
“Patients put off these types of surgeries, but often waiting is not always better,” he said. “Once they’re recovered and back doing the things they weren’t able to do before, they often say, ‘I should have done this sooner.’”
Mary Gay Broderick writes for UCHealth. She can be reached at firstname.lastname@example.org.
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