Joint Replacement at University Hospitals

Joint Replacement Procedures

Our board-certified and fellowship-trained orthopedic surgeons have specialized training in knee, hip and shoulder replacement and are experts in performing:

Total hip replacement (hip arthroplasty)

In total hip replacement, also called hip arthroplasty, the surgeon will remove the damaged portions of the hip joint and replace them with an artificial joint, or prosthesis. This artificial joint is usually made of hard and durable materials such as metal, ceramic and plastic.

During hip replacement surgery, your orthopedic surgeon will make an incision in either the front (anterior) or side (posterior) of your hip. After removing the damaged areas but leaving healthy bone intact, they will implant the artificial socket in the pelvic bone and attach the prosthetic ball to the top of your femur (thighbone).

After your surgery, you will likely be up and walking with a cane or walker the same day or the following day. Some people are even able to go home the same day and continue their recovery there. Patients will usually walk with the assistance of a cane for about three weeks post-procedure and are fully functional at three to six months. Physical therapy may or may not be required.

Partial hip replacement

In a partial hip replacement surgery, the surgeon replaces the ball of the hip joint with a prosthesis, but not the socket. This surgery is often done to repair certain types of hip fractures.

Anterior approach for hip replacement

With anterior approach, the surgeon makes the incision for the hip replacement at the front of the hip instead of the side (posterior). This approach allows the surgeon to reach the hip joint by separating the muscles instead of splitting them. This can potentially mean less post-operative pain for the patient. Patients with anterior approach hip replacement are usually up and walking with assistance the same day or the next day after surgery. The recovery time is similar to that of the posterior approach.

Hip revision surgery

A hip revision surgery is the re-operation of a total hip replacement surgery. This may be necessary due to regular wear and tear, damage to the artificial joint, an infection, or recurring dislocation of the hip. A hip prosthesis in general should last 15 to 20 years, so when a younger person has a hip replacement surgery, a revision surgery may be necessary later.

Total knee replacement (Knee arthroplasty)

Total knee replacement – or knee arthroplasty – is a procedure in which the surgeon will resurface the knee joint, cutting away the damaged bone and cartilage and replacing it will an artificial joint, usually made of metal or plastic. The most common reason for knee replacement is to relieve debilitating arthritis pain and improve quality of life.

During total knee replacement surgery, your surgeon will expose the knee joint, move aside the kneecap and remove the damaged portions of the joint. They will then attach the pieces of the prothesis to the bone and test the new joint’s function before closing the incision. The surgery usually lasts about two hours.

Hospital stay length will depend on many factors, but some people are able to go home the same day. You will be able to resume normal daily activities three to six weeks after surgery.

Partial knee replacement

With a partial knee replacement surgery, your surgeon replaces only one part of a damaged knee – the medial (inside), lateral (outside), or the kneecap. A surgeon may use this procedure when arthritis is only present in part of the knee. The damaged portions are replaced with a prosthesis and the rest of the knee joint is preserved.

A partial knee replacement often uses smaller incisions, so recovery time is shorter than with a total knee replacement.

Shoulder replacement

Shoulder replacement surgery is done to relieve pain and other symptoms caused by damage to the shoulder joint. During total shoulder replacement surgery, the ball and socket of the joint are replaced by implants, or metal and plastic prosthetics. With a partial shoulder replacement, only the ball is replaced.

Reverse shoulder replacement

A reverse shoulder replacement transforms the shoulder to allow mobility without a rotator cuff. During the procedure, the ball and socket of the shoulder joint are replaced, but reversed. The ball is attached to the shoulder while the socket is attached to the arm, so that the deltoid muscle is responsible for the shoulder’s mobility instead of the rotator cuff.

Reverse shoulder replacement procedures are often the best option for patients who have both a significant rotator cuff injury and shoulder arthritis. In addition, some patients who’ve had an unsuccessful traditional shoulder replacement may be a good candidate for reverse shoulder replacement.

How to Prepare for Knee or Hip Replacement Surgery

Once your surgeon has determined that you're a good fit for a hip or knee replacement, you will be required to go to medical consultations, physical evaluations and a preop joint replacement class about a month before your operation date. At your consultation, nurses or your surgeon will consult with you about how to prepare for your operation as well as the risks involved with surgery. The following are some general things to do before your surgery date.

• Maintain a healthy diet
• Manage blood glucose if diabetic
• Quit smoking
• Review medications
• Exercise regularly

Day of Your Surgery

The operation itself can take anywhere from 45 minutes to over two hours, depending on the complexity of the surgery. You will usually be under general, spinal or epidural anesthetic. Implants are typically made of chrome and cobalt or titanium as well as a plastic material called polyethylene.

Immediately following your knee or hip replacement surgery, you’ll spend some time in recovery where you’ll be given various painkillers and fluids. You can usually leave the hospital within one to two days. Arrangements will be made for wound care, follow-up appointments and physical therapy.

What to Bring to the Hospital

There are a few items that you’ll want to bring to the hospital to make your brief stay more comfortable. Keep it to necessities and must-have comfort items.

• Undergarments
• Loose clothing
• Loose pajamas or a short nightgown
• Socks
• Closed-heel slippers with rubber soles
• Sneakers or shoes with Velcro or elastic laces
• Eyeglasses (if needed)
• Hearing aid and batteries (if needed)
• CPAP machine, tubing and settings (if needed)
• List of current medications and supplements, noting those which have been stopped prior to surgery (do not bring your own medications)
• Toiletry items, including toothbrush, toothpaste, denture cleanser, razor, shaving cream, brush/comb, deodorant, etc.
• Driver’s license or photo ID
• Insurance card, Medicare or Medicaid card
• Cellphone, smartphone or calling card
• Emergency contacts and the phone number of the person who's bringing you home
• A copy of advanced directives
• Any hand-carry medical equipment you may need (e.g., reachers or a long-handled shoehorn)

What to Expect After Joint Replacement Surgery

Your knee or hip replacement surgery recovery time will depend on your age, general health, muscle strength and the overall condition of your other joints. But there are some things you can do to help aid in your recovery:

• Let your surgeon and nurses know if you’ve had any issues with pain medications in the past.
• Keep drinking fluids. Once you’re drinking enough, your IVs will be removed.
• Keep moving. Immediately after surgery with the assistance of your therapist you will get up to go to the bathroom, get out of bed, etc. As you continue with therapy, your mobility level will increase.
• Utilize the cold packs, wraps and oral pain medication provided to manage pain and reduce swelling.
• Exercise following your physical therapist’s recommendations to improve your mobility. This includes moderate to low-impact exercises like walking, biking and swimming.
• Monitor for signs of infection, blood clotting and pulmonary embolism.

What Not To Do After Joint Replacement Surgery

Most patients can resume normal activities and routines six weeks after surgery, but keep in mind that there may be pain and swelling for up to three months. To lessen the chances of issues and complications, there are a few things you’ll want to avoid for a speedy and successful recovery.

• Don’t pivot or twist the leg that has been operated on.
• Don’t bend down, kneel or squat.
• Don’t lift heavy things.
• Don’t stand for long periods.
• Don’t soak your wound until the scar is healed to avoid infection.