The Top 15 Questions to Ask your Orthopedic Surgeon Before a Joint Replacement . . . but were Afraid to Ask
Joint replacement surgery, knee, hip, shoulder, or ankle, can be a significant step toward a more active, pain-free lifestyle. However, since you are replacing a joint in your body, it is easy to be overwhelmed and forget to ask important questions about the surgery, recovery time, and future expectations. 1. Are there alternatives to joint replacement surgery? Direct Orthopedic Care provides conservative, nonsurgical treatment options to total joint replacement including: physical therapy, hyaluronic injections, corticosteroids injections, and regenerative medicine therapies. Your DOC provider can discuss all options for nonsurgical and surgical joint treatments during your initial consultation. 2. Is there any harm in waiting? Do you want relief from pain, but are not ready to proceed with major surgery? If you wish to delay joint replacement surgery for a few months, it may not have significant consequences. However, as arthritis gradually worsens, deformity of the joint can increase, complicating surgery. The joint can stiffen and muscles weaken, making rehabilitation after surgery more challenging. 3. Am I too young or too old? The DOC healthcare team is much more concerned about your overall health than chronological age to determine if joint replacement surgery is right for you. Eight-five percent of knee replacements last for 20 years. The younger you are when you have the first surgery and the longer you live afterward, the more likely the replacement will need revision surgery. If you are older and need joint replacement surgery, you must be committed to postoperative rehabilitation. 4. How much does joint replacement surgery cost? The average hospital charge for a total knee replacement in the U.S. is $49,500. Inpatient charges from the surgeon and other healthcare providers may add an average of $7,500 to the basic hospital charge for the procedure. This brings the average total charges closer to $57,000. Preexisting conditions and complications may increase these average cost estimations. 5. Will my insurance pay for all or part of the surgery? How do I make sure that my healthcare plan covers both the surgeon and hospital or surgery center? Private insurance varies. It is important to review your benefits plan before scheduling a joint replacement. Understand which providers are in your insurance network and what services are covered. DOC strives to be in network with most insurance companies. Determine your deductible, copay, co-insurance, and maximum out-of-pocket cost. 6. What can I do before the surgery, such as exercise, lose weight, refrain from alcohol, or stop smoking, so the replacement will be more successful for me? Strengthening your upper body before surgery will make it easier to use crutches or a walking aid. If you are overweight, your surgeon may recommend that you lose weight to put less stress on your new joint after surgery. Do not consume any alcohol for at least 48 hours before surgery. Smoking affects blood circulation, delays healing and slows recovery, so quit smoking several months before surgery. 7. Do I need to stop taking any medications prior to surgery? Get a list of medications and dosages from your primary care physician. Share this information with your DOC team during one of your postoperative visits. In most cases, your surgeon will instruct you not to eat or drink anything after midnight the night before surgery. However, your surgeon may recommend that you take your heart and blood pressure medication the morning of surgery with a few sips of water. Your surgeon will advise you about best medication protocol. 8. How long will I be in the hospital or surgery center? Typically you will stay in the hospital one to three days, depending on how quickly you progress with physical therapy. 9. How much pain can I expect, and how will it be managed in the hospital or surgery center and after I go home? Pain management begins with preoperative medications given in the pre-op area, spinal anesthesia, and use of regional and local blocks about the joint. In the hospital or surgery center, pain is managed using acetaminophen, anti-inflammatory medications, and non-narcotic or narcotic pain medications. At home it is important to stay on the pain management medication schedule prescribed by your surgeon. Pain medication dosages decrease as the joint tissues heal and the muscles gain strength. Ice and elevation also help to reduce swelling and relieve pain. 10. How long do I need physical therapy after surgery? Outpatient physical therapy after a total knee replacement typically lasts four to eight weeks. Everyone heals at different rates, and your recovery time may be shorter or longer. Be sure to work closely with your doctor and physical therapist to understand your personalized rehabilitation schedule. Your DOC physical therapist provides an at home exercise program to help you continue to make progress after discontinuing physical therapy. 11. Do I need to rearrange my home to make it safer and easy to navigate? Rearrange furniture before surgery so you can maneuver with a walking device after surgery. Remove throw rugs and secure electrical cords to avoid anything that could cause you to slip and fall. Install a shower chair, gripping bar, and raised toilet seat in the bathroom. Due to mobility limitations, you will do a lot of sitting the first few weeks after surgery. Enjoy the comfort of a sturdy chair, possibly a recliner, in order to elevate your legs. 12. What will I be able to do/not do after my total joint replacement? Once you get home, you should stay active. Continue to do the exercises prescribed by your physical therapist. Do not do too much, too soon. Your doctor will help to determine when it is safe to resume driving, return to your normal work activities, and participate in sports activities. Lower impact fitness activities such as swimming, golfing, bicycling, and light tennis will help increase the longevity of your knee and are preferable over high-impact activities. 13. How long will the joint replacement last, and what can I do to make it last as long as possible? The good news is that studies show that common types of knee replacements can last more than 20 years. One recent study on long-term outcomes of a commonly used knee replacement found the implant to still be functioning in 96% of patients 20 years after being implanted. One very large study found that 80% of hip replacements were functioning well after 15 years in the younger (less than 65) patients, and 94% of the older (over 65) patients. 14. What are the major and/or most frequent complications of surgery? Your doctor will explain the potential risks and complications of total joint replacement, including those related to the surgery itself and those that can occur over time after your surgery. Most complications can be treated successfully. Some of the more common complications of joint replacement surgery include infection, blood clots, nerve injury, and prosthesis problems like loosening or dislocation. 15. Who do I contact after surgery if I have a question or problem? Contact your Direct Orthopedic Care team.
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