Understanding Hip and Knee Replacement Surgery

Each year, more than 450,000 total hip replacement surgeries and more than 600,000 total knee replacement surgeries are performed in the United States. With each surgery, it is important to understand the procedure and establish realistic goals for your post-surgery recovery.

Nicholas Valente, MD, an orthopaedic surgeon with Rochester Regional Health, explains what makes a person a candidate for these surgeries and what the next steps might look like.

Should I get this surgery?

Experiencing joint pain doesn’t automatically mean that you need a joint replacement.

Replacement surgery is generally a last measure to treat pain that interferes with daily life, and has not responded to appropriate non-surgical treatments such as exercise, weight loss, physical therapy, and medications.

Total hip replacement surgery is generally performed for late-stage conditions - most commonly osteoarthritis - or irreversible damage caused by fractures, torn cartilage, or torn ligaments after other options have failed.

With total knee replacement surgery, there is a common misconception that it only needs to be done in people over the age of 60. The truth is osteoarthritis - the source of most knee replacement surgeries - is caused by wear and tear. This is often from repetitive movements and can affect much younger people.

The surgical process

The approaches for total hip replacement and total knee replacement surgeries are different.

For hip replacements, there are currently three options: posterior, lateral, and anterior. The anterior approach offers less post-surgical pain, shorter recovery, and fewer post-surgery limitations in movement, such as bending over and crossing your legs.

“The anterior approach, doesn’t require cutting through muscle to get into the hip joint, it maneuvers in between muscles, so it’s less compromising,” Dr. Valente said. “That means being able to get rid of a walker or cane faster, returning to work sooner, and taking less pain medicine after surgery.”

Knee replacements are traditionally successful in reducing pain. Robotic-assisted procedures are being used more often. They help patients gain more postoperative mobility and range of motion by allowing surgeons to make more precise incisions, remove damaged cartilage, and more accurately select the size of the new joint. This means tracking and alignment will more closely match each patient’s natural gait. “We take a preoperative scan and combine it with the robotic technology to create an individualized pre-op plan,” Dr. Valente said. “Using 3D image mapping and the robotic-arm, we’re able to replace a knee with an unrivalled level of accuracy.”

Taking the next step

Ensuring each person meets the qualifications for these surgeries is a top priority.

Hip replacements can restore movement and reduce pain. Knee replacements can help people get back to living their daily lives. Patients should choose a surgeon who will offer a one-on-one consultation, assessment, and personalized rehabilitation to help them establish and reach their goals.

Ensuring each person meets the qualifications for these surgeries is a top priority.

Hip replacements can restore movement and reduce pain. Knee replacements can help people get back to living their daily lives. Patients should choose a surgeon who will offer a one-on-one consultation, assessment, and personalized rehabilitation to help them establish and reach their goals.