Earlier this month, we hosted a total joint replacement seminar at Baptist Memorial Hospital-Collierville, where Campbell Clinic physician Dr. John Crockarell presented on how to manage hip and knee pain caused by osteoarthritis. For those who were unable to attend, we’ve compiled a recap on some of the major questions that were asked during the Q&A portion of the event. Keep reading to learn about this innovative, same day procedure.
Q. How quickly after having the surgery and returning home do you generally begin physical therapy? Does it start in the home, or do you go to a facility to start that?
Dr. Crockarell: It depends either way. We encourage outpatient therapy, where you go to the therapist’s facility. The therapist can also come to your house; they can do in-home physical therapy. They are simply limited about what they can do there. Outpatient therapy can start as soon as the day after you go home from the hospital or surgery center. The sooner you get up and going, the better you’ll feel, and we encourage that.
Q. Can running affect your hip and knee?
Dr. Crockarell: Running is a high-impact activity. If patients are coming in with early arthritis and are wanting to go back to running, I’m not going to stop them. But we at least try to offer them alternatives of low-impact exercise that allow you to continue cardiovascular fitness without wearing out your joint so quickly. That’s why we recommend low-impact exercises like swimming or the elliptical machine.
Q. You already talked about primary joint replacement and revision. Can you speak (for a moment) about revisions and the primary causes of those?
Dr. Crockarell: Total joints can fail for a number of reasons. One of the most common reasons for them to fail early on after the surgery are infection or instability. Again, the infection rate is very low. It’s maybe one in a hundred on average, if you look at large groups of patients. If there’s an infection, and if you catch it early after the surgery, and early on after the patient starts having symptoms, sometimes you can salvage the joint that is in place. It’s still a surgical procedure. We have to go in, open up the wound and clean it out completely.
In the long term, the things that make total joints fail are loosening, wear and tear, or mechanical problems with the prosthesis. Having said that, the implants that we have now are the best on the market.
Q. How does the knee replacement size vary with your body type and structure?
Dr. Crockarell: It is based on their bone size and structure more than anything. There is some cross over between males and females, but obviously males tend to have larger bones so they tend to get larger implants. It’s determined preoperatively. Based on your x-rays, we have a pretty good idea within a size or two, and intraoperatively, we measure. We have tools to measure both the top of the knee joint, the bottom and the patella. And of course, we have all of the implant sizes available.
Q. If you get a partial knee replacement, is it sometimes necessary to come back and change it to a full?
Dr. Crockarell: The most common reason for a partial knee needing to be converted to a full, is if you get arthritis in other parts of the joint. You can get arthritis on the outside part, in the front, or around the kneecap. That is the most common reason to have to switch to a total knee replacement.
If you have any questions about total joint replacement, please contact Campbell Clinic to meet with a physician.