What is arthritis and why does it cause pain?
Osteoarthritis is the loss of cartilage , which causes bone to rub against bone exposing the nerve endings. In attempt to displace the added stress, the bone develops osteophytes (bone spurs). The joint secretes extra fluid to try to lubricate and the fluid then pushes into the exposed bone forming cysts. Deformity overloads the bone causing micro fractures. Depending on the amount of deformity, the bone may move out of alignment (bow legged or knock kneed) stretching the ligaments.
What does an arthritic joint feel like?
An arthritic hip feels like a pulled groin. An arthritic knee feels like grinding pain deep inside. Both joints will feel stiff. You have to take some time to warm up. You move at a slower pace. You decrease your activities. You lose cardiovascular fitness.
When should I have a joint replacement?
When the effects of arthritis greatly interfere with your quality of life, affect your sleep, cause joint deformity, and/or when non-surgical treatments no longer work. On x-ray we often refer to it as "bone on bone", when the cartilage is gone and the end of the bones rub together. We don't tell patients when they need replacement, they tell us because they've had enough!
What does bone on bone mean for my prognosis?
Bone on bone arthritis is a one way street that will progressively get worse. Ambulatory aids such as a cane or walking stick, anti-inflammatories, cortisone, and viscosupplementation (gel) shots may decrease the pain. Physical therapy will not help. Joint replacement is the definitive treatment.
What do I need to do before joint replacement surgery?
You will need to see both your dentist and primary care physician (PCP) for physical exams and clearance. Your PCP may also require you to have cardiac testing or see another type of specialist. Dr. Brooks will send you for some tests and lab work. You must attend our joint class and a pre-admission appointment, both at VacaValley Hospital. You will also have a pre-operative appointment with Hannah, the physician assistant with Dr. Brooks.
It may seem like many steps, but a thorough pre-op work up helps provide a smoother surgery and post operative course, and a more successful long term outcome. When you decide to move forward with surgery, our staff will walk you through all the necessary steps and provide you with materials.
For how long am I in the hospital and when do I go home?
You may stay in the hospital 2-3 nights, and then go home if you have someone there to help you 24 hours a day for one to two weeks. Patients without help at home will go to a rehab facility for 10-14 days.
What steps do you take to ensure a great outcome?
Our office staff carefully plans for your surgery ahead of time, including thorough medical preparation and patient education. From the time you enter the hospital to the time you leave you will be cared for by staff who are well educated and trained as part of the joint replacement program.
How will you manage my pain after surgery?
Pain is usually controlled well with nerve blocks, IV and oral pain medications.
How long will I be off of work after my surgery?
Usually 6-12 weeks, but this may depend on your type of work. Some patients return to work as soon as 3 weeks post op.
When can I drive after my surgery?
This depends on a few factors: you must be off of all narcotic pain medications and be comfortable getting in and out or your vehicle. Your brain-muscle connection must be working well enough to respond quickly to unpredictable driving situations.
Will I need to take antibiotics before I go to the dentist after my hip or knee replacement?
We follow the guidelines from the American Academy of Orthopedic Surgery that says patients must take antibiotics for 2 years after their joint replacement if they are not immunocompromised. Patients who are immunocompromised, obese, have rheumatoid arthritis, diabetes, autoimmune diseases or more than one joint replacement, need to take antibiotics before they see the dentist for the rest of their lives.
How long do hip and/or knee replacements last?
It's possible for replacements to last beyond 20 years. It depends on how active the patient is and how much they abuse the joint.
What do I need to do before a knee scope or ACL reconstruction?
If you're over the age of 50 and/or have any cardiac history, you will need to obtain an EKG. If you have an extensive medical history you may also need to see your PCP for a physical exam and clearance.