Heal with steel

Arthritis is one of those very real obstacles that many of us face as we age. The pain it brings is extremely debilitating and can significantly lower one’s quality of life and daily activity. When this happens to one of my patients, then we discuss total joint replacement.

Cue the cringe. I know the thought of total joint replacement might make your spine shiver, but think of it as replacing a part of your body that is holding you back with a new part that will allow you to take your life back!

Chapter 11 of Fitness After 40, Second Edition tells you everything you need to know about joint replacements. If becoming “bionic” like the Six Million Dollar Man sounds like science fiction to you, below is a quick joint replacement rundown using an old nonfiction mantra: who, what, when, why and how.

  • Who: I was taught, “We don’t treat X-rays. We treat patients.” It’s not enough for a patient’s X-ray to show arthritis. We perform a total joint replacement only when patients have exhausted all other measures, can’t take the pain another day, and simply want their life back.
  • What: Doctors can now replace many joints, including knuckles and ankles. However, knee and hip replacements are much more common. The American Academy of Orthopaedic Surgeons estimates that by 2030, there will be a 637% increase in knee replacements and a 174% increase in hip replacements.
  • When: Doctors used to wait as long as possible to perform replacements, as the average total joint requires additional revision surgery after 10 to 15 years. Now, the trend is to replace bad joints earlier in life rather than wasting years sitting around in pain waiting for surgery… and getting fat! Though this does mean additional surgery, doing so gives the patient the ability to live an active and healthy (and as we now know, longer) life.
  • Why: Surgeons perform total joint replacements to decrease pain, realign joints, increase mobility, support functional independence and psychological well being, and last but not least… to return to sport!
  • How: As cartilage wears down, bones rub against each other causing pain and deformity. In short, a total joint replacement is performed by removing the ends of the bones that no longer have cartilage and cementing metal replicas in their place with a strong plastic (or poly) in between. The new implants move over the plastic like a natural joint over cartilage.

After the surgery, the patient either undergoes inpatient or outpatient physical rehabilitation. Rather than limiting an active lifestyle, total joint replacements do the opposite. I encourage my patients to get moving doing anything they want (even Alpine skiing!) after I replace their knees or hips, with one exception: running. Though it takes work, if you were active before surgery, you will be active after.

If you were told you need a total joint replacement, chapter 12 of Fitness After 40, Second Edition is an excellent resource for you. I give you all the information you need plus some tips on finding the right surgeon and specific homework assignments to get you back on your feet.

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