What to consider when thinking about joint replacement surgery

For years, Susan had used a combination of medication, exercise, and occasional steroid injections to reduce her pain from osteoarthritis of the hip and increase her mobility. But over time she found that she was having increased stiffness and difficulty walking. She began to wonder if it was time for surgery.

When she talked with friends who had had hip replacement surgery, she heard two very different stories. Some swore by it. Their pain subsided and their joint function improved. Others reported tough recoveries. Then she talked with a physician friend. After hearing Susan describe her pain and how it affected her, the friend encouraged Susan to meet with her own primary care provider, and also to consider a consultation with a specialist, to help her make a decision about whether to have surgery. When she did, Susan decided that she was a good candidate for a hip replacement.

What factors should you weigh before planning knee or hip joint replacement surgery? Consider the following:

    • How much is your pain affecting your quality of life?
      If arthritis pain prevents you from living fully, you may be a good candidate for joint replacement surgery. Chronic pain can force you to bow out of get-togethers with family or friends. Even basic daily activities, such as walking, sitting, and climbing stairs, become more difficult. Chronic pain also can disrupt your sleep, making you tired during the day and less inclined to be active or social.
    • Is this the right time in your life?
      Rehabilitation after surgery can take weeks, even months, depending on your procedure. Do you have the support in place to cover your responsibilities at home and work, and enough money to manage? Will you need someone to drive you to and from the hospital or rehabilitation center?Also take time to review your insurance coverage. Some plans make you pay out of pocket for rehabilitation aids such as canes, raised toilet seats, or shower chairs.Joint replacements don’t last forever. If and when the artificial joint needs to be replaced, that means a second surgery. Are you prepared for the possibility of repeat surgeries? Your health care provider also may advise you to lose weight or quit smoking before surgery. Are you willing to commit to making those kinds of changes?

      Your health care provider will look at several areas of your health before making a recommendation about surgery. Factors such as your age, weight, and overall health play a big part in making the decision. Your bone density—the amount of minerals you have in a square centimeter of bone—is another consideration. Your bones will need to be strong enough to support a new joint and heal. Your provider also will talk to you about your overall medical history, current medications, and any other health problems you may be experiencing. All this information will help to paint a picture of how your body will respond to surgery and rehabilitation.

    • What are your expectations about surgery?
      Ask your provider to explain the specific goals of the procedure. Is the expected outcome in line with what you hoped for? How about the rehabilitation? Don’t be afraid to ask for details. Everyone is unique, and your hospital stay, rehabilitation period, and overall outcome may be different from someone else’s. Knowing what may lie ahead for you will help you to weigh the pros and cons of surgery realistically.
  • How will you make the final decision?
    Rally all your resources before reaching an answer. Carefully weigh your primary provider and the specialist’s recommendations. But don’t be afraid to visit another health care provider for a second opinion. Many patients do this before deciding about a major surgery. Ask significant others in your life for their thoughts, too. Like Susan, you may find that talking through your hopes and concerns and hearing others’ perspectives can help you determine what’s best for you.