We endevour to provide our patients with Information to make informed decisions about their surgery as well what are to be expected before, during and post surgery. Below we have answered the most frequently asked questions. For detail information about hip or knee replacements please download our brochure. Download Brochure

What is a joint?

Joints are composed of two or more bones, cartilage that cushions and separates the bones, and ligaments that attach the bones together. For example, the knee joint refers to the point of connection between the femur, or thigh bone, and the tibia, or shin bone. Joints also contain a variety of fibrous connective tissue such as ligaments, which connect the bones together and tendons which connect muscle to bone and cartilage, which covers the ends of bones and provides some cushioning.
Joint types

  • ball and socket joints
  • hinge joints
  • condyloid joints
  • pivot joints
  • gliding joints
  • saddle joints

What is arthritis?

Arthritis is an inflammatory disorder of the joints that may produce pain and swelling that lasts a lifetime. It affects and limits everyday activities and is a leading cause of disability.

Osteoarthritis is the most common form of arthritis. It is most often related to wear and tear that has been placed on the joints over the years. Its onset is usually after the age of 50. Factors that predispose this condition include family history, obesity, previous surgery to the joint where a large piece of cartilage (cushion between the bones) was removed, or previous fractures in the area of the joint.

Rheumatoid Arthritis is one of the more common kinds of inflammatory arthritis. It is a chronic inflammatory disorder affecting the joints of the body which are lined with a membrane called synovium. These joints include the hip, knee, shoulder, elbow, wrist, hands and feet. Rheumatoid arthritis is likely of autoimmune origin, which means the body produces cells that irritate the synovium in the joint leading to destruction of the cartilage. This form of arthritis occurs in all age groups. It is characterised by stiffness, joint swelling, and laxity of the ligaments, pain, and decreased range of motion.

What are the consequences of injury?

The consequences of injuries can be extensive and wide ranging. Injuries have physical, emotional, and financial consequences that can impact the lives of individuals, their families, and society. Some injuries can result in temporary or long-term disability.

When should I have a joint replacement operation?

The decision to have joint replacement surgery should be made very carefully after consulting your doctor and learning as much as you can about your condition and the surgery.
Most patients who undergo a joint replacement are between the ages of 50 and 80 although people of all ages can undergo this procedure.
Recommendations for surgery are based on your level of pain and disability, rather than your age. After an orthopaedic evaluation, you and your surgeon should decide if joint replacement surgery is the best possible treatment.
If you have any of the following signs you should speak to an orthopaedic surgeon about the possibility of a joint replacement operation:

  • Difficulty to sleep at night because of pain
  • If your activity is restricted to the point where you have trouble getting out of a chair, climbing stairs, getting up from the toilet or the floor
  • Medications you’ve been using no longer helps to alleviate pain
  • You can no longer enjoy regular outings such as visiting friend or going on holiday because of pain.
  • Stiffness in a hip limits your ability to move or lift your leg.
  • Other treatments such as physiotherapy or the use of a walking aid such as a cane don’t relieve your hip pain.

What are the benefits of the operation?

  • Improved movement and use of a joint. Surgery can replace or stabilise a joint allowing you to move more easily.
  • Pain relief. Joint replacement surgery can help relief pain that does not respond to other treatment options.
  • Improved alignment of deformed joints. Re-alignment of joint can help improve the function of those joints.

What should I do in the waiting period?

  • Before the operation, your doctor will give you a complete physical examination to ensure that you do not have any conditions that will interfere with the operation and its outcome. Routine tests, such as blood tests and X-rays are usually performed a week before surgery. Tell your doctor of all other preexisting deceases that you may have including all previous infection incidents.
  • Discuss any medications you are taking with your orthopaedic surgeon to see which ones you should stop taking before the operation, tell your doctor if you are using Warfarin or Cortisone.
  • Losing weight before the operation will help decrease the stress you place on your new joint. However, you should not diet the month before your operation.
  • If you are taking aspirin or anti-inflammatory medications, you will need to stop taking them one week before the operation to minimise bleeding.
  • If you smoke, you should stop or cut down to reduce your operation risks and improve your recovery.
  • Have any tooth or gum problems treated before the operation to reduce the risk of infection later.
  • Eat a well-balanced diet, supplemented by a daily multivitamin with iron.
  • Report any infections to your orthopaedic surgeon. No surgery can be performed until all infections have cleared up.

How successful is joint replacements?

Both hip and knee joint replacements are recognised as miracles of modern surgery.It has allowed countless people with arthritis to get back on their feet and resume an active lifestyle. Since the new surfaces are artificial, mobility is painless. In 9 out of the 10 cases the results are very well and hold for 10 to 15 years or longer. Joint replacement is the most successful operation for acute arthritis if the following three requirements are met:

  • the operation is properly carried out by experienced and specially trained surgeons;
  • the operation is performed in a well-equipped center with the necessary facilities; and
  • It is executed on a motivated patient who understands its limitation.
What type of anaesthetic will be used? A through physician and cardiac check is done prior to the operation. A member of the anaesthesia team will evaluate you after your all tests are over. The most common types of anaesthesia for hip replacement surgery are spinal and epidural anaesthesia (which allows you to breathe on your own but anaesthetises your body from the waist down) or general anaesthesia (which puts you to sleep throughout the procedure and uses a machine to help you breath). The anaesthetist team will discuss these choices with you and help you to decide which type of anaesthesia is best for you.
Is the operation painful? Thanks to advances in medication technology, we are able to keep you very comfortable after surgery. After surgery, any temporary discomfort does not compare to the pain of arthritis endured by most people in months and years before surgery.

Our goal is to manage your pain effectively and maximise your comfort.
Will a blood transfusion be necessary?

As in any major surgical intervention, bleeding may occur and you may need a blood transfusion.

Will I need physiotherapy after the operation?

To avoid lung congestion after surgery, you will be asked to breathe deeply and cough frequently. 

To protect your hip during early recovery, a positioning or abduction splint, such as a V-shaped pillow placed between your legs, may be used.
 
Walking and light activity are important to your recovery and will begin the day after your surgery. Most hip replacement patients begin standing and walking with the help of a walking support and a physiotherapist the day after surgery. The physiotherapist will teach you specific exercises to strengthen your hip and restore movement for walking and other normal daily activities.
Depending up-on the type of procedure and implant used weight bearing will differ from partial weight to full weight bearing.

How long will I be in hospital?

Your hospital stay will typically be five to seven days for total knee replacement or total hip replacement. With the preoperative education, combined with physiotherapy most patients return to everyday activities within two to three months.

How quick will I recover?

Recovery takes time and will require a commitment from the patient. There are exercises and a strict treatment plan that the patient should follow after the operation. The patient’s willingness to put effort into the recovery process will make a big difference in how well he or she recovers. The patient must be ready for several weeks of work after the operation to make it a success.

What is the prominent risk in my case?

Research suggests that in hospitals that do lots of knee replacement operations things are less likely to go wrong.

  • Other health problems must be under control. If you have a heart condition or lung problems, surgery may be too strenuous for you.
  • Infections should be cleared up before surgery as they could cause serious complications.
  • Blood clots could develop. Your doctor will advise you on how to reduce this risk.
  • Being overweight can add extra stress on your heart and lungs during surgery. If you are overweight consider losing weight before the operation.
  • Leg-length inequality. May occur or may become or seem worse after a hip replacement operation.
  • Aseptic loosening. Over years, your hip prosthesis may wear out or loosen. This problem will likely be less common with newer materials and techniques. When the prosthesis wears out, bone loss may occur because of the small particles produced at the wearing surface. This process is called osteolysis.
Other complications. Dislocation, nerve and blood vessel injury, bleeding, fracture and stiffness can occur.

What will happen if I choose not to have the operation?

If you choose not to have the operation, your arthritis or injury may not get better. Arthritis usually progresses very slowly, often over many years. Having arthritis can make your life more difficult, but it is unlikely to make it shorter. Injury to the joints should be treated if it is causing you pain or difficulty in moving.

What is the cost of a joint replacement?

Please consult with the doctors office to confirm the level of cover from your medical aid and what you should do to obtain authorisation from your medical aid. Different procedures and underlying deceases and the posibility of complications may have different cost implications.
   
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