When Is It Time for Shoulder, Hip or Knee Replacement Surgery?

During shoulder, hip or knee replacement surgery, orthopaedic surgeons replace arthritic or damaged joint surfaces with metal, plastic or ceramic parts that function like a normal, healthy joint. But experiencing joint pain alone doesn’t necessarily mean it’s time for a new joint.

Learn when you need total joint replacement surgery for a shoulder, hip or knee; and when it may be better to wait.

How Joints Work

There are two types of joints: ball-and-socket joints and hinge joints. The difference between them is how they’re structured and work to allow movement.

Ball-and-socket joints, such as hips and shoulders, are shaped just like it sounds. One bone that’s shaped like a ball sits in the curve of another that acts as a socket. With connective tissue joining them together, they work as a system that allows for a broad range of motion. Imagine your shoulder joint giving you the ability to draw a full 360-degree circle in the air with your arms or your hip joint giving you the ability to do the same with your legs.

Hinge joints, such as your knee joints, have a smaller range of motion but are, by far, the largest and strongest joints in your body. So, while they only allow one plane with small degrees of motion, they can support a greater amount of force.

Understanding Joint Problems

Joint problems usually bring people to orthopaedic specialists when the pain begins to affect their ability to carry out normal activities.

“People just get frustrated when they aren’t able to stand, walk or participate in the activities they love,” says Karl Beer, MD, an orthopaedic surgeon with ProMedica Physicians, “But we’re always ready to help.”

Typically, joint issues fall into two basic categories: arthritis or injury.

Arthritis is a progressive condition that damages the cartilage lining sockets of the shoulder, knee or hip, and the ends of the upper arm, thigh and shin bones. Though it usually affects people 50 and older, it can affect younger people, too. As the cartilage wears it causes inflammation, swelling, and pain.  Eventually, you have bone-on-bone contact and end stage disease which results in the need for joint replacement.

Injury. Traumatic injuries can result in the need for joint replacement. So can rotator cuff tears, which cause debilitating pain in about 2 million adults in the United States. Left untreated, a torn rotator cuff muscle can atrophy (waste away) and become unrepairable.

“While all joint issues are painful, hips and knees are often worse because they are weight-bearing joints,” Dr. Beer says. “So, hip and knee problems tend to interfere most with quality of life.”

When to Have a Joint Replacement

So, how do you know it’s the right time for you to get a new joint? The short answer is that everyone is different. But for most, it’s a matter of when your pain prevents you from managing the activities of daily life or keeps you from doing the things that matter most to you.

“Hip arthritis especially, can cause people to lose mobility to the point where they have trouble with simple things like putting their shoes and socks on. And in many cases, they can’t even reach their foot,” says Dr. Beer. “So, we do surgery to relieve progressive pain and loss of motion in the joint, so they can get back to living their best life.”

But joint replacement surgery shouldn’t be rushed. Although modern joint replacement surgery is very successful, any type of surgery has risk of complications. These include infection, fractures around the joint and the long-term consequences of wear or loosening — not to mention recovery, which usually takes weeks and may include physical therapy. Your best bet is to wait until nonsurgical treatments, such as medication, injections, and physical therapy, no longer manage your symptoms and your X-rays show the joint has deteriorated.

“With hips or knees, for example, it makes more sense not to replace them until you absolutely have to,” says Dr. Beer. “Then, you know the benefits outweigh the risks.”

If you think you may be ready for joint replacement surgery, ProMedica’s orthopaedic experts are here to help you stop hurting and start living.

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