Vim & Vigor - Spring 2018 - Gwinnett Medical Center - 21

Why You're READY

1 You've already tried modifying

your lifestyle. At some point, aging
joints don't let you run and jump like
you used to. But if you're still in pain
after you've traded running for biking or
reduced your hourlong walk to 30 minutes, it's time to explore the next level
of treatment options.

2 Pain is inhibiting you from everyday activities. You can change your
hobbies and possibly even your job to
accommodate joint pain, but you can't
eliminate the physical demands of simply getting through the day.
"I have to be able to get off a toilet or
chair. I have to be able to fi x meals for
myself or walk to the mailbox. I need
to walk at least a couple of blocks,"
Johnson says.
3 You're in pain more often than
not. Johnson recommends starting a
daily log in which you record the pain
levels you experience on a scale of
zero to 10.
"If you have more bad days than good
days, maybe surgery is a consideration,"
he says.
4 Your joint is damaged from osteoarthritis. The bones of a healthy joint
glide over each other thanks to cartilage, the tissue that covers the ends
of the bones and helps absorb shock.
But when the joint is damaged by
osteoarthritis, the cartilage breaks
down, causing bones to rub together.
Your doctor will take X-rays to
look for space between bones, which
should be filled with cartilage. If bones
are instead touching, Johnson says,
"They've essentially lost all of their cartilage ... they'd be a candidate for total
knee or total hip replacement."
5 You've exhausted all other non-

surgical treatments. Before recommending surgery, your doctor may
prescribe physical therapy to alleviate

stress on the joint by strengthening
the muscles surrounding it. Antiinflammatory medications or steroid
injections to reduce swelling might be
part of treatment, too.
If nothing helps manage the pain,
you probably need joint replacement.
But that doesn't mean the time spent
strengthening muscles during physical
therapy was wasted.
"Your recovery will be that much
better," Johnson says.

Why You're NOT READY
1 You haven't tried losing weight.

Extra weight means extra stress on
your joints. A study in Arthritis &
Rheumatology found that every pound
of weight lost reduced pressure on
the knee fourfold-so if you drop 10
pounds, you'll take off 40 pounds of
pressure. Losing weight can help you
be more active and, in turn, prolong
or even avoid the need for surgery.

2 You haven't quit smoking. Studies
show that joint replacement surgery is
riskier and less effective for people who
smoke. In one study, smokers were 10
times more likely to undergo revision
surgeries and almost twice as likely to
develop surgical complications, including blood clots and kidney failure.
A successful joint replacement surgery requires the bone to grow into
the implant. But because nicotine
constricts blood vessels, smokers are
slower to heal and more prone to infection and blood clots.

3 You're not healthy enough for
surgery. Joint pain can trigger a vicious
cycle: A sedentary lifestyle and weight
gain can lead to heart disease or type 2
diabetes that makes surgery risky.
If you're not in good health, make it
your goal to get well enough for joint
replacement. It's worth it, Johnson says.
"The vast majority of patients have
significant improvement, if not complete resolution of their pain." ■

TOTAL KNEE
REPLACEMENT:
A TIMELINE
Getting back on your feet with a new knee
might not take as long as you think.
"Knee replacement surgery is currently
performed as an outpatient procedure or
with a single overnight stay in the hospital,"
says Mary J. Albert, MD, an orthopedic
surgeon affiliated with Gwinnett Medical
Center. "Most patients are doing so much
better in just a six-week period."
Here's what recovery time may entail:
* The day of surgery: Up and walking
with physical therapy within an hour of
surgery. Learn to do steps and stairs.
* Day of surgery to day 1: Get discharged from the hospital and return
home. Physical therapy will come to your
home to work with you.
* 2-3 weeks later: Walk without a cane
* 2-3 weeks later: Drive
* 6 weeks later: Return to most
activities
* 3-6 months later: Return to full
strength and endurance

WEBSITE

Are You Ready for a Joint Replacement?
Getting joint replacement surgery is a big decision. Gwinnett Medical Center
offers an array of resources to help. To begin your joint replacement journey with
GMC, complete the Joint Health Quiz at gwinnettmedicalcenter.org/jointquiz.

SPRING 2018

21
http://www.gwinnettmedicalcenter.org/jointquiz
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