1233 North 30th Street, Billings, MT 59101      406-237-7000
St. Vincent Healthcare
 
 
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FAQs Joint Replacement

What is osteoarthritis and why do my joints hurt?
Joint cartilage is a tough, smooth tissue that covers the ends of bones where joints are located. It helps cushion the bones during movement, and because it is smooth and slippery, it allows for motion with minimal friction. Osteoarthritis, the most common form of arthritis, is a wear and tear condition that destroys joint cartilage. Sometimes, as the result of trauma, repetitive movement, or for no apparent reason, the cartilage wears down, exposing the bone ends. Over time, cartilage destruction can result in painful bone-on-bone contact, along with swelling and loss of motion. Osteoarthritis usually occurs later in life and may affect only one joint and many joints.

What is total knee replacement?
The term total knee replacement is misleading. The knee itself is not replaced, as is commonly thought, but rather an implant is used to re-cap the worn bone ends. This is done with a metal alloy on the femur and a plastic spacer on the tibia and patella (kneecap). This creates a new, smooth cushion and a function joint that can reduce or eliminate pain.

What is total hip replacement?
The term total hip replacement is somewhat misleading. The hip itself is not replaced, as is commonly thought, but rather an implant is used to re-cap the worn bone ends. The head of the femur is removed. A metal stem is then inserted into the femur shaft and topped with a metal or ceramic ball. The worn socket (acetabulum) is smoothed and lined with a metal cup and either a plastic, metal, or ceramic liner. No longer does bone rub on bone, causing pain and stiffness.

How long will my new knee or hip last and can a second replacement be done?
All implants have a limited life expectancy depending on an individual's age, weight, activity level, and medical condition(s). A total joint implant's longevity will vary in every patient. It is important to remember that an implant is a medical device subject to wear that may lead to mechanical failure. While it is important to follow all of your surgeon's recommendations after surgery, there is no guarantee that your particular implant will last for any specified length of time.

Recent studies have shown that for appropriately selected patients, partial knee replacement can last 10 years or more and total knee replacement can last up to 20 years or more.

What are the major risks?
Most surgeries go well, without any complications. Infection and blood clots are two serious complications. To avoid these complications, your surgeon may use antibiotics and blood thinners. Surgeons also take special precautions in the operating room to reduce the risk of infection.

How long will I be in the hospital?
You will be up the evening of surgery. The nursing staff will sit you on the edge of the bed or stand at the bedside. The next morning most patients will get up, sit in a chair or recliner, and should be walking with a walker or crutches the next day. Most patients will be hospitalized for two to three after surgery. There are several goals that must be achieved before discharge.

What if I live alone?
A couple of options are available to you. You may return home and receive help from a relative or friend. You may also stay in a sub-acute facility following your hospital stay, depending on your insurance.

How do I make arrangements for surgery?
After your surgeon has scheduled surgery, the Joint Replacement Center Coordinator will contact you. The Coordinator will guide you through the program and make arrangements for both pre-op and post-op care.

What happens during the surgery?
The hospital reserves approximately two and one half hours for surgery. Some of this time will be taken by the operating room staff to prepare for surgery. You may have a general anesthetic, which most people call "being put to sleep." Some patients prefer to have a spinal or epidural anesthetic, which numbs the legs and does not require you be asleep. The choice is between you, your surgeon and the anesthesiologists.

Will the surgery be painful?
You will have discomfort following the surgery, but we will try to keep you as comfortable as possible with the appropriate medication. After surgery, you may be started on oral or IV pain medications depending on the severity of your pain.

How long and where will my scar be?
Surgical scars will vary in length, but most surgeons will make it as short as possible. It will be straight down the center of your knee, unless you have previous scars, in which case your surgeon may use an existing scar. There may be lasting numbness around the scar.

Will I need a walker, crutches, or a cane?
Patients progress at their own rate. Normally we recommend that you use a walker, crutches or a cane for four to six weeks. The Case Manager at SVH can arrange for them if necessary.

Where will I go after discharge from the hospital?
Most patients are able to go directly home after discharge. Some patients may transfer to a sub-acute facility, where they will stay from three to five days. Case management will help you with this decision and make the necessary arrangements. You should check with your insurance company to see if you have sub-acute rehab benefits

Will I need help at home?
Yes for the first few days or weeks, depending on your progress, you will need someone to assist you with meal preparation, etc. Family or friend need to be available to help if possible. Preparing ahead of time, before your surgery, can minimize the amount of help needed. Having the laundry done, house cleaned, yard work completed, clean linens put on the bed, and single portion frozen meals will help reduce the need for extra help.

Will my new joint set off security sensors when traveling?
Your joint replacement is made of a metal alloy and may or may not be detected when going through some security devices. Inform the security agent you have a metal implant. The agent will direct you on the security screening procedure. You should carry a medic alert card indicating that you have an artificial joint. Check with your surgeon on how to obtain one.

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