FAQs About Anterior Hip & Knee Replacement Surgery
COMMON QUESTIONS FROM PATIENTS
What type of anesthesia will I have?
Almost all patients have spinal/epidural anesthesia which makes their legs numb for surgery but doesn't require general anesthesia with a breathing tube. You will get "twilight" sedation so that you are not aware of what is happening during the procedure.
How long do I have to be off work after hip or knee replacement?
It depends on your recovery and what type of work you do. You can start working from home within days of surgery. A desk job can usually be returned to within 2-4 weeks after surgery. More rigorous manual-type labor may require 2-3 months for a return to full activity.
When can I drive after hip or knee replacement?
If your surgery was on the right leg you should not drive for about 3-4 weeks after surgery. It has been shown that reaction time from the gas to the brake pedal is slow for about a month after joint replacement surgery. For surgery on your left leg you can drive after 2-3 weeks if you feel comfortable and are finished taking narcotic pain medicine. Many patients drive themselves to their 1st postoperative appointment two weeks after anterior hip replacement, knee replacement recovery usually takes a little longer.
Will I need hip precautions after anterior total hip replacement?
Because of the way in which an anterior total hip replacement is performed and the lower dislocation rate associated with this surgery no hip precautions are required postoperatively. This is different from a traditional posterior hip replacement which has a higher dislocation rate and usually requires that the patient not cross their legs, not sit in low chairs, and use a pillow between their legs while in bed. None of those precautions are needed after anterior hip replacement.
Is a hip or knee replacement painful?
Because anterior hip replacement is minimally invasive it is usually not very painful. Many patients report that their arthritis pain is gone almost immediately after surgery. They do still have some surgical pain after the surgery but it is usually easily managed and most patients can be done taking strong pain medicines within a few days or two weeks after anterior hip replacement. Partial knee replacement is similarly not too painful for most patients. Total knee replacement can be a relatively painful procedure that will often require anti-inflammatory and pain medicines for 3-4 weeks after surgery.
How long does hip or knee replacement surgery take?
The surgical time to perform a hip or knee replacement usually takes about 1-1.5 hours to perform. The length of the surgery may vary depending on how big the patient is and if they have very bad arthritis. The full procedure time including anesthesia, surgery, and time spent in the recovery room is usually about 3-4 hours.
How long will I be in the hospital after hip or knee replacement?
Most patients stay in the hospital 1 or 2 nights following surgery before going home. Some patients may be able to go home on the day of surgery if they are doing well. Almost all patients that undergo partial knee replacement will be done as outpatients and go home on the same day as surgery. Last year all of my partial knee patients went home on the day of surgery, 60-65% of my total hip or total knee replacement patients went home after one night in the hospital, 10-15% of total hip or total knee patients went directly home after surgery, and ~25% of my total hip or total knee replacement patients stayed two or three nights in the hospital.
Will I go home or to rehab after hip or knee replacement surgery?
The vast majority of patients are able to go home after both hip and knee replacement. Occasionally patients who are older or have multiple medical problems may require a short stay in a rehab facility postoperatively. It depends on your activity level before surgery as well as the degree to which friends and family can help you at home but most patients should plan to go home after surgery. You will get physical therapy while in the hospital and then start outpatient physical therapy within a few days after surgery to continue the recovery process. Some patients do not require any physical therapy after anterior hip replacement because the recovery can be very easy, but this is not always the case. All partial and total knee replacement patients should plan to need outpatient physical therapy for at least 6 weeks after surgery to regain their knee strength and range of motion.
When do the staples or stitches get removed afterwards? What is the scar like after hip or knee replacement?
I use absorbable sutures under the skin so that no staple or suture removal is required. This also makes the scar look better without the "train track" appearance that skin staples sometimes leave. I also use a skin glue on top of the incision to help give the closure extra strength. The incision for a knee replacement is directly over the front of the knee, the incision for anterior hip replacement is a few inches towards the side of the body away from the groin and is about 6 inches in length going down the thigh. I use a special bandage with antimicrobial properties that can be left on top of the incision for two weeks when you go home. This bandage is waterproof so patients can shower as soon as they get home after hip or knee replacement.
How long do hip or knee replacements last?
Historically about 1% of joint replacements per year "failed", or required a revision surgery. This means that 20 years after surgery about 80% of patients are still doing well with their original implants. The implants being used today improve on these results but we don't have enough long-term data yet to make conclusions. For the majority of patients today in their 50s, 60s or 70s a hip or knee replacement will last for the rest of their life.