Expert Care and Options to Meet Your Needs

Joint Replacement Surgery

For people whose joints have been damaged by degenerative disease, fractures or other conditions, total joint replacement can decrease pain, improve range of motion and increase mobility. You might consider joint replacement if you have:

• Avascular necrosis
• Femoral-acetabular impingement
• Gout
• Hip dysplasia
• Osteoarthritis
• Post-traumatic arthritis
• Psoriatic arthritis
• Rheumatoid arthritis

Surgery isn't typically the first line of treatment. At MetroHealth, we believe in exploring less invasive options first—such as weight loss, physical therapy, anti-inflammatory medications and cortisone injections. These treatments are available through our Orthopedics Department.

If surgery is recommended, you can rely on your surgeon to thoroughly review the procedure with you. Benefits and risks, what you can expect while you're in the hospital, and the important role physical therapy plays in your recovery are discussed prior to surgery.

Top Three Procedures We Perform

• Hip replacement surgery. Your hip is a ball-and-socket joint. The ball, called the femoral head, is at the top of your thigh bone. It fits in the acetabulum, or socket, of your pelvis. During total hip replacement, the femoral head is removed. A metal stem is inserted into the top of the thigh bone. A metal or ceramic ball is placed on the stem. The damaged part of your acetabulum is removed and replaced by a metal socket. A plastic spacer is inserted between the new ball and socket.
• Knee replacement surgery. Your knee joint is where the bottom of your thigh bone, or femur, meets with the top of your shinbone, or tibia. At the front of this joint is your kneecap, or patella. Cartilage protects the bones. C-shaped cushions, called the menisci, sit between your femur and tibia. During a total knee replacement, damaged cartilage is removed from the femur and tibia. The removed cartilage and bone are replaced with metal components. A plastic spacer is inserted between the two new components. The patella usually is cut and given a new plastic surface.
• Shoulder replacement surgery. Your shoulder is the most flexible joint in your body, allowing you to move your arm to the front and back, to the side, to the sky and to the ground. That flexibility makes the shoulder prone to injuries. People with very painful shoulder joints and limited movement may benefit from shoulder replacement surgery, in which the entire socket of the shoulder, or portions of the shoulder, are replaced. We partner with the MetroHealth Hand and Upper Extremity Center to assist people with shoulder issues.

What to Expect

Whether you're planning to have one of these surgeries or another form of joint surgery, the intake procedure will be much the same. You will be admitted to the hospital on the day of your surgery, and in most cases, you can expect to be in surgery for about 90 minutes.

Several hours after you are awake and in your hospital room or while still in the PACU (post anesthesia care room), a physical therapist will visit you. They will ask questions about your home setup, medical equipment, and assistance that you will have after discharge.  You will learn how to use a walker or crutches to get in and out of bed, and how to sit and get up from a chair. You may be up and walking—with help—on the day of surgery.

Many people can go home within one to two days after surgery. Some go home, on the same day of surgery if this has been previously arranged with your surgeon. It's helpful to involve family and friends in your recovery process. In many cases, a lengthy or costly stay in a rehabilitation center can be avoided if you have someone to stay with you at home for a short time. Many patients do have insurance benefits that cover a physical therapist coming to your home after discharge for 1-2 weeks prior to starting outpatient therapy. Discharge to home is the preferrable destination.

You may start physical therapy the day after you go home. You can expect to return to most normal activities in about six weeks.

Total joint replacement surgeries are some of the most successful and effective surgeries available. In many cases, there is an almost immediate relief of pain. With the materials used today, you can expect your joint replacement to last for many years—if not for the rest of your life.

Anterior Approach

We use minimally invasive techniques whenever we can, which offer many benefits over older techniques.

For example, we use an anterior approach to hip replacement, which can:

• Allow you to bear weight and bend your hip soon after surgery
• Create a stable and secure joint, as muscles and tendons remain functional
• Create smaller incisions that heal fast
• Minimize blood loss
• Minimize scarring
• Reduce dislocation risks
• Reduce the amount of pain you'll feel after surgery
• Reduce the need for walking aids
• Shorten hospital stays and recovery times