Joint Replacement Resources & FAQs

Often the first clues are pain, instability and loss of flexibility in the knee joint. The arthritic process that renders the knee painful and unstable occurs over time and may have been precipitated by trauma, a tear to the meniscus (cartilage), or a condition called avascular necrosis (dead tissue) in the bone. Knee injuries, often occurring decades in the past, may have resulted from a work-related event; contact or other sports; an automobile accident; or juvenile rheumatoid arthritis.

Candidates for partial knee replacements are adults 40 to 60 years old who are in good health and who have exhausted conservative means for managing arthritic pain, such as medications, braces, or limiting activities. These people have degeneration or arthritis on one side of the knee only. In the general population, about 10 percent of people are candidates for this surgery.

If you’re a candidate for a partial knee replacement, there are many advantages to having this surgery instead of a total knee replacement. First, many of your natural tissues, including most of the joint surface, cartilage and knee ligaments, are retained during partial knee replacement surgery. This helps you recover faster and shortens your rehabilitation time. Studies show that over a 10-year period and longer, a partial knee implant is still functioning in 90 percent of people.

If you eventually need a total knee replacement in the knee that had the partial knee implant, a revision surgery can be done. Studies show few complications with this second surgery.

If you have significant degeneration in your knee as seen on imaging studies (X-rays, etc.) and you're experiencing pain and restricted movement, more than likely you're a candidate for a total knee replacement.

No. The two are not mutually inclusive. Your partial knee replacement helps to restabilize the knee and may last a lifetime. Some people, however, do experience more degeneration in the knee and may opt to have the knee totally replaced. In this instance, the whole knee, including the partial knee implant, is replaced.

Yes. In this instance, the entire knee joint, including the previously implanted partial knee, is removed and replaced with the new implant.

Yes. Virginia Mason Franciscan Health orthopedic surgeons routinely perform what is called a bilateral knee replacement of both knees. This procedure can even be performed simultaneously by two surgical teams and in most instances does not increase the average surgical time (one to two hours). Two partial knee replacements are rarely done at the same time, primarily because most people who qualify for this procedure have wear on one side of the knee only and only in one knee. However, if a patient becomes a candidate for a partial knee replacement of the other knee, that procedure certainly can be done.

All people undergoing joint replacement surgery must have clearance from their dentists showing that there is no infection, such as an abscessed tooth, in the mouth. The reason is that infection in one part of the body can travel to the new joint and cause infection in these newly replaced parts.

Our knees absorb quite a bit of shock over the course of our lifetimes and can begin to show wear and tear on the surface of bone and in the cartilage that sits between bones. Some medical conditions—inflammation or rheumatoid arthritis—also can cause this same type of degeneration. Additionally, direct injury to the knee joint from contact sports or accidents can destabilize the knee and cause uneven wear, eventually leading to arthritis later in life.

We have found that about 40 percent of people with arthritis in one knee will also develop arthritis in the other knee. But having arthritis in one knee does not necessarily mean that arthritis will develop in your other knee.

Knee replacement devices are comprised of cobalt-chrome alloy, titanium alloy, and polyethylene plastic. A partial knee replacement is quite small. A total knee replacement is the same size as the actual knee. Other materials such as ceramics have been used. You surgeon will decide which materials are best for you.

A total knee replacement is a major surgical procedure performed in the operating room. During this operation, your surgeon removes damaged bone and cartilage, resurfaces the top and bottom of your leg bones that meet to form the knee joint, and resurfaces the underside of the knee cap. Virginia Mason Franciscan Health has one of the best anesthesia programs in the country, and we specialize in regional anesthesia. You'll be well cared for during your operation by your anesthesiologist.

Your recuperation and rehabilitation begin while you're still in the hospital and often on the same day as your surgery. Your physical therapist and nurse will help you sit on the side of the bed and walk. They will also show you exercises to do while you are in bed and when you are discharged home.

There are very few restrictions after successful total knee replacement surgery. Walking, swimming, golf, biking, yoga, low-impact or water aerobics, cross-country skiing, and low-resistance weight training are all examples of very reasonable activities to pursue after knee replacement surgery. 

It's not advisable to take part in repetitive high-impact activities such as running or jogging. On the other hand, if you were already an expert downhill snow skier, you might return to skiing but will be advised to avoid the more high-impact aspects of the sport.

Usually not. Some people will note the occasional tapping of the artificial implant surfaces against each other but, in general, the joint returns to feeling like a natural knee.

However, the knee replacement only replaces the surfaces of the joint. The new surfaces will eliminate pain and stiffness associated with those surfaces only. If you have scarring or damage to the muscles and tendons around the joint from previous surgery or injury, these structures can cause continued stiffness and pain just as they would around a normal natural joint. Discuss any concerns you have with your surgeon.

The answer depends on the type of implant you have had and must take into account several factors, such as your age, physical condition, weight and activity level. Because these devices are made with stronger materials today and provide a secure fit, a partial knee implant is expected to last beyond 10 years. A total knee replacement can last more than 30 years. 

Yes. Women are more active, so we are seeing more of them having partial and total knee replacement surgeries, and at younger ages. We do expect—with the aging of the population and higher activity levels of some baby boomers—that more people will require knee replacements in the near future.

Yes. You’ll be able to go through a metal detector. Some metal detectors are more sensitive than others, and you may set off the alarm. However, we provide all joint replacement patients with a card to present to airport security.

A deep infection in an artificial knee replacement is a very rare and serious complication. It usually requires the complete removal of the implant before the infection can be cured. During the time the implant is gone and the patient is being treated with powerful antibiotics, a temporary antibiotic-soaked cement implant is often used to maintain joint spacing and motion. After the infection is gone, a new knee replacement can be put in.

Loosening of implants can occur and would require a replacement operation. Fortunately, with today's knee replacement designs, loosening has become rare.

Yes. But if the MRI imaging is being done to look at structures near the knee implant, the metal of the implant can distort the image.

Often the first clues are pain, limited range of motion in the arm and loss of strength. The arthritic process that renders the shoulder weak and painful occurs over time and may have been started with the wearing down of cartilage that covers bone surfaces, a tear in the rotator cuff (a tendon surrounding the shoulder joint) or necrosis (dead tissue) in bone from a loss in blood supply to bone. These situations, often occurring decades in the past, may have resulted from a work-related event, contact or other sports, an automobile accident, or rheumatoid arthritis.

A shoulder replacement implant consists of three parts:

• A new socket (glenoid) that is implanted within the shoulder blade (scapula)
• A new "ball" to replace the head of the top of the arm bone (humerus)
• A stem that secures the ball within the arm bone

These materials are comprised of titanium or chrome-cobalt stainless steel and polyethylene plastic.

Having a shoulder replaced is a major surgical procedure performed in the operating room. During this procedure, your surgeon removes damaged bone and cartilage, resurfaces the socket within your shoulder blade, and replaces the ball or head of the humerus at the top of your arm bone. Virginia Mason Franciscan Health has one of the best anesthesia programs in the country, and we specialize in regional anesthesia. You'll be well cared for during your operation by your CRNA or anesthesiologist.

Your recuperation and rehabilitation begin while you're still in the hospital and often on the same day as your surgery.

After surgery and rehabilitation, you’ll have much more range of motion than what you had prior to your surgery. How much range of motion you achieve will depend on your own unique circumstances and anatomy. Most people are quite satisfied with the painless restored motion they find they have following their surgery and rehabilitation.

All people undergoing joint replacement surgery must have clearance from their dentists showing that there is no infection (such as an abscessed tooth) in the mouth. The reason is that infection in one part of the body can travel to the new joint and cause infection in these newly replaced parts.

The shoulder joint allows more range of motion than any other joint in the body. The cartilage that covers bone surfaces in the joint can begin to wear down, causing stiffness and pain. Some medical conditions—inflammation or rheumatoid arthritis—also can cause this type of degeneration. Direct injury to the shoulder joint from contact sports, an accident or a fall can destabilize the joint and cause uneven wear, eventually leading to arthritis.

This is usually not the case, but it can happen. 

You’ll be able to drive about three to six weeks after your surgery.

Yes. You’ll be able to play basketball and golf at the end of your rehabilitation time, or about 12 weeks after surgery. But you'll be advised to go slowly, gradually increasing your time doing these activities. 

Some people do continue to bowl. We advise caution to preserve the joint since it's artificial.

People who are younger and require joint durability, such as construction workers or anyone doing physical labor, may have early failure of the polyethylene socket and would be better candidates for partial shoulder replacement. Athletes also fall into this category.

Usually not.

The answer depends on several factors, such as your age, physical condition, and activity level. Most people who have a shoulder replaced are older and have fewer physical demands. Because these devices are made with stronger materials and provide a secure fit, a shoulder replacement is expected to last the remainder of your life.

Most people are middle age or older. But the shoulder joint can degenerate from a number of factors that have nothing to do with age. Athletes in middle age who have participated in contact sports have had shoulders replaced. A traumatic injury from an accident or fall also may require that the shoulder be replaced. Rheumatoid arthritis at any age can affect the shoulder and cause degeneration.

Yes. You’ll be able to go through a metal detector. Some metal detectors are more sensitive than others, and you may set off the alarm. We give all people undergoing joint replacement a card to carry in a wallet or purse to show to security at the airport.

Infections are highly unusual. If an infection does occur, we may have to remove the implant and treat you with antibiotics for six weeks to cure the infection prior to re-implanting new sterile components.    

Over a long period of time, perhaps. We have many options for what is called "revision" surgery, and implants are lasting longer now due to improved materials and geometry.

Yes.

A shortened gait, especially if you're without pain, is probably not related to your hip but instead to tightness in the muscles, tendons, and ligaments that surround the hip joint. Light stretching exercises and a regular walking program may help restore your range of motion.

A hip replacement comprises chrome-cobalt, titanium alloy, and polyethylene plastic. Ceramics may be used as well. Your surgeon will determine what’s best for you.

Having a hip replaced is a major surgical procedure performed in an operating room. During this procedure, your surgeon will remove damaged cartilage and bone, resurface the "socket" in your pelvis, and replace the "ball" or head of the thigh bone (femur) that moves within the socket. 

The length of your surgery may range from one to two hours. Virginia Mason Franciscan Health has one of the best anesthesia programs in the country, and we specialize in regional anesthesia. You’ll be well cared for during your operation by your CRNA or anesthesiologist.

Your recuperation and rehabilitation begin while you're still in the hospital and often on the same day as your surgery. A physical therapist will help you sit up and will also show you light exercises to do while in bed. Eventually, you'll stand and walk a short distance with a walker. Each day you're in the hospital, and several times a day, your physical therapist or nurse will work with you. Your road to recovery begins with these simple exercises that will eventually help you regain strength and functional use of your hip.

Your surgeon or physical therapist will talk with you about exercises to do at home after surgery, either on your own or with the help of home health services. Rehabilitation services also are available through Virginia Mason Franciscan Health.

Most people reach a point of independence within three days. You'll continue to slowly improve for about a year because you won’t just be recovering from the operation. You also will be recovering from the weakening of muscle and tendons that may have been occurring for years before the surgery.

All people having joint replacement surgery must have clearance from their dentists showing that there is no infection (such as an abscessed tooth) in the mouth. The reason is that infection in one part of the body can travel to the new joint and cause infection in these newly replaced parts.

It's not advisable to take part in repetitive high-impact activities such as running or jogging. On the other hand, if you were already an expert downhill snow skier, you might return to skiing but will be advised to avoid the more high-impact aspects of the sport.

It's best not to drive until six weeks have passed because of the fatigue factor that occurs after most major surgeries. Reflexes are impaired, and you may be taking pain medications.

Yes, you'll be able to play golf approximately eight to 12 weeks after surgery.

As a weight-bearing joint, our hips absorb shock over the course of our lifetime and can begin to show wear and tear on the surface of bone and in the cartilage that sits between bones. This damage can be accelerated with even mild congenital structural abnormalities of the hip that you may not even know about. Some medical conditions—inflammation or rheumatoid arthritis—also can cause degeneration. Direct injury to the hip from contact sports or accidents can destabilize the joint and cause uneven wear, eventually leading to arthritis later in life.

No. The hip can degenerate from a number of factors that have nothing to do with age. Athletes in their 30s who participate in contact sports, for example, have had hips replaced. A traumatic injury from an accident also may require that the hip be replaced. Rheumatoid arthritis and avascular necrosis (dead tissue) of the hip can occur at any age and affect the hip, causing degeneration.

No, not always. However, some conditions leading to degeneration of the hip can occur in both hips. Your surgeon can explain this process in more detail.

The answer depends on several factors, including your age, physical condition and activity level. Because these devices are made with strong materials that provide a secure fit, 20-year implant survival is not an unreasonable expectation. The exact survival rates aren’t yet known.

No, most hip replacements result in a natural-feeling joint. Weak or damaged soft tissues existing before surgery, however, can sometimes persist after the hip has been repaired, and symptoms may continue to occur in those tissues.

Yes, you'll be able to go through a metal detector. Some are more sensitive than others, however, so you may "set off" the alarm in some instances. All patients who have joint replacement surgery at Virginia Mason Franciscan Health will be given a card to show airport security.

A deep infection in an artificial hip replacement is a very rare and serious complication. It usually requires the complete removal of the implant before the infection can be cured. During the time the implant is gone and the patient is being treated with powerful antibiotics, a temporary antibiotic-soaked implant is used to maintain joint spacing and motion. After the infection is gone, a new hip replacement can be placed.

It's very unlikely that your implant will loosen. But if it does, it can usually be redone. Oftentimes, only a part of the implant needs to be revised.

Yes, but if the MRI imaging is being done to look at structures near the hip implant, the metal of the implant can distort the image.