Pretty Nice Joint

JOINT REPLACEMENT surgery is a rite of passage for many retirees. I’d be willing to wager that a majority of HumbleDollar readers have either had one themselves or know someone who has.

The American Academy of Orthopaedic Surgeons says hip and knee replacements are the most common types of total joint replacement. From 2012 to 2021, 2.55 million of these procedures were performed, according to the American Joint Replacement Registry, which is the academy’s data repository. Today, younger and more active patients are undergoing joint replacements. Patients who had total knee or hip replacement procedures were age 67, on average.

I developed severe osteoarthritis in my right knee in my late 50s. I lived with it until it became debilitating. I elected to have a total knee replacement in September 2019. At the time, my left knee also showed signs of osteoarthritis, but it wasn’t as severe. I was told I could have both knees replaced simultaneously, but it wasn’t recommended, so I chose to have just the right knee done.

My surgery and rehabilitation went well, and my right knee feels great. My left knee hung in there for the next two years. In 2022, I started to have more knee pain, as well as “referred” pain in the lower leg. My knee joint wasn’t straight and put constant stress on the leg muscles. Standing was worse than walking. I decided to have the left knee joint replaced last fall, and had the surgery on Jan. 3.

My 2019 surgery was performed in a hospital and included an overnight stay. I was not a candidate for a same-day procedure in an ambulatory surgery center because of my weight. I had in-home physical therapy for three weeks and then did outpatient physical therapy at a local office. It took six weeks and a lot of hard work, but the knee responded well, and is now strong and flexible.

The second time I was much better prepared for surgery. I was 110 pounds lighter than I was in 2019, and I’d been walking and exercising regularly. Because of these improvements, the surgery was done in a same-day surgery center. I showed up at 9:30 a.m. and walked out with a new joint six hours later.

I started outpatient physical therapy two days after surgery, and it continued three days a week for five weeks. I also did the recommended exercises several times a day at home.

My therapist Kevin was great, offering a mix of compassion, experience and pushiness. The knee responded well. At the seven-week checkup with the surgeon, he was very pleased with the results. I was cleared to bike, swim and hit the gym. There’s still some minor swelling and pain, especially after exercising. I think my knees are good for another 50,000 miles.

A significant difference between my two knee replacement surgeries is the cost. In 2019, we had a high-deductible health plan, with a $3,000 deductible and a $6,500 maximum out-of-pocket limit, so a big part of the cost fell on my shoulders. I’m now on traditional Medicare with a Part B supplemental policy. The bills are still trickling in. I expect to pay the $226 Part B deductible and I might have some small doctor visit copays. But I think that should be about it.

My mom had a total knee replacement about 20 years ago. At that time, the conventional wisdom was a new joint would last about 10 years. Because of that time limit, she delayed the surgery for as long as possible and suffered several years of significant pain. That’s no longer necessary. Both of my replacement knees are Triathlon by Stryker. The titanium joint has an expected life of 25 years, although each patient’s outcome will depend on individual factors.

Based on my two positive knee replacement experiences, here are 10 suggestions:

• Avoid the need for surgery if possible. This seems obvious, but our younger selves seldom think ahead. Try to maintain a healthy weight, exercise regularly, maintain flexibility and avoid traumatic activities.
• If you’re having a joint replacement, consider “prehabing.” Lose weight if needed, keep walking and work on your flexibility. I could have worked more on my hamstring flexibility.
• Think about your shoes. My wife bought me a pair of hands-free step-in shoes. They were a great help after the surgery, and made it easier to be mobile.
• Find a great surgical team. You want to have confidence in your surgeon.
• Find a great physical therapist, and begin PT as soon as you can.
• After surgery, manage your pain but watch your pain medication intake. Ice is your friend. Reuseable ice packs are great. Get several so you always have one at the ready.
• Expect sleep to be an issue. This is under-discussed by medical personnel. After my first replacement, my wife bought a box of instant ice packs from Amazon. We kept a few on the bedside and they were a big help at night. If I woke up in pain, I could grab one without waking her. It also reduced the need for pain medication.
• After the surgery, walk as much as possible, increasing distance and duration.
• Don’t be surprised if you hit a wall a few weeks after surgery. Pain and swelling are challenging and can persist for several months. My physical therapist helped prepare me for this. Recovery wasn’t a straight line, especially as I increased my activity. Connecting with friends and family helped me through this stretch.
• It’s easy to worry and limit your activity. Listen to your doctor and physical therapist, and get back to living your life.

Richard Connor is a semi-retired aerospace engineer with a keen interest in finance. He enjoys a wide variety of other interests, including chasing grandkids, space, sports, travel, winemaking and reading. Follow Rick on Twitter @RConnor609 and check out his earlier articles.

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