FREE NEWSLETTER
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:
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.
Want to receive our weekly newsletter? Sign up now. How about our daily alert about the site's latest posts? Join the list.
New technology may make the actual operation of joint replacement much easier. Comments?
https://www.monogramorthopedics.com/
As a long career inpatient Physical Therapist, you gave excellent suggestions. Anyone at home wanting to make an ice pack: 3 parts water to 1 part rubbing alcohol in a gallon ziploc bag. PLEASE start pre-surgery rehab, it truly will help. If a pre-op surgery class is offered, take it! Those patients do much better because they are educated and prepared for the process after surgery.
Lot of good points here. I had a knee replacement at age 64 when it was bone on bone. Fortunately I was not overweight and had exercised regularly. I had 4 previous surgeries on the knee since tearing the ACL and cartilage way back in college. Started PT immediately but 3 months later needed to have the knee manipulated by the surgeon. There was too much scar tissue from all the surgeries, and he was able to break it up. A year later I started martial arts training (Krav Maga) and the knee is not a problem at all. It is definitely worth doing, even if recovery takes more time than planned.
As I have commented before I retired from 30 years practicing as an outpatient orthopedic physical therapist. I also am a proud recipient of hip replacements at 47 and 49, and nearing the 20 year mark. Some tips from my experience:
1) Recovery from hip replacement is much easier than knees
2) Most patients should not undergo replacement of both knees at the same time unless you lean towards the fitness fanatic side as the majority of most non-athletically inclined will not tend to put in the necessary time for each knee with poorer outcomes than if each were performed separately
3) Pain control is all about limiting inflammation and swelling. Swelling increases your pain and decreases your range of motion (more so for knees) and inhibits muscle contraction
4) As such the best approach is to use ice in doubled up in gallon freezer bags) rather than other more “convenient” means. Note: If it doesn’t feel cold it isn’t doing any good.
5) Anti inflammatory medications when allowed by MD along with ice can significantly reduce the need for addictive narcotics
6) Do Your Exercises!
Being diligent with your rehabilitation program will allow you to return to doing almost all activities of daily living and athletic activities, running excepted!
This is a really good list. I’ve had both a knee and a hip replacement. Recovery from hip replacement (for me) was much quicker than from knee replacement. In both cases, I’m pain-free and my mobility has been restored. When recovering from knee replacement, I recommend something like the DonJoy Iceman for continuously circulating cold water in a wrap you place around your knee.
One thing I would add to this list is to make sure your PT understands both your prior activity level and hoped-for recovery goals. Create a plan to accomplish those goals. My primary goal was to maintain fitness, both on my mountain bike and at the YMCA. I recently had my hip (1 year) and knee (3 year) checkup. All X-rays look good, and I took a 21-mile mountain bike ride two days ago.
Thanks Jeff. Glad you are doing so well. I was lucky that the PT for both of my knee replacements asked my goals and worked with me.
Rick, I really appreciate your article. A good friend of mine is a couple weeks removed from a knee replacement, and I was happy to be able to share your encouragement and tips.
Thanks Matt. Best of luck to your friend.
Both my father-in-law (a couple of years ago) and my wife (four months ago) had hip replacement surgery. The improvement in their quality of life has been nothing short of remarkable. The new method of hip replacement is much less intrusive than it used to be. My wife’s surgeon put her on a blood thinner after surgery to reduce the risk of clots.
Folks I know who have had hip replacement have done very well. Many have not needed PT. Thanks for reading.
I had a complete shoulder replacement almost 3 years ago. Full recovery took about one year. I have about 90% ROM and strength back, but pain free, which is the most important part. Fortunately I had it done in Palm Springs, Ca where they do LOTS of joint replacements. Thank you Medicare Plan G so I could pick my surgeon! Physical therapy was very helpful in my rehab by providing a road map to recovery, making sure I was doing the very specific exercises correctly and keeping me accountable. Before my surgery I had read that complete shoulder replacement outcomes can be tricky because it’s a very complex joint with lots of moving parts. I wanted to pick my surgeon and hospital carefully. I can now play pickleball for hours and get my weight training in at the gym.
That’s great to hear Mike. I have several family and friends who have had shoulder surgery and it can be a hard recovery. Glad to hear you’re back in action.
Rick, excellent article, and my wife and I read it with interest as she may be on the knee replacement track before long.
And 110 lbs. lighter?! That is a terrific accomplishment—hearty congratulations!
Thanks Andrew. Best wishes to your wife.
Rick, I always enjoy your writing and so glad to hear you are on the mend and thriving!
Thanks John!
Congratulations on the good outcomes, and also on the significant weight loss! (Maybe another article on that?) Friends who have had joint replacement have said that (aside from a good surgeon) the PT is key to a good recovery.
Thanks for the kind words.
Please discuss blood clot risk, mitigation strategy, and warning signs with your orthopedist. Unfortunately, a close family member, who was otherwise healthy pre-op with no history of clots, experienced this complication a few months after her first knee replacement. It was a significant setback as clots migrated from leg to lungs (pulmonary embolism). fortunately she slowly recovered, was happy with how her knee felt after completing rehab, and did proceed later with the 2nd knee which was uncomplicated.
My wife reminded me that I was on baby aspirin for a month after surgery to prevent clots, and they/she had me moving early and often to keep the blood moving. I’m sorry to hear bout your family member, but glad she recovered.
Critical point. I would add that a small percentage of people have a genetic blood defect named Factor V Leiden (FVL) that causes their blood to clot quicker than typical. One of the causes of such clotting onset is major surgery. I do not know if routine medical diagnostic tests are now done to reveal the genetic defect prior to surgery. Those with this DNA defect may pass FVL through to their children.
The Mayo Clinic was a leader in developing the testing over 20 years ago regarding FVL and you can read about it here – https://www.mayoclinic.org/diseases-conditions/factor-v-leiden/symptoms-causes/syc-20372423
Good read Rick, glad you’re walking the boardwalk again..of course nurse Vicky I’m sure has contributed to your quick recovery as well..
Thanks Mark. My favorite nurse has been tough yet loving!
Rick, my wife had her first knee replacement surgery just over two weeks ago. Interestingly, she is not going to physical therapy. They gave her a list of exercises to do 4x per day. The surgeon said it will be clear at her two-week check-up, based on her range of motion, if she has been doing them. If she has not been doing them, he would assign PT. We just got back from her two-week check-up. Everything is fine. Continue the exercises. No PT.
Larry, thanks for reading. My wife has worked in the industry for years and has observed many different approaches to rehab, based on the surgeons experience. I found PT helpful – it forced me out of the house and the therapist was able to push me further than I likely would have done myself. It sounds like your wife is doing great on her own – I wish her a speedy and successful recovery.
Rick, excellent article. Your ten suggestions are very insightful and accurate. I’m very happy to hear you are having a good outcome from your surgery.
Thanks Edmund, and thanks for the service you provide your patients. PT can really help a patient get their life back.