Why do people have their joints replaced?
Arthritis plays a major role in the creation of hip and knee joint problems. Other factors can include general wear and tear of joints, obesity, age and previous surgery. Inflammation of joints caused by rheumatoid arthritis can also cause extreme discomfort, an awkward range of movement and damaged cartilage.

What happens during consultation?
The surgeon will examine your medical history, family background and discuss what options are available in your circumstances. This will depend on your age, weight and other general health factors.

Getting the most out of your consultancy
Often in cases where clients are unhappy with the results of surgery it is because they did not discuss their expectations thoroughly or were afraid to talk about the outcome or risks.

You have to make an informed decision before signing the consent form so ask plenty of questions. You want to feel relaxed and confident and completely understand what will happen during surgery.

You may want to know:

• About the surgeon’s qualifications.
• How many operations of your procedure are carried out each year.
• How you prepare for the surgery.
• What realistic results can be expected and when.
• How long the results will last.
• About the side-effects and possible complications.
• How long it will take to recover.
• About the extent of scarring and how it will change in time.
• What happens if anything goes wrong.

Preparation for surgery

• Avoid alcohol, aspirin, garlic and food oils a least a week before surgery as they can cause excessive bleeding.
• Do not eat or drink anything six hours before your general anaesthetic.
• The surgeon and anaesthetist need to know your medical history.
• You will be advised of any health checks or X-rays required before your procedure.
• Prior to surgery you will be met by your surgeon who will assess you and discuss your queries.

Knee replacement surgery
The thigh and shin bones converge to meet at the knee cap and are protected by a layer of cartilage which can be damaged by a variety of factors ranging from wear and tear to arthritis. The result is pain and restricted movement.

During knee replacement surgery metal components are added to the ends of the bones and a plastic liner is inserted between them. The knee cap is also lined with plastic. Once all these elements are in place the joint can move normally.

Hip replacement surgery
Two bone areas are connected at the hip, the top of the thigh bone and the socket of the pelvis. The connection is covered with cartilage that enables the bones to move freely. As a result of deterioration caused by arthritis, for example, this cartilage becomes damaged and the unprotected bone ends rub against one other causing pain and limited mobility.

During hip replacement surgery a metal ball is inserted into the end of your thigh bone and a new socket created in your pelvis made from a plastic and metal shell. Combined these two procedures allow you to return to normal activities free from pain.

After surgery

• Your first day is likely to be spent in a recovery room bed being cared for by nursing staff. Your surgeon will visit you and advise you when you can leave.
• Enjoy plenty of rest and avoid any energetic activities.
• If you have had a drainage tube inserted it will be removed within two days. Bandages are normally taken off after one to five days.
• Avoid alcohol, aspirin, garlic, food oils and smoking. All of these can interfere with the body’s healing processes.
• Any discomfort, bruising or swelling should be treated with prescribed medication.

Road to recovery

• It can take several weeks to recover from these major surgeries.
• Your surgeon will tell you when you can return to normal activities.
• Scars may initially appear noticeable. In time they will take on a more normal skin colour but will not disappear completely.
• You must contact your doctor if you suffer from an abnormally high temperature, severe pain that is not treated with medication or if you experience severe bleeding.
• Long-term success rates range from between 10 to 20 years.

All surgery carries an element of risk
Most people believe that the benefits of joint replacement far outweigh the risk. However before you sign the surgery consent form you should be aware of any possible complications and side effects.

Physical complications associated with any type of surgery include problems healing, the danger of infection and the potential formation of clots that may be life-threatening. Excessive bleeding or bleeding under the skin, known as a haematoma, may require a return visit to the surgery. Some patients may also have an allergic reaction to anaesthesia. In a minority of cases there may be a problem with fluid loss or an excessive build up of fluid that needs to be drained.

Other considerations

• There will be scars left by the incisions. Scars fade but do not disappear completely. This depends on your skin type.
• There may be a future risk of future dislocation with a hip replacement.
• Following a considerable period of time the artificial joint may become loose or wear out. This will require further surgery.

Complications are rare and depend on individual circumstances such as a person’s health and the extent of the procedure. Your surgeon will be able to explain how the risks apply in your circumstances.