Joint Replacement: What to Expect Before, During, and After Surgery

Overview

Joint replacement is a safe, common surgical procedure that replaces a damaged, painful joint with a man-made prosthetic implant. It is most often performed on the hip, knee, or shoulder to relieve severe pain and restore mobility when other treatments like physical therapy, medication, or lifestyle changes no longer work. More than 1 million joint replacement surgeries are performed in the United States each year, with high success rates for pain relief and improved quality of life.

Signs & Symptoms That May Lead to Joint Replacement

You may be a candidate for joint replacement if you experience persistent joint symptoms that do not improve with conservative treatments, including: constant pain that interferes with sleep or daily activities, stiffness that makes it hard to walk, dress, or climb stairs, swelling that does not go away with rest or ice, reduced range of motion that limits your ability to move the joint fully, visible deformity of the joint, or pain that does not improve with over-the-counter or prescription pain medication.

Causes & Risk Factors for Joint Damage

• Osteoarthritis: the most common cause, caused by wear and tear on the joint over time
• Rheumatoid arthritis: an autoimmune condition that causes chronic inflammation and damage to the joint lining
• Post-traumatic arthritis: joint damage that develops after a serious injury like a fracture or ligament tear
• Avascular necrosis: loss of blood supply to the bone, leading to bone death and joint collapse
• Congenital joint deformities: abnormal joint development present from birth

Additional risk factors for severe joint damage include age over 50, family history of arthritis or joint disease, previous joint injury, obesity (which puts extra stress on weight-bearing joints like the hips and knees), repetitive joint use from work or sports, and other autoimmune conditions like lupus.

How Joint Damage Is Diagnosed

To diagnose severe joint damage and determine if joint replacement is right for you, your doctor will start with a physical exam to check your joint’s range of motion, swelling, tenderness, and alignment. They will also order imaging tests: X-rays to see the extent of joint damage and bone alignment, and an MRI if soft tissue damage (like torn cartilage or ligaments) is suspected. Blood tests may be ordered to rule out autoimmune conditions like rheumatoid arthritis. Your doctor will also ask how your joint symptoms affect your daily life, work, and ability to do activities you enjoy.

Treatment & Management: The Joint Replacement Procedure

There are two main types of joint replacement surgery: partial joint replacement, where only the damaged portion of the joint is replaced, and total joint replacement, where the entire joint surface is removed and replaced with a prosthetic. The surgery is performed under general anesthesia (you are asleep) or spinal anesthesia (you are awake but numb from the waist down). Your surgeon will remove the damaged bone and cartilage, then attach the prosthetic implant (made of metal, plastic, or ceramic) to the remaining healthy bone using medical cement or a press-fit technique. The surgery typically takes 1 to 2 hours, depending on the joint being replaced.

Recovery After Joint Replacement

Recovery begins immediately after surgery. You will be encouraged to move your new joint the same day or the day after surgery to prevent stiffness and blood clots. Pain is managed with a combination of prescription and over-the-counter pain medication, ice, and elevation of the operated limb. Most people can walk with a walker or crutches within a few days, and return to light daily activities like cooking and dressing in 4 to 6 weeks. Physical therapy is a core part of recovery, starting with gentle range-of-motion exercises, then progressing to strength, balance, and gait training to help you walk safely without assistive devices.

Living Well After Joint Replacement

Most people experience significant pain relief and improved mobility after full recovery from joint replacement. To protect your new joint long-term: maintain a healthy weight to reduce stress on weight-bearing joints, stay active with low-impact exercises like swimming, walking, or cycling to keep the joint strong, attend all scheduled follow-up appointments to monitor the function of your prosthetic, and report any new pain, swelling, or mobility issues to your doctor right away. Many people return to most of their normal daily activities and low-impact hobbies within 3 to 6 months, though your surgeon will advise you on any activities you should avoid long-term.