When is the Right Time for Hip or Knee Replacement

0:00 · Start

Hi,, I'm Dr Chien-Wen Liew from Adelaide, South Australia, from Orthopaedics 360.. I'm a hip and knee replacement surgeon, so today I'd just like to talk to you a little bit about hip and knee arthritis. And when? The right time to come and see someone like me to discuss your needs for a hip or knee replacement?

0:26 · What non operative measures you can try

Now, in general, most of my patients have gone through a series of non-operative measures prior to seeing me. This might include physiotherapy, analgesia, simple lifestyle changes, weight loss and more. And by the time that they have accomplished all of those things and they're no longer finding that, it gives them the relief that they're after. That's the time to see an orthopaedic surgeon.

0:52 · When to see me for your joint replacement

But sometimes you still can enhance things even more now, whilst we have a very large regime of non-operative measures. By the time someone comes to see me, it is usually at a point where things are so uncomfortable that quality of life is impaired. And that is the critical feature whilst we do our scans before the surgery, which may include x-rays, ultrasounds or MRIs, to confirm the diagnosis.

And we examine the joint to feel and ensure that what you're describing and what we're hearing matches exactly. It certainly isn't the case that if you do find that an x-ray shows advised osteoarthritis, you have to have a joint replacement.

1:29 · When is a hip or knee replacement performed

A hip or a knee replacement is performed only when your quality of life is impaired. And that means that things like walking distance, ability to go up and down stairs, ability to negotiate uneven ground, and functional things like reaching shoes and socks, getting in and out of a car and climbing up and down off objects is impaired. If you're finding that your sleep has started to become affected, then that can be something that gives you a lot of trouble. And each and every person has a different set of criteria that will lead them to want to get a hip or knee replacement.

2:05 · Waiting as long as possible for a hip or knee replacement

Whilst it is true that we like to wait as long as possible until you do come in to see me for your hip or knee replacement. There are a few things to add to that. if you are taking a heavy pain medication now, that means that if you're managing your pain with an opiate, analgesia, or an everyday anti-inflammatory. Or something that affects your ability to perform normal daily functions, such as driving, operating heavy machinery, or more complex tasks,

then that is something that I feel affects your quality of life. So we don't want to leave it to the point where you're in a wheelchair, unable to walk until we do your hip or knee replacement. Part of that is so that we can maintain the muscles around the hip and knee. To give you the best possible outcome that we can in the easiest possible way. And that means that you shouldn't wait until the last minute to have your hip or knee replacement. If you're finding that your muscles have already started to deteriorate despite the help from your physiotherapist,

3:07 · How long does a hip or knee replacement last

a hip or knee replacement should last a long time. And for our cohort of patients who have hip or knee replacements over the age of 55, we do find that the rate of revision is very low, somewhere in the vicinity of. One in 10 people at the 20-year mark would have had something happen to their hip or knee replacement, such as a revision operation. This means that 9 out of 10 people, on average, by 20 years, would not have had anything done to their hip or knee replacement during that time.

Which is a good result and is something that is improving every single year that we have access to. The National Joint Replacement Registry, which tracks every single hip or knee replacement performed in Australia and has done so for the last 20 years.

3:53 · How you decide if you need a joint replacement

So when it comes time that your quality of life is impaired, that you're noticing the trajectory of your capabilities decreasing. That you're starting to get affected by, and thinking about your hip or knee every single day, then that's the time that you want to consider making an appointment to see me to discuss a hip or knee replacement. A hip or knee replacement is certainly not something to rush into.

But once you get to that point, you should be excited about the future of having a hip or knee replacement, as it is something that should positively change your quality of life significantly.

I hope that gives you a little bit of insight into how we think as orthopaedic surgeons about whether or not you should have a hip or knee replacement. And give you a little bit of guidance about when to come and see someone like me to discuss your hip and knee replacement requirements. But certainly, there are a series of non-operative measures out there that can certainly help with your hip and knee arthritis.

And that will be in one of the videos attached to this as well. I hope that's helped you a lot. Please like and subscribe our channel and follow us on Facebook if you if you can. Look forward to catching up with you next time on another video. Have a lovely day.

Transcript edited lightly for readability.