Frequently Asked Questions

Ever wonder how many hip replacement procedures are performed each year, if hip replacement surgery is permanent or how many men and women suffer from arthritis? Here are some answers to questions about hip and knee replacement surgery.

Arthritis

How many Americans suffer from arthritis?

“Forty-three million Americans report that a doctor told them they have arthritis or other rheumatic conditions. Another 23 million people have chronic joint symptoms but have not been diagnosed with arthritis. Arthritis is the leading cause of disability in the United States, limiting the activities of more than 16 million adults.”

Centers for Disease Control and Prevention (CDC)
http://www.cdc.gov/arthritis/

Does arthritis affect more men or women?

More women suffer from arthritis. According to the Arthritis Foundation, 25.9 million women have doctor-diagnosed arthritis, while 16.8 million men have the condition.

Arthritis Foundation
http://www.arthritis.org/resources/gettingstarted/default.asp


How debilitating is arthritis?

Among Americans over age 15, arthritis is the leading cause of disability in the U.S.

Arthritis Foundation
http://www.arthritis.org/resources/gettingstarted/default.asp

What are the costs associated with arthritis?

“In 1997, the national direct costs (costs due to medical expenditures) were $51.1 billion, and national indirect costs (costs due to lost earnings) were $35.1 billion. These are the most recent U.S. population-based cost estimates for arthritis and were generated from the Medical Expenditure Panel Survey.”

Centers for Disease Control and Prevention (CDC)
http://www.cdc.gov/arthritis/data_statistics/faqs/cost_analysis.htm#1

Is arthritis a disease of the elderly?

“Baby boomers are now at prime risk. More than half those affected are under age 65.”

Arthritis Foundation
http://www.arthritis.org/resources/gettingstarted/default.asp

Background on joint replacement

When did surgeons first start performing joint replacement surgery?

Modern-day joint replacement surgery has been performed in the United States since the 1970s - helping hundreds of thousands of individuals regain their mobility.
American Association of Hip and Knee Surgeons (AAHKS)

How many hip and knee replacements occur each year?

More than 800,000 hip and knee replacement surgeries were performed in 2003 in the United States.

American Academy of Orthopaedic Surgeons (AAOS)

How long is a patient in the hospital for joint replacement surgery?

Hip replacement surgery: An important factor is how well the patient heals after surgery. The length of hospital may range from three to 10 days. Patients who have minimally invasive hip replacement surgery, requiring only several small incisions, may have a shorter hospital stay. Knee replacement surgery: Patients are generally in the hospital for several days.

AAOS
Activities After a Total Hip Replacement
Activities After a Total Knee Replacement

Is joint replacement surgery permanent?

According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), "More than 90 percent of people who have hip replacement surgery will never need revision surgery. However, because more younger people are having hip replacements, and wearing away of the joint surface becomes a problem after 15 to 20 years, revision surgery is becoming more common."

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
http://www.niams.nih.gov/hi/topics/hip/hiprepqa.htm#8

Hip Replacement Surgery

What is hip replacement surgery or hip arthroplasty?

According to the MEDLINEPlus website, "The hip is essentially a ball-and-socket joint, linking the "ball" at the head of the thigh bone (femur) with the cup-shaped "socket" in the pelvic bone. A total hip presthesis is surgically implanted to replace the damaged bone within the hip joint."

MEDLINEPlus Health Information<
http://www.nlm.nih.gov/medlineplus/ency/article/002975.htm

When is hip replacement necessary?

Hip replacement may be needed if a patient has severe pain from an arthritic hip, a tumor in the hip joint or a fracture in the femur.

MEDLINEplus Health Information
http://www.nlm.nih.gov/medlineplus/ency/article/002975.htm

What are the risks and complications of hip replacement surgery?

The most common problem to occur soon after surgery is hip dislocation. The artificial ball and socket are smaller than the body's ball and socket. As a result, the ball may become dislodged from the socket if the hip is placed in various positions. The most common complication to occur later is an inflammatory reaction that triggers cells to eat away some of the bone - causing the implant to loosen. Less common complications include blood clots, infection and abnormal bone growth.

NIAMS
http://www.niams.nih.gov/hi/topics/hip/hiprepqa.htm#8

Knee Replacement Surgery

What Happens During Knee Replacement Surgery?

The surgeon removes damaged knee cartilage and bone during the procedure, which takes about two hours. The surgeon then inserts the new metal and plastic joint surfaces in the knee - improving function and restoring alignment.

AAOS
Total Knee Replacement What are the risks and complications of knee replacement surgery?

Complications may include blood clots in the leg, infection and loosening of the component

AAOS
Total Knee Replacement

Are there non-surgical options to knee replacement surgery?

According to the American Academy of Orthopaedic Surgeons (AAOS), non-surgical treatment options can be divided into four categories, including:

• health and behavior modifications, such as physical therapy and exercise, weight loss and education
• drug therapy, such as pain relievers or COX-2 inhibitors (drugs that interrupt the cycle of inflammation
• intra-articular (within the joint) treatments, such as injections
• alternative therapies such as herbal remedies, acupuncture or magnet therapy What are glucosamine and chondroitin?

They are nutritional supplements that are sold over the counter in health food stores and pharmacies. Some persons with osteoarthritis of the knee take glucosamine and chondroitin sulfate for pain relief.

AAOS
Glucosamine and Chondroitin Sulfate

Benefits and Risks

What are the benefits of joint replacement surgery?

The benefits of joint replacement surgery include pain relief, better use of the joint and increased flexibility, and better alignment of a deformed joint.

Arthritis Foundation
http://www.arthritis.org/conditions/surgerycenter/benefits.asp

Is joint replacement surgery safe?

Although the majority of joint replacement surgeries in the United States are performed without complications, there are some known risks to having this procedure. Patients should discuss the benefits and risks of this operation with their orthopaedic surgeon. Web-based resources on risks and complications can be found on the AAHKS website link below.

AAHKS
Web-based resources for hip and knee replacement patients and their families (PDF)

What are the risks of surgery?

According to the American Academy of Orthopaedic Surgeons (AAOS), joint replacement surgery is successful in more than nine out of 10 people. When complications occur most are successfully treatable. Possible complications include:

• infection
• blood clots
• loosening of the prosthesis
• dislocation
• wear or breakage of the metal or plastic components
• injury

AAOS

Research and Awareness

How has orthopaedic research advanced technology?

Joint replacement research in the 1960s to 1970s led to the development of a functional knee and hip replacement. Throughout the 1970s and 1980s, the emphasis in research shifted from implant design to finding the best materials for the implant. Research today is focused on genetic research, and how bone, cartilage and soft tissues grow and regenerate - allowing surgeons to repair injured or defective parts of the musculoskeletal system (see link below).

AAHKS
New Techniques

What is being done to raise awareness of joint problems?

The World Health Organization initiated a proposal at a 1998 meeting in Sweden for a new program, "The Bone and Joint Decade," to run from 2000 to 2010. The global campaign, which promotes musculoskeletal initiatives in all parts of the world, involves patients, healthcare providers, medical communities and researchers.

The Bone and Joint Decade
http://www.usbjd.org/about/index.cfm

What are the goals of The Bone and Joint Decade?

According to The Bone and Joint Decade, the goals include:

• raising awareness of the growing burden of musculoskeletal disorders on society
• empowering patients to participate in their own care
• promoting cost-effective prevention and treatment
• advancing understanding of musculoskeletal disorders through research to improve prevention and treatment.

The Bone and Joint Decade
http://www.usbjd.org/about/index.cfm

How can I learn more about orthopaedic initiatives?

The Orthopaedic Research and Education Foundation (OREF) is an independent organization that raises funds for research and education on diseases and injuries of bones, joints, muscles and nerves. For more information about OREF and research grants, visit the site below.

Orthopaedic Research and Education Foundation (OREF)
http://www.oref.org/

Resources

How do I find a qualified orthopedic surgeon?

The American Association of Hip and Knee Surgeons (AAHKS) has on its website a Doctor Locator feature, which enables patients to find a local board-certified physician with advanced training in arthroplasty or joint replacement surgery. The American Academy of Orthopaedic Surgeons (AAOS) also has a link on its website to find a local orthopaedist. Click on links below.

Doctor Locator
AAOS Find an Orthopaedist