Out of Joint: Should You Consider Joint Replacement
Surgery?
by Jonathan P. Garino, MD
Patients ask me the same question almost every
day: Should I have joint replacement surgery?
But that’s not an easy question to answer.
Here’s why: Some people want to avoid surgery
– any kind of surgery – for as long
as possible. These include the folks who postpone
joint replacement surgery even though they are
unable to walk just a few steps because of severe
joint pain. Eventually, even a trip to the corner
market seems insurmountable and they become virtually
housebound.
On the other side of the scale are the people
who have trouble completing 18 holes of golf because
their knees are giving out. They don’t want
to forgo their beloved golf game because it would
cramp their style. To be proactive about their
health, they choose joint replacement surgery
to get them back on course again, literally.
These two cases exemplify the wide spectrum of
patients who are “ready” for joint
replacement surgery. If you are content with your
mobility and joint pain has not overwhelmed your
life, replacement surgery may not be appropriate
for you. There are a number of non-operative treatments
that can prove helpful and may postpone joint
replacement surgery for a period of time.
On the other hand, if joint pain or stiffness
has become unbearable and negatively impacted
your lifestyle, joint replacement surgery may
prove beneficial.
Let me add that age, which was previously a major
consideration regarding joint replacement surgery,
is no longer an issue today. I’ve performed
joint replacement surgery on both ends of the
age spectrum – a knee replacement for a
teenager who suffered trauma in an auto accident
and hip replacement for a very active 100-year-old
woman. Basically, the rule today is that patients
have to be in good general health to undergo joint
replacement surgery, no matter what their age.
So a healthy 90-year-old whose joint pain prohibits
mobility and greatly limits his or her independence
may be a candidate for the procedure.
On the other hand, joint replacement surgery
may not be appropriate for a 60-year-old with
multiple medical conditions such as severe heart
disease and diabetes. Of course, every person
considering joint replacement undergoes a complete
and detailed medical evaluation to determine if
there are any significant health issues that need
to be reviewed or improved prior to surgery in
order to minimize complications and optimize the
rehabilitation process that follows.
So if you are contemplating joint replacement
surgery, consider you lifestyle, your goals and
your overall physical condition.
Think about it and talk it over with your family
and your physician before deciding what works
best for you.
 Jonathan
P. Garino, MD is a board-certified orthopaedic
surgeon and Director of the Joint Reconstruction
Center at the Penn Orthopaedic Institute at Penn Presbyterian Medical Center. He is the author
of several books used by practicing orthopaedic
surgeons throughout the world and was recognized
in Philadelphia Magazine’s 2002 Tops
Docs issue.
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