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Conservative Treatment Options Before Joint Replacement Surgery

By April 1, 2021 May 26th, 2021 Bones of the Bay

By Katheryne “Kat” Downes, PhD, MPH
Director of Health Research, Outcomes & Evaluation
Florida Orthopaedic Institute

This post is not a substitute or replacement for professional medical advice. If you have any questions about your medical condition or treatment, please seek the advice of your doctor.

Each year, there are roughly 450,000 total hip replacements and 650,000 total knee replacements in the US. With our aging population, it is estimated that by 2030, there will be 635,000 total hip replacements and 1.28 million total knee replacements yearly, and these numbers are expected to continue to rise over the next few decades. 1

In other words, a LOT of people get joint replacements nowadays!

If you have really bad pain in your hips or knees, a joint replacement can really improve your quality of life, but the timing of seeing an orthopedic surgeon and the timing of the surgery itself are important. Why?

Well, if you are starting to have joint pain, it is a good idea to come in to see an orthopedic doctor sooner, rather than later. You will have more choices when your joints have only a little damage and getting treatment early may give you more time before you will need a joint replacement. (Keep reading to learn more about conservative treatment options).

As for the timing of your surgery, there are a couple of different things to think about:

Your age: If you have your hip or knee replaced, your new joint will likely be made of things like metal, plastics, and/or ceramics. Like any other machine parts, your joint can wear down over time and need to be replaced. Studies show that patients should expect their total hip and total knee replacements to last up to 25 years. 2-3

So, if you are 40 when you have your first surgery, you will probably need another one when you are around 65 years old. This does not mean that you should not have surgery if you are only 40 and in a lot of pain, but your age should be part of the decision.

Planning for time off to recover from surgery and getting the help you will need:
Joint replacement is also not a minor surgery. It takes about 6 months to heal from a total knee replacement. But it will often be a year or more before you feel completely “back to normal.” This means that you must plan ahead to make sure you can take time off. You also need to make sure you will have the help you need at home during your early recovery.

Timing surgery to get the most benefit:

Finally, when it comes to joint replacement, patients seem to feel best after surgery when they wait until their joint is really bothering them a lot. This may seem strange, but it makes sense when you think about it: you are more likely to notice a big change if you go from a painful joint to a brand new one!

So, what can you do now if you are not ready for a joint replacement?

If your doctor thinks you are not yet a good candidate for joint replacement (or you are not ready to get one yet), they will talk to you about “conservative treatment options” such as conservative treatment options before joint replacement surgery. These are things that tend to be lower risk and less invasive and can provide some relief for a while.

It is a good idea to try the easiest things first (like exercise, stretching, hot/cold packs) before trying any sort of medication or injections. Here are some of the options your doctor may talk to you about:

* Glucosamine and chondroitin are common over-the-counter (OTC) supplements for osteoarthritis. The scientific evidence has been mixed as to whether these supplements help or not. Some studies show that chondroitin can reduce pain and improve function better than a placebo and that glucosamine can reduce stiffness. Other studies show the opposite: taking these supplements does not help more than taking anything at all. 4-6 As always, talk to your doctor before starting any new medications (including supplements) to make sure it is safe.

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