What Makes for a Good Joint Replacement Candidate? | One Healthy Boston

Joint Health

What Makes for a Good Joint Replacement Candidate?

When a person’s joints break down, usually the hip, knee or shoulder, they develop disabling pain which leads to stiffness, lack of mobility, and a lower quality of life. Joint replacement is a surgical treatment that is very successful at restoring motion, limiting pain, and ultimately restoring quality of life.

Exhaust Non-Surgical Options First

Before considering joint replacement, it’s important to explore conservative measures of treatment and pain management. For most people, that includes:

  • Over-the-counter medications like Tylenol or Advil.
  • It’s been proven that strengthening the quadricep, or thigh muscles, can greatly aid in pain relief.
  • A cane or a walking stick.
  • Losing weight to take extra pressure off joints.
  • Cortisone injections to temporarily reduce pain and inflammation in the affected joint.

When all these things fail, that’s a sign that you may want to consider a joint replacement.

Evaluate Mental and Physical Readiness

The decision to undergo a joint replacement surgery is really an individual one, and it usually comes about when someone’s immobility and pain disables them from being able to carry out daily activities.

Objectively, a doctor will base readiness on findings in an x-ray and a physical exam. But ultimately, the choice for joint replacement is made when a person is ready for it. And that can vary greatly between people.

Knowing that joint replacement surgery is an elective procedure makes it tough to determine when exactly is the best time. To give a more structured guideline, there are usually three qualifying criteria that I look for in a patient:

  1. The patient shows objective signs of disease and arthritis. That means an x-ray will show a deteriorating joint, bone spurs, disease, etc.
  2. There’s a record of joint problems in physical exams and patient history. Maybe they can no longer do their laundry, or they’ve stopped walking the dog, or they’ve started taking medication for depression because they can’t live their normal lives without pain. There’s also the physical exam where the patient displays pain and stiffness from moving a joint.
  3. The patient needs to want it. Sometimes a person will be limping, but they still don’t want the surgery. So there has to actually be a desire for joint replacement. People are very different, and the point at which one person says they’re ready to undergo surgery might not be the same point as another person. A patient wanting, and being ready for, joint replacement is a key part of the process.

Managing Expectations

Expectations are huge in joint replacement. It’s a fantastic procedure that’s 95% effective for the right candidate. But it’s not a miracle. And by that I mean that it can restore function, but it can’t restore performance. This surgery isn’t about trying to get a better golf score, it’s about minimizing pain and allowing patients to perform day-to-day activities. When someone can’t move, walk, or sleep, that has a profound adverse effect on their life, and that’s the type of person who’s ready for a joint replacement because they feel so debilitated.

Ultimately, you know your body best, and only you can determine how much pain you can tolerate. If you’ve tried non-surgical treatments without any relief, it may be time to consider a joint replacement. As a first step, talk with an orthopedic nurse or doctor. They will be able to answer your questions and help you better understand the process so you can make an informed decision.

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