Second Time Around

Cars and machines needs parts replacement are needed over their lifetime. The same is true of our bodies. Since we live longer lives, items we might have had put in along the way, like fillings in our teeth, or joint replacements in our knee, wear over time and may need to be replaced. Dr. Xie is here to tell us about what it's like to get that joint replaced a second time.
Second Time Around
Featured Speaker:
Ke Xie, M.D
Dr. Ke Xie is a board-certified, fellowship-trained orthopaedic surgeon who specializes in total joint replacement of the knee and hip. 


Learrn more about Ke Xie, M.D
Transcription:
Second Time Around

Caitlin Whyte: Cars and machines need replacements over their lifetimes, and the same is true for our bodies. Since we live longer lives, items we might have put in along the way, like fillings in our teeth or joint replacements in our knee wear over time and may need to be replaced. Dr. Xie is here to tell us about what it's like to get that joint replaced a second time.

Dr. Ke Xie is an orthopedic surgeon, joint replacement and revision surgery specialist at the Centers for Advanced Orthopedics Orthopedic Associates of Central Maryland Division, in practice for over 50 years.

Hello. I'm Caitlin Whyte, and I've got a bone to fix with you. Doctor, what kind of wear and tear can happen to a replacement over time?

Ke Xie, M.D.: So a knee replacement can wear out after years of use. It is different timeframe for each person, and it depends on a person's weight, activity level, injuries as well as how well you take care of the knee replacement. I mean, in general, we say that a knee replacement can last anywhere between 15 to 25 years and sometimes even longer than that. But normal wear and tear in the knee replacement is where the plastic in the knee replacement starts to wear out. And when it does, you can have symptoms of swelling, instability, and sometimes pain. When that happens, then we talk about potentially revision knee replacement or redo knee replacement, but that's the type of wear and tear that happens over time.

Caitlin Whyte: And Is there an average life span to a replacement part?

Ke Xie, M.D.: So the average lifespan is somewhere in that 15 to 25-year range. Some knees in some people can last a lot shorter than that. And in some situations, it can last a lot longer. If someone is in very good shape, is not overweight, does not perform any high impact exercises and takes care of the knee, that knee replacement can last 25 or 30 years. But if someone is younger, overweight, a little more active or has a very demanding job, then that knee replacement sometimes only lasts 10 years. But on average, I would say it's about 15 to 25 years for most people.

Caitlin Whyte: So how can we tell when it might be time to replace our joint replacements?

Ke Xie, M.D.: Sometimes it is actually difficult to tell from the patient's perspective. What I tell my patients is that if we had done a knee replacement 15 years ago and they had done well, it's actually time to have closer followup with your surgeon on your knee replacement, and sometimes that's every year or every two years. The initial symptoms of wearing out of a knee replacement is typically some swelling and maybe some feelings of instability where the knee would give way. It usually doesn't involve a whole lot of pain. Therefore, people typically don't come to us with pain and sometimes they just watch it or live with it. But sometimes that's not a good option because we can tell sometimes whether the knee is worn out on the x-ray that we take before the patients even feels the symptoms. And the earlier that we find this out, the more treatment options there are and the less invasive options are to the patients.

Caitlin Whyte: Is this common?

Ke Xie, M.D.: It is not extremely common, but it does happen at a pretty good rate, just because of the sheer number of knee replacements that are performed nowadays. You can have a redo of a knee replacement for a couple of reasons. One is that it just wears out over time. The other one is an early failure where you have had a knee replacement very recently, like in the last year, year, last two years, last three years. And those modes of failure would include infection, loosening, instability, and those aren't expected reasons to replace a knee, but they do happen to anywhere between 1% to 3% of the people who have had a knee replacement.

Caitlin Whyte: And wrapping up here, is there anything we can do to increase the lifespan of these parts?

Ke Xie, M.D.: Yes. I would say that the most important thing is weight. If you are in the overweight or obese or morbidly obese range, losing the weight will significantly increase the lifespan of the knee replacement. The second thing is to avoid any high impact exercises. The knee replacement was not designed for running or for jumping, so sports such as basketball, volleyball, soccer aren't great exercise to do. If you keep your exercises to walking, swimming, cycling, doubles tennis, golf, and lower impact exercises, that would also lengthen the time of a knee replacement.

Caitlin Whyte: Well, thank you so much for joining us today. That was Dr. Ke Xie, an orthopedic surgeon, joint replacement and revision surgery specialist at the Centers for Advanced Orthopedics Orthopedic Associates of Central Maryland Division. Find out more about us online at mdbonedocs.com. And please remember to subscribe and share this podcast. That's all for today. I'm Caitlin Whyte, and that was a bone that's fixed.