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Announcer: With a relentless focus on excellence in healthcare, Pullman Regional Hospital presents The Health Podcast.

Deborah Howell: So the old joints aren't what they used to be. Well, a lot of us can relate to that. So what's to be done about it? To talk about total joint replacement and what you need to know, today we'd like to welcome our newest orthopedic surgeon at Pullman Regional, Dr. Mathew Taylor. Welcome, Dr. Taylor.

Mathew Taylor: Thank you very much. Thanks for having me.

Deborah Howell: Lovely to have you with us. We all want to welcome you warmly to the Palouse. What do you want your patients to know about you and your approach to orthopedics?

Mathew Taylor: Well, I love orthopedic surgery. It's a passion of mine. It's something that gets me excited in the morning and excited to get up and go to work. And I'm excited to be here in the Palouse. This is where my wife's family is from, and so this is a second home for me. And we've been looking for a little while for a chance to get back here and we're able to come and excited to be here.

Deborah Howell: It's funny that they call these the flyover states, right? Because they're really some of our most beautiful ones.

Mathew Taylor: You said that. That's exactly right.

Deborah Howell: So you really enjoy doing total joint replacement surgeries. What exactly is a total joint replacement?

Mathew Taylor: Well, a total joint replacement is where we take the joint that exists and we replace both sides of the joint with metal and plastic to get rid of the damaged cartilage so that it no longer provides that pain, prevents the swelling from occurring that keeps people from living their life and doing what they want to do.

Deborah Howell: Now you said plastic. Some people listening might think, "Yeah, my kid's toys are made with plastic. How strong can that be?

Mathew Taylor: Exactly right. Well, the plastic has come a long way. In fact, in the way of innovation in the total joint, the plastic is what has really evolved over the last 20 years. They've made what's called highly cross polyethylene. And what it does is it allows that plastic to be extremely strong and doesn't wear over time. You know, total joints, 20, 30, 40 years ago, they were using an older plastic, which had some wear and with time of 20 years or so, but that plastic would wear out. The plastic that we're using nowadays wears out at less than 10% of what it used to, so we're hoping that this will last a lot longer.

Deborah Howell: Wonderful. What excites you particularly about total joint replacement surgery?

Mathew Taylor: Oh, I love seeing patients get back to their life. Joint pain can be so debilitating. It can really prevent people from doing the things they want to do, especially in these golden years where they've worked their entire life to save up, you know, their time and their money, that they can do the things they want to do and to see them not be able to do that because of pain is so heartbreaking. And I love when they're able to get back to their life and able to do those things that they had planned on.

Deborah Howell: And what's the normal course of recovery? How long does it take to get back to normal activities?

Mathew Taylor: Well, every joint is a little bit different. You know, we do total joint replacements on shoulders, on hips, on knees, and everyone's a little bit different. But in general, I would say that most people by about two months are about 75% better. By about three months, they are 90% better, doing almost all the things they wanted to do, but they continue to improve for up to a year after surgery. And I would say around that year mark is where people are back to where they want to be. But, you know, at that three-month mark, they are 90% of what they are going to be. And they're doing very well, very happy, but there's still some improvement for up to a year.

Deborah Howell: Now this is with PT?

Mathew Taylor: Yes. Typically, we do get patients into physical therapy after surgery, help get their range of motion back, help with strengthening exercises. And that being said, most of this is done at home, but that therapy really helps guide them along through the process, helps them make sure that what they're seeing is normal and allows them to feel confident in their recovery.

Deborah Howell: How important is it for a patient to actually do the PT?

Mathew Taylor: It's very important. If we don't put in the time and effort to get the range of motion back, well, then you lose range of motion and that can really debilitate and prevent the excellent things that we wanted to achieve. And so the therapy really is important. Now that being said, some of it can be done at home. It's not like we want you to in therapy for a year or anything like that. We do the therapy until you're progressing and able to do it on your own. And then it's, you know, activities of everyday, walking, getting up, doing those things are the therapy for the future.

Deborah Howell: Right, right. But there is a certain window where you can get most range of motion back in most cases. But if that window closes, it becomes a lot tougher, right?

Mathew Taylor: That's exactly correct. If we're not seeing good range of motion by about that three-month mark, well, then every now and then we do have to help them along with extra stretching or sometimes we even have to take people back to the operating room. Now, that's very rare. That doesn't happen very often. However, it can happen.

Deborah Howell: What's the goal of total joint replacement surgery?

Mathew Taylor: Well, the first goal is to decrease pain or eliminate pain rather. The end of a joint as it wears down and arthritis sets in is just so painful. It causes swelling and that swelling causes even more pain, and it's a vicious cycle. The goal of the total joint is to eliminate that stimulus for the pain and the swelling. And as those go away, that is our first goal, is to get rid of the pain.

The second goal is to get them back to their function for, you know, a total knee who maybe is not able to fully straighten their knee because of bone spurs or osteophytes, then the goal is to get that all the way straight again so that they can have a normal gait and normal walking.

Deborah Howell: Over the course of her life, my mom had three total knee replacements. It's not like that anymore though, is it?

Mathew Taylor: Typically not. These joint replacements are getting better. The technology is better. We're using navigation. We're using computers to help make sure that everything is dialed in to that perfect amount that we can. And as we do that, and we talked about the plastic piece, the advances that we've made there, we're hopeful that these total joints will last even longer and longer.

The data that we have right now is about 20-year data, which shows excellent survivorship of all of these joints. However, we need more time to show exactly how long those can go because the studies just aren't long enough at this point.

Deborah Howell: Right, right. And I know we touched on this, but I just like to hit it again because it's so important to people. People often worry about the recovery time after total joint replacement surgery. So what do you tell your patients to ease their minds?

Mathew Taylor: Well, I tell them that it's a process and that anything that's worth going through or worth having does take some getting there. And I think that the process in and of itself, if you ask someone who's had a total knee done or a total hip done, and they say, "Well, would you go through it again?" Almost all of them say, "Yes, I would go through it again. And I probably would've done it sooner." And so I encourage those people to go talk to their friends, talk to their neighbors who have had total joints done and see what their recovery was like and see what they would recommend. Like I said, most of them will say, "My only complaint is I wish I would have done it sooner."

Deborah Howell: Right. Exactly. What excites you the most about working on the Palouse?

Mathew Taylor: Well, this is where my family is, and these are the friends and neighbors that I have come to love and know, and I enjoy taking care of people and helping them feel better and get back to the things they want to do. I love this area. I love the rolling hills, the sunsets, the beautiful surroundings, and I love to be out in nature. And I love to take this type of people, it's my favorite. They just know how to work hard. They appreciate things in life and it makes a big difference.

Deborah Howell: Absolutely. I'm from the Midwest as well. And I totally get that. And the work ethic and just the neighborliness, you can't find that in other places.

Mathew Taylor: Exactly.

Deborah Howell: Anything else you'd like to add to our conversation today?

Mathew Taylor: Oh yeah. I think that if you've been thinking about a total joint, you've been thinking about, "Is it right for me?" I think you should come in and talk about it. We're never going to push surgery on anybody. We're never going to say you have to have a total knee or a total hip or total shoulder done, but having that conversation, we're happy to answer any questions, help you know exactly what it would look like, what the recovery would look like, and specifics about any other questions that they would have, and there's no harm in having a conversation. No one's going to push it into anything. But if you're thinking about it and wondering what it would be like, come on in and let's talk about some options.

Deborah Howell: That's right. Information is power. Well, Dr. Taylor, we so appreciate your time and everything you do to help our wonderful patients. Thanks so much for being with us today.

Mathew Taylor: Thank you for having me.

Deborah Howell: And you can learn more about this subject, providers and services at Pullman Regional Hospital online at pullmanregional.org/orthopediccenterofexcellence.

This has been The Health Podcast from Pullman Regional. I'm your host, Deborah Howell. Thanks for listening and have yourself a terrific day.