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Total Joint Replacement
Severe damage due to injury or arthritis may not be eased by non-surgical treatments and that is when a total joint replacement surgery may become an option. Dr. Wasik Ashraf discusses this option and if it may be right for you.
Featured Speaker:
Wasik Ashraf, DO
After graduating summa cum laude with a degree in biology from the New York Institute of Technology in Old Westbury, New York, Dr. Ashraf went on to receive his medical degree from the New York College of Osteopathic Medicine, also in Old Westbury. He then trained in Orthopaedic Surgery at North Shore University Hospital in Plainview, New York, and recently completed a sports medicine fellowship at the Hughston Foundation in Columbus, Georgia. Before becoming a surgeon, Dr. Ashraf was a licensed emergency medical technician who worked as a volunteer and participated in community education programs. Dr. Ashraf has a passion for sports medicine and research. He has provided team coverage for the Roslyn, Manhasset, and Hewlett, New York high school football teams, and during his Hughston Sports Medicine Fellowship at the Hughston Foundation took care of team coverage for the Columbus Cottonmouth professional hockey team. Dr. Ashraf is currently board eligible in orthopaedic surgery and is a member of the American Orthopaedic Society of Sports Medicine (AOSSM) and the American Osteopathic Academy of Orthopaedics (AOAO) as well as Arthroscopy Association of North America (AANA). He is also the Medical Director of Sports Medicine for MSLC. Transcription:
Total Joint Replacement
Caitlin Whyte: Severe damage due to injury or arthritis may not be eased by non-surgical treatments. That is when a total joint replacement may become an option. To talk to us about this surgery, we are joined by Dr. Wasik Ashraf, an orthopedic surgeon at the SLCH Center for Total Joint Replacement.
This is Doc Talk, presented by Montefiore St. Luke's Cornwall. I'm your host, Caitlin Whyte. Doctor, begin by telling us just what total joint replacement is and who is a good candidate for it?
Wasik Ashraf, DO: That's a great question. So total joint replacements are surgeries we do for shoulders, knees, hips, and even ankles. And my specialty is hip, knees and shoulders where we remove the bad cartilage and replace it with metal and plastic.
And as far as the patient selection for a joint replacement, it truly is multifactorial. The biggest factor is quality of life. If joint pain is causing a patient not to be able to enjoy their life and do the things they want to do and the way they want to do it, and they have failed conservative management such as injections and therapy, and x-ray show they have enough joint deterioration to warrant a joint replacement, they would be the perfect candidate for a joint replacement.
Caitlin Whyte: Now, what are some of the most common total joint replacements that you see?
Wasik Ashraf, DO: Overall, total knee replacement is definitely the most common type of a joint replacement in the lower extremity, followed by total hip replacement and third being a total shoulder replacement, which is definitely gaining momentum as technology has been advancing with the reverse shoulder replacement.
Caitlin Whyte: Now, let's talk recovery time. I know we're talking about a wide range of joints here, but what does that look like afterwards? And when do you start to see the effects of having a total joint replacement?
Wasik Ashraf, DO: Each joint is slightly different. For a knee replacement, which I would say is probably the hardest joint to recover from, there are two types of total knee replacements. One is a total knee replacement, where we'd remove all three parts of the knee and replace it with metal and plastic. And then there's a partial knee replacement where you only target the affected part of the knee and replace that with metal and plastic. I will say that a partial knee replacement is definitely an easier recovery because it's not as invasive and not as much recovery compared to a total. But for a total knee replacement, the first three to four weeks are just difficult because there's pain, there's swelling. And then between all of that, we're going to ask along with the physical therapists to move that joint and do the therapy required to have a successful outcome.
Overall, I think it's always better to underpromise and overdeliver. So I tell all my patients that the first six weeks, we'll take you to be about 50% improved. By four to five months, to be about 70%, 80% improved. And it will take a full year to fully recover the muscle strength, stamina, and balance that we all lose from chronic osteoarthritis. But one thing I always point out is things will never be like it was in your 20s, but it'll be better than what you have to deal with now with that knee.
Caitlin Whyte: And then how long does a total joint replacement last? I'm sure it's not forever.
Wasik Ashraf, DO: Oh, a great question. So, you know, with technological advancements, such as minimally invasive surgery that we offer here at St. Luke's along with improved material from the vendors and metal, we are seeing increased survivability of the implant itself. The other factor that I will throw in there is patient selection. You know, patients that have a higher body weight index or higher comorbidities, they just don't last as long. So if you have the perfect patient with the new technology that we have all for now with, you know, faster recovery, really this can last anywhere between 18 to 20 years is what I quote with my patients.
Caitlin Whyte: Now, of course, major surgery is happening here. So is there anything that we can do to avoid having a total replacement if we have arthritis or another injury that could lead up to it?
Wasik Ashraf, DO: Absolutely. You know, again, multiple factors to this. There's a huge genetic factor that I think and many times gets overlooked. You know, if you have your aunt, your grandma, your mom who are suffering from arthritis, you could start at an early age, in your late 20s, early 30s to start taking joint supplementation, which is chondroitin sulfate, glucosamine sulfate, fish oil, turmeric, which is a good antioxidant. Number two is patient factors such as weight and strengthening and keeping that joint mobile. So there are joint-preserving exercises, such as elliptical, biking, swimming, and maintaining a healthy weight, I think is key. Things such as squatting, lunges, running with a history of arthritis in the family is just not a great idea past a certain age. So mobility, staying active, eating right and supplementing, I think they're all good preventative measures for osteoarthritis
Caitlin Whyte: And wrapping up here, doctor, I'd love to hear about your team here at Montefiore. Can you tell us a bit more about what you do?
Wasik Ashraf, DO: Yes. We are an orthopedic hospital where we have a total joint specific floor where all we do are total knees, hips, and shoulders. We have a team of therapists, social worker, case manager, nursing staff, who all work together to really make sure all your questions are answered before surgery. Your needs are met as far as therapy required. Help at home required are taken care of before surgery, so after surgery, all you have to worry about is just recovering.
Technologically, we have robotic joint replacement. We have minimally invasive joint replacement and cutting edge opioid-sparing surgeons who really can help you recover quicker without using opioids. So this is something we offer here at Newburgh, New York at St. Luke's Hospital. And you don't only have to go to the city to get this type of care.
Caitlin Whyte: Well, thank you so much for joining us today. That was Dr. Wasik Ashraf, an orthopedic surgeon at the SLCH Center for Total Joint Replacement. Visit montefioreslc.org for more information about our orthopedic services.
And if you found this podcast helpful, please share it on your social channels and be sure to check out all the other Doc Talk episodes. This has been Doc Talk, the podcast from Montefiore St. Luke's Cornwall Hospital. I'm Caitlin Whyte. Stay well.
Total Joint Replacement
Caitlin Whyte: Severe damage due to injury or arthritis may not be eased by non-surgical treatments. That is when a total joint replacement may become an option. To talk to us about this surgery, we are joined by Dr. Wasik Ashraf, an orthopedic surgeon at the SLCH Center for Total Joint Replacement.
This is Doc Talk, presented by Montefiore St. Luke's Cornwall. I'm your host, Caitlin Whyte. Doctor, begin by telling us just what total joint replacement is and who is a good candidate for it?
Wasik Ashraf, DO: That's a great question. So total joint replacements are surgeries we do for shoulders, knees, hips, and even ankles. And my specialty is hip, knees and shoulders where we remove the bad cartilage and replace it with metal and plastic.
And as far as the patient selection for a joint replacement, it truly is multifactorial. The biggest factor is quality of life. If joint pain is causing a patient not to be able to enjoy their life and do the things they want to do and the way they want to do it, and they have failed conservative management such as injections and therapy, and x-ray show they have enough joint deterioration to warrant a joint replacement, they would be the perfect candidate for a joint replacement.
Caitlin Whyte: Now, what are some of the most common total joint replacements that you see?
Wasik Ashraf, DO: Overall, total knee replacement is definitely the most common type of a joint replacement in the lower extremity, followed by total hip replacement and third being a total shoulder replacement, which is definitely gaining momentum as technology has been advancing with the reverse shoulder replacement.
Caitlin Whyte: Now, let's talk recovery time. I know we're talking about a wide range of joints here, but what does that look like afterwards? And when do you start to see the effects of having a total joint replacement?
Wasik Ashraf, DO: Each joint is slightly different. For a knee replacement, which I would say is probably the hardest joint to recover from, there are two types of total knee replacements. One is a total knee replacement, where we'd remove all three parts of the knee and replace it with metal and plastic. And then there's a partial knee replacement where you only target the affected part of the knee and replace that with metal and plastic. I will say that a partial knee replacement is definitely an easier recovery because it's not as invasive and not as much recovery compared to a total. But for a total knee replacement, the first three to four weeks are just difficult because there's pain, there's swelling. And then between all of that, we're going to ask along with the physical therapists to move that joint and do the therapy required to have a successful outcome.
Overall, I think it's always better to underpromise and overdeliver. So I tell all my patients that the first six weeks, we'll take you to be about 50% improved. By four to five months, to be about 70%, 80% improved. And it will take a full year to fully recover the muscle strength, stamina, and balance that we all lose from chronic osteoarthritis. But one thing I always point out is things will never be like it was in your 20s, but it'll be better than what you have to deal with now with that knee.
Caitlin Whyte: And then how long does a total joint replacement last? I'm sure it's not forever.
Wasik Ashraf, DO: Oh, a great question. So, you know, with technological advancements, such as minimally invasive surgery that we offer here at St. Luke's along with improved material from the vendors and metal, we are seeing increased survivability of the implant itself. The other factor that I will throw in there is patient selection. You know, patients that have a higher body weight index or higher comorbidities, they just don't last as long. So if you have the perfect patient with the new technology that we have all for now with, you know, faster recovery, really this can last anywhere between 18 to 20 years is what I quote with my patients.
Caitlin Whyte: Now, of course, major surgery is happening here. So is there anything that we can do to avoid having a total replacement if we have arthritis or another injury that could lead up to it?
Wasik Ashraf, DO: Absolutely. You know, again, multiple factors to this. There's a huge genetic factor that I think and many times gets overlooked. You know, if you have your aunt, your grandma, your mom who are suffering from arthritis, you could start at an early age, in your late 20s, early 30s to start taking joint supplementation, which is chondroitin sulfate, glucosamine sulfate, fish oil, turmeric, which is a good antioxidant. Number two is patient factors such as weight and strengthening and keeping that joint mobile. So there are joint-preserving exercises, such as elliptical, biking, swimming, and maintaining a healthy weight, I think is key. Things such as squatting, lunges, running with a history of arthritis in the family is just not a great idea past a certain age. So mobility, staying active, eating right and supplementing, I think they're all good preventative measures for osteoarthritis
Caitlin Whyte: And wrapping up here, doctor, I'd love to hear about your team here at Montefiore. Can you tell us a bit more about what you do?
Wasik Ashraf, DO: Yes. We are an orthopedic hospital where we have a total joint specific floor where all we do are total knees, hips, and shoulders. We have a team of therapists, social worker, case manager, nursing staff, who all work together to really make sure all your questions are answered before surgery. Your needs are met as far as therapy required. Help at home required are taken care of before surgery, so after surgery, all you have to worry about is just recovering.
Technologically, we have robotic joint replacement. We have minimally invasive joint replacement and cutting edge opioid-sparing surgeons who really can help you recover quicker without using opioids. So this is something we offer here at Newburgh, New York at St. Luke's Hospital. And you don't only have to go to the city to get this type of care.
Caitlin Whyte: Well, thank you so much for joining us today. That was Dr. Wasik Ashraf, an orthopedic surgeon at the SLCH Center for Total Joint Replacement. Visit montefioreslc.org for more information about our orthopedic services.
And if you found this podcast helpful, please share it on your social channels and be sure to check out all the other Doc Talk episodes. This has been Doc Talk, the podcast from Montefiore St. Luke's Cornwall Hospital. I'm Caitlin Whyte. Stay well.