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Am I a Good Candidate for a Hip or Knee Replacement?
If you have hip or knee pain, you may wonder if a joint replacement would provide relief. Did you know that not everyone is a good candidate for this surgery? What makes someone a good candidate and what are alternative treatments? In this podcast, Dr. Sumon Nandi, a hip and knee surgeon with the University of Maryland Medical System, talks about hip and knee replacements, how they help, and who is a good candidate to have one.
Featured Speaker:
Sumon Nandi, MD, MBA, FAOA
Sumon Nandi, MD, MBA, FAOA, is an Associate Professor and Chief of Adult Reconstruction in the Department of Orthopaedics at the University of Maryland School of Medicine, and is a Hip and Knee Surgeon at University of Maryland Medical System. Dr. Nandi is a board-certified, fellowship-trained hip and knee replacement specialist who is committed to providing compassionate care of only the highest quality. Dr. Nandi believes in patient-focused care, where time with patients and bedside manner is as important as exceptional surgical results. He completed his residency and fellowship training at medical institutions nationally recognized for excellence in orthopaedic surgery. Dr. Nandi is an active clinician-educator and researcher with more than 200 publications and presentations at regional, national, and international conferences. He has a special interest in rapid recovery hip and knee replacement surgery. Dr. Nandi brings his expertise, as well as years of experience, to each joint replacement surgery. Transcription:
Am I a Good Candidate for a Hip or Knee Replacement?
Prakash Chandran: Welcome to Live Greater, a Health and Wellness podcast brought to you by the University of Maryland Medical System. We put knowledge and care within reach so you have everything you need to live your life to the fullest. Today we'll be discussing who a good candidate is for hip or knee replacement. I'm Prakash Chandran and my guest today is Dr. Sumon Nandi, an associate professor and chief of adult reconstruction in the Department of Orthopedics at the University of Maryland School of Medicine and Hip and knee Surgeon at University of Maryland Medical System. Dr. Nandi, thank you so much for joining us today. I truly appreciate your time. I wanted to get started by asking what exactly are the conditions that cause the need for a hip or knee replacement?
Dr Sumon Nandi: Well, first and foremost, it's a pleasure for me to have the opportunity to speak to you and your audience, so hip and knee replacements are performed for arthritis of the hip and knee. So there are lots of conditions that can cause hip or knee pain, right? So a broken bone can cause hip or knee pain. Ligaments that are injured or torn can cause hip or knee pain, but you can also get arthritis in the hip or knee just like you can get in any other joint. So arthritis is a process. It's not a thing, it's a process by which the cushion in the joint wears away, and then the bones grind against one another, and that causes pain. And hip as well as knee replacements are performed for arthritis.
Prakash Chandran: I understand. Okay. And so whether it be that hip or knee replacement, are you actually replacing it with like a prosthetic or synthetic hip or knee? Can you talk a little bit about what exactly a hip or knee replacement is?
Dr Sumon Nandi: Yes, absolutely. So that's exactly what is done in a hip or knee replacement. So let's take a step back first before we actually get to the surgical procedure. So, how do we know that someone's ready for a hip or knee replacement if they do have arthritis? Well, first and foremost, you gotta have pretty severe arthritis. All right? So again, arthritis is a process, not a thing processed by which the cushion and the joint wears away, and then the bones grind against one another causing pain. Now all the cushion, at least in some parts of the joint, has to be gone for a patient to be a candidate for a hip and knee replacement. So that's the first and foremost criteria.
Second, you gotta try everything short of surgery. And what do I mean by that? Well, there are lots of things to try before you proceed to a hip or knee replacement. So if you got hip or knee pain for arthritis, you can try anti-inflammatory medications like naproxin or ibuprofen. All right. You can try physical therapy to strengthen the muscles around your joints. So those muscles can function like shock absorber when your natural shock absorber isn't working so well. You can try not doing the things that bother you, but there's only so much of that that you can do, right? Because you wanna do the things that you enjoy. You can, if it really gets severe, try a cane or a crutch, although I haven't met a patient yet who really wants resort to that.
Some of the things you can try are braces, particularly for the knee as well as injections, such as cortisone injections that are basically supercharged anti-inflammatories that can be directly injected into the joint and provide some relief. So, You got a patient who has really severe arthritis, you got someone who has tried everything short of surgery. What else do you need in order to be a good candidate for a hip and knee replacement? Well, that patient has to say, you know what, doc, I've tried everything and I just can't live like this anymore. And if that patient has all three of those factors, all three of those criteria, then they are an outstanding candidate for a hip and knee replacement.
And, getting back to your original question, which was what do you exactly do in a hip and knee replacement? Well, what you do is you resurface the ends of the bones, right? The ends of the bones when you get arthritis are really beat up. They're grinding against one. Causing pain they can even cause feelings of grinding because that's exactly what's going on in the joint. And you resurface the ends of those bones and you cap them with, at least in the case of the knee, with metal at the end of the thigh bone, metal at the end of the shin bone and a piece of plastic in between. And in the case of a hip which is a ball and socket joint.
You remove the arthritic ball of the ball and socket joint. You resurface the socket with a metal socket and a plastic liner and then put a stem down the thighbone and a ball on top. And that gives patients nice, smooth surfaces that glide against one another, and that takes away their pain. So that's what's involved in a hip or knee replacement.
Prakash Chandran: You talked about three major factors that kind of make someone a good candidate for a hip or knee replacement. Those being, you have to have. Severe arthritis, all that cushion needs to be gone. The second is they've gotta try everything else short of surgery. And the third is that it's affecting their quality of life. They do not like to live with that pain anymore. Are there any other factors that make someone a good candidate for this type of replacement?
Dr Sumon Nandi: So, those are really the three. Now there are some other criteria that come into play. Now for knee replacements, it's been shown that patients who are younger than 50 don't do as well as patients who are older than 50. All right. Who have had more than 50 birthdays. And what do I mean by that? What do I mean don't do as well? Well, if you're younger than 50, it's been shown that the prosthesis doesn't last as long as if you're older than 50. So we prefer to do knee replacements in patients who are at least 50 years of age or older. As far as hip replacements go, now there's no such data. So there are some conditions that affect the hip that cause patients as young as 20, alright, who are in their early to mid twenties to have complete destruction of their hip joint.
And those patients are perfectly acceptable candidates to have a hip replacement. And those patients do very, very well. Their pain is gone and they're able to go back to their lives. Now, there are some other considerations as well. So for example, if someone, Significant medical problems, for example, diabetes, that's not so well controlled, then it'd be important to get that patient very good care prior to surgery with regard to their diabetes. So their diabetes is well controlled, so their risks after the surgery are minimized. If someone is smoking, for example, then you know, it's been shown in all the data that we have and we've got a lot of data because a million people a year, if you can believe that a million people a year in the US alone get joint replacement.
So we've got just so much freedom on how to get patients to do well. With a million people a year getting joint replacements, of course with any surgical procedure, but particularly when a million people a year are getting joint replacements, everyone needs to do well. So the data that we have shows that if you're smoking, it really compromises the blood flows. So, nicotine constricts those blood vessels and blood can't get to the operative site to heal it up. And then as a result, patients don't heal as well. So we have folks quit smoking prior to surgery. All right, to optimize their outcomes after the surgery. So those are some other considerations that come into play before someone schedules or proceeds with a hip and knee replacement.
Now that being said, you don't have to be perfectly healthy to have a hip and knee replacement. I've replaced patients joints who have had heart transplants and kidney transplants. Certainly, of course, patients who diabetes, who have been able to with the assistance of their primary care physician get their diabetes under control. Which is not only important for the surgery, but for their general wellbeing. I've operated on patients with heart problems and valve replacements and who have had bypass surgery. So you certainly don't need to be perfectly healthy to have a hip replacement or a knee replacement, but we do have data that shows there are some things that we can do to really maximize the likelihood that you're gonna fly through the surgery and just do beautifully afterwards, which is what we all want.
Prakash Chandran: So I do want to get to the surgery itself, especially the recovery time. Before that, I kind of wanted to touch upon the signs and symptoms that someone might experience that tell them that hip or knee replacement might be beneficial. Can you speak to those?
Dr Sumon Nandi: Yeah, absolutely. So first and foremost is pain, right? So if your hip or knee hurts, right? And actually let's talk about that in some greater detail because it's not even as simple as that. So, as far as the knee goes, it is simple. You know, if your knee is the source of your troubles and you, you've got some arthritis in that knee, you're gonna feel it in the area of your knee. But what about the hip? If you've got hip arthritis, where do folks feel pain coming from their hips? Well, they actually feel it in their groin where the thigh meets the body in the front, alright?
They feel it in the side of their hip and they can feel it in their rear ends. Now, what's actually even more interesting than that is if you've got hip problems, you can actually feel pain in your knee. Every now and again, I see patients who come to my office who have horrible hip arthritis, who don't have pain in their hip. They actually feel pain in their knees. So that's why whenever patients come to my office complaining about knee pain, I always examine the hip and I always actually get x-rays of the hip, as unusual as that may seem. Patients who have knee. of their troubles could actually be their hip, so I'm careful to examine and ask about both.
Prakash Chandran: Makes a lot of sense. I am curious about that third piece around or sorry, the second piece that you mentioned in terms of trying things short of surgery. So if they are experiencing some of that pain, whether it be exclusively in the hip or the knee, You talked about anti-inflammatories for, getting some relief. Is there anything else that you recommend that people do for relief if they have hip or knee pain?
Dr Sumon Nandi: Yeah. So that's really important, so first of all, Since we touched on anti-inflammatories like ibuprofen, naproxen. I wanna make sure the audience doesn't just go out and start popping pills. Talk to your primary care doctor before you start taking these medications, because any medication can have side effects. And certainly if you have ulcers, kidney problems, heart problems, take any blood thinners, then do not take anti-inflammatory medications and also be sure to check with your primary care before you start taking anti-inflammatory medications because they know your medical history the best. So in addition to anti-inflammatory medications, what are the other things that can be tried prior to surgery?
And we're always very careful to always make sure we try everything short of surgery. So if you walk into my office, you're not gonna be drag kicking and screaming in into the operating room just because you tell me you have hip or knee pain. Right? I always make sure that we always try everything short of surgery, and those things include braces for the knee. Physical therapy to strengthen the muscles around the joints so that those muscles function like a shock absorber, when your natural shock absorber isn't working so well. Perhaps changing some of the activities that you're participating in that really exacerbate your symptoms, although, that's typically why patients start asking about surgery because they say, you know what?
I don't wanna give up the things that I enjoy doing. And also, there are various injections to try. Most commonly cortisone injections and cortisone is different than oral anti-inflammatory medications different than ibuprofen and naproxen, but it's a supercharged anti-inflammatory that. Decrease the inflammation that's going on in the joint from the bones grinding against one another and can provide some symptomatic relief. So, to also answer your prior question. In addition to pain, you can feel grinding. You can actually feel the bones grinding against one another in your joints, in your hip or your knee. If you have bad arthritis, you can feel clicking, you can have swelling. These are all the symptoms that you can have, and those are the things that you can try to alleviate them short of surgery.
Prakash Chandran: Let's talk about the surgery itself. Can you talk a little bit about, how long it takes and what the recovery time is like?
Dr Sumon Nandi: Yeah, absolutely. That's really an important question for our audience because patients wanna know, if I'm gonna undergo this surgery, what does the subsequent hours and subsequent weeks look like after undergoing a procedure like this? So, hip knee replacement recovery starts out pretty similar, so everyone gets up and walks the same day after surgery. That's actually been shown to improve the speed and quality of patient's recovery after surgery. And again, that goes back to all that data that we talked about. With over a million people a year getting joint replacements. In the US alone, we've got a lot of data. So we try to benefit from what we've learned over the years.
So one, we get everyone up and walking the same day. Two, for medically suitable patients, those patients go home the same day. And why is that? It is certainly not because the insurance companies are telling us to do that or because we're running outta room in the hospital or we're getting tired of spending time with you. Certainly not any one of those. It's because, again, the data tells us that if you go home the same day, and you're medically suitable, you do better. There are lower risks with going home the same day as opposed to staying in thehospital. Lower risks, lower risks of having any problems in the weeks and months following the surgery.
Now, what happens after you go home? Well, that's when the experience diverges. Between hip replacements and knee replacements. So hip replacements are pretty easy to recover from. Really just walk around and six weeks later you're outta pain and you're walking pretty normally. So pretty easy to recover from knee replacements now require a bit more work on the part of the patients, so you really gotta work on some exercises, primarily directed. Maintaining and achieving a certain desired level of range of motion of the knee because a happy knee is one that defense. So about six weeks after surgery, you're really working on achieving and maintaining desired range of motion of the knee.
So that takes a bit of work after surgery, but what hip and knee replacements have in common is once you're done healing, you're pain free and you can go about your desired activities. What do I mean by desired activities? So, certainly walking unlimited distances, swimming unlimited distances. Climbing gentle trails, skiing down gentle slopes, not moguls, of course, going to the gym and using the elliptical for unlimited distances. The step machine, doubles tennis. The only thing we tell folks to avoid is repetitive high impact activities, because that theoretically can decrease the longevity of the prosthesis. And what we want is to operate on you and have you be good forever.
Prakash Chandran: Now I think that's the perfect place to start wrapping up. We have covered a lot around what makes a good hip or knee replacement candidate, what they can expect during surgery and afterwards. Is there any. Anything else that you wanted to share for our listeners, and especially maybe focus on those that maybe don't meet the criteria that you mentioned, but kind of want to turn things around. Any final parting words for those people and beyond?
Dr Sumon Nandi: Yeah, absolutely. That's a very important point, so what I would say is if you have hip or knee pain, come see us at the University of Maryland Faculty Practice. We will listen to you. And what you have been experiencing, we will examine you very carefully and thoroughly. We'll look at your imaging, your x-rays and your MRIs, and we'll come up with a comprehensive treatment plan for you and we'll answer all your questions. And what's particularly important is if you don't need surgery, that is what we will tell you. We will tell you. You are not gonna benefit from surgery and or you don't need surgery. We're not gonna, just because you walk into our office, drag you kicking and screaming and, and screaming into the operating room.
So now if you do need surgery, of course we'll take outstanding care of you. We take care of the most complex cases in the region, so that informs our practice of more routine problems like arthritis. So that by taking care of the most complex cases, we're very well equipped to take outstanding care of you if you have a more routine issue like hip or knee arthritis. And we'd be happy to do so. For patients, a again, to answer your question, who perhaps may not need surgery. There are a whole host of interventions that we can institute to make you feel better and for patients who do need surgery, but maybe need some medical optimization. We've got a multidisciplinary team available who can help get you ready for surgery so that we can once and for all take care of your problem and get you feeling better.
Prakash Chandran: Dr. Nandi, thank you so much for your time today. I truly appreciate
Dr Sumon Nandi: Thank you so much to both you and your listeners.
That was Dr. Sumon Nandi, an associate professor and chief of adult reconstruction in the Department of Orthopedics at the University of Maryland School of Medicine and Hip and Knee Surgeon at University of Maryland Medical System. Find more shows just like this one at umms.org/podcast. Thank you for listening to Live Greater a Health and Wellness podcast, brought to you by the University of Maryland Medical System. We look forward to you joining us again.
Am I a Good Candidate for a Hip or Knee Replacement?
Prakash Chandran: Welcome to Live Greater, a Health and Wellness podcast brought to you by the University of Maryland Medical System. We put knowledge and care within reach so you have everything you need to live your life to the fullest. Today we'll be discussing who a good candidate is for hip or knee replacement. I'm Prakash Chandran and my guest today is Dr. Sumon Nandi, an associate professor and chief of adult reconstruction in the Department of Orthopedics at the University of Maryland School of Medicine and Hip and knee Surgeon at University of Maryland Medical System. Dr. Nandi, thank you so much for joining us today. I truly appreciate your time. I wanted to get started by asking what exactly are the conditions that cause the need for a hip or knee replacement?
Dr Sumon Nandi: Well, first and foremost, it's a pleasure for me to have the opportunity to speak to you and your audience, so hip and knee replacements are performed for arthritis of the hip and knee. So there are lots of conditions that can cause hip or knee pain, right? So a broken bone can cause hip or knee pain. Ligaments that are injured or torn can cause hip or knee pain, but you can also get arthritis in the hip or knee just like you can get in any other joint. So arthritis is a process. It's not a thing, it's a process by which the cushion in the joint wears away, and then the bones grind against one another, and that causes pain. And hip as well as knee replacements are performed for arthritis.
Prakash Chandran: I understand. Okay. And so whether it be that hip or knee replacement, are you actually replacing it with like a prosthetic or synthetic hip or knee? Can you talk a little bit about what exactly a hip or knee replacement is?
Dr Sumon Nandi: Yes, absolutely. So that's exactly what is done in a hip or knee replacement. So let's take a step back first before we actually get to the surgical procedure. So, how do we know that someone's ready for a hip or knee replacement if they do have arthritis? Well, first and foremost, you gotta have pretty severe arthritis. All right? So again, arthritis is a process, not a thing processed by which the cushion and the joint wears away, and then the bones grind against one another causing pain. Now all the cushion, at least in some parts of the joint, has to be gone for a patient to be a candidate for a hip and knee replacement. So that's the first and foremost criteria.
Second, you gotta try everything short of surgery. And what do I mean by that? Well, there are lots of things to try before you proceed to a hip or knee replacement. So if you got hip or knee pain for arthritis, you can try anti-inflammatory medications like naproxin or ibuprofen. All right. You can try physical therapy to strengthen the muscles around your joints. So those muscles can function like shock absorber when your natural shock absorber isn't working so well. You can try not doing the things that bother you, but there's only so much of that that you can do, right? Because you wanna do the things that you enjoy. You can, if it really gets severe, try a cane or a crutch, although I haven't met a patient yet who really wants resort to that.
Some of the things you can try are braces, particularly for the knee as well as injections, such as cortisone injections that are basically supercharged anti-inflammatories that can be directly injected into the joint and provide some relief. So, You got a patient who has really severe arthritis, you got someone who has tried everything short of surgery. What else do you need in order to be a good candidate for a hip and knee replacement? Well, that patient has to say, you know what, doc, I've tried everything and I just can't live like this anymore. And if that patient has all three of those factors, all three of those criteria, then they are an outstanding candidate for a hip and knee replacement.
And, getting back to your original question, which was what do you exactly do in a hip and knee replacement? Well, what you do is you resurface the ends of the bones, right? The ends of the bones when you get arthritis are really beat up. They're grinding against one. Causing pain they can even cause feelings of grinding because that's exactly what's going on in the joint. And you resurface the ends of those bones and you cap them with, at least in the case of the knee, with metal at the end of the thigh bone, metal at the end of the shin bone and a piece of plastic in between. And in the case of a hip which is a ball and socket joint.
You remove the arthritic ball of the ball and socket joint. You resurface the socket with a metal socket and a plastic liner and then put a stem down the thighbone and a ball on top. And that gives patients nice, smooth surfaces that glide against one another, and that takes away their pain. So that's what's involved in a hip or knee replacement.
Prakash Chandran: You talked about three major factors that kind of make someone a good candidate for a hip or knee replacement. Those being, you have to have. Severe arthritis, all that cushion needs to be gone. The second is they've gotta try everything else short of surgery. And the third is that it's affecting their quality of life. They do not like to live with that pain anymore. Are there any other factors that make someone a good candidate for this type of replacement?
Dr Sumon Nandi: So, those are really the three. Now there are some other criteria that come into play. Now for knee replacements, it's been shown that patients who are younger than 50 don't do as well as patients who are older than 50. All right. Who have had more than 50 birthdays. And what do I mean by that? What do I mean don't do as well? Well, if you're younger than 50, it's been shown that the prosthesis doesn't last as long as if you're older than 50. So we prefer to do knee replacements in patients who are at least 50 years of age or older. As far as hip replacements go, now there's no such data. So there are some conditions that affect the hip that cause patients as young as 20, alright, who are in their early to mid twenties to have complete destruction of their hip joint.
And those patients are perfectly acceptable candidates to have a hip replacement. And those patients do very, very well. Their pain is gone and they're able to go back to their lives. Now, there are some other considerations as well. So for example, if someone, Significant medical problems, for example, diabetes, that's not so well controlled, then it'd be important to get that patient very good care prior to surgery with regard to their diabetes. So their diabetes is well controlled, so their risks after the surgery are minimized. If someone is smoking, for example, then you know, it's been shown in all the data that we have and we've got a lot of data because a million people a year, if you can believe that a million people a year in the US alone get joint replacement.
So we've got just so much freedom on how to get patients to do well. With a million people a year getting joint replacements, of course with any surgical procedure, but particularly when a million people a year are getting joint replacements, everyone needs to do well. So the data that we have shows that if you're smoking, it really compromises the blood flows. So, nicotine constricts those blood vessels and blood can't get to the operative site to heal it up. And then as a result, patients don't heal as well. So we have folks quit smoking prior to surgery. All right, to optimize their outcomes after the surgery. So those are some other considerations that come into play before someone schedules or proceeds with a hip and knee replacement.
Now that being said, you don't have to be perfectly healthy to have a hip and knee replacement. I've replaced patients joints who have had heart transplants and kidney transplants. Certainly, of course, patients who diabetes, who have been able to with the assistance of their primary care physician get their diabetes under control. Which is not only important for the surgery, but for their general wellbeing. I've operated on patients with heart problems and valve replacements and who have had bypass surgery. So you certainly don't need to be perfectly healthy to have a hip replacement or a knee replacement, but we do have data that shows there are some things that we can do to really maximize the likelihood that you're gonna fly through the surgery and just do beautifully afterwards, which is what we all want.
Prakash Chandran: So I do want to get to the surgery itself, especially the recovery time. Before that, I kind of wanted to touch upon the signs and symptoms that someone might experience that tell them that hip or knee replacement might be beneficial. Can you speak to those?
Dr Sumon Nandi: Yeah, absolutely. So first and foremost is pain, right? So if your hip or knee hurts, right? And actually let's talk about that in some greater detail because it's not even as simple as that. So, as far as the knee goes, it is simple. You know, if your knee is the source of your troubles and you, you've got some arthritis in that knee, you're gonna feel it in the area of your knee. But what about the hip? If you've got hip arthritis, where do folks feel pain coming from their hips? Well, they actually feel it in their groin where the thigh meets the body in the front, alright?
They feel it in the side of their hip and they can feel it in their rear ends. Now, what's actually even more interesting than that is if you've got hip problems, you can actually feel pain in your knee. Every now and again, I see patients who come to my office who have horrible hip arthritis, who don't have pain in their hip. They actually feel pain in their knees. So that's why whenever patients come to my office complaining about knee pain, I always examine the hip and I always actually get x-rays of the hip, as unusual as that may seem. Patients who have knee. of their troubles could actually be their hip, so I'm careful to examine and ask about both.
Prakash Chandran: Makes a lot of sense. I am curious about that third piece around or sorry, the second piece that you mentioned in terms of trying things short of surgery. So if they are experiencing some of that pain, whether it be exclusively in the hip or the knee, You talked about anti-inflammatories for, getting some relief. Is there anything else that you recommend that people do for relief if they have hip or knee pain?
Dr Sumon Nandi: Yeah. So that's really important, so first of all, Since we touched on anti-inflammatories like ibuprofen, naproxen. I wanna make sure the audience doesn't just go out and start popping pills. Talk to your primary care doctor before you start taking these medications, because any medication can have side effects. And certainly if you have ulcers, kidney problems, heart problems, take any blood thinners, then do not take anti-inflammatory medications and also be sure to check with your primary care before you start taking anti-inflammatory medications because they know your medical history the best. So in addition to anti-inflammatory medications, what are the other things that can be tried prior to surgery?
And we're always very careful to always make sure we try everything short of surgery. So if you walk into my office, you're not gonna be drag kicking and screaming in into the operating room just because you tell me you have hip or knee pain. Right? I always make sure that we always try everything short of surgery, and those things include braces for the knee. Physical therapy to strengthen the muscles around the joints so that those muscles function like a shock absorber, when your natural shock absorber isn't working so well. Perhaps changing some of the activities that you're participating in that really exacerbate your symptoms, although, that's typically why patients start asking about surgery because they say, you know what?
I don't wanna give up the things that I enjoy doing. And also, there are various injections to try. Most commonly cortisone injections and cortisone is different than oral anti-inflammatory medications different than ibuprofen and naproxen, but it's a supercharged anti-inflammatory that. Decrease the inflammation that's going on in the joint from the bones grinding against one another and can provide some symptomatic relief. So, to also answer your prior question. In addition to pain, you can feel grinding. You can actually feel the bones grinding against one another in your joints, in your hip or your knee. If you have bad arthritis, you can feel clicking, you can have swelling. These are all the symptoms that you can have, and those are the things that you can try to alleviate them short of surgery.
Prakash Chandran: Let's talk about the surgery itself. Can you talk a little bit about, how long it takes and what the recovery time is like?
Dr Sumon Nandi: Yeah, absolutely. That's really an important question for our audience because patients wanna know, if I'm gonna undergo this surgery, what does the subsequent hours and subsequent weeks look like after undergoing a procedure like this? So, hip knee replacement recovery starts out pretty similar, so everyone gets up and walks the same day after surgery. That's actually been shown to improve the speed and quality of patient's recovery after surgery. And again, that goes back to all that data that we talked about. With over a million people a year getting joint replacements. In the US alone, we've got a lot of data. So we try to benefit from what we've learned over the years.
So one, we get everyone up and walking the same day. Two, for medically suitable patients, those patients go home the same day. And why is that? It is certainly not because the insurance companies are telling us to do that or because we're running outta room in the hospital or we're getting tired of spending time with you. Certainly not any one of those. It's because, again, the data tells us that if you go home the same day, and you're medically suitable, you do better. There are lower risks with going home the same day as opposed to staying in thehospital. Lower risks, lower risks of having any problems in the weeks and months following the surgery.
Now, what happens after you go home? Well, that's when the experience diverges. Between hip replacements and knee replacements. So hip replacements are pretty easy to recover from. Really just walk around and six weeks later you're outta pain and you're walking pretty normally. So pretty easy to recover from knee replacements now require a bit more work on the part of the patients, so you really gotta work on some exercises, primarily directed. Maintaining and achieving a certain desired level of range of motion of the knee because a happy knee is one that defense. So about six weeks after surgery, you're really working on achieving and maintaining desired range of motion of the knee.
So that takes a bit of work after surgery, but what hip and knee replacements have in common is once you're done healing, you're pain free and you can go about your desired activities. What do I mean by desired activities? So, certainly walking unlimited distances, swimming unlimited distances. Climbing gentle trails, skiing down gentle slopes, not moguls, of course, going to the gym and using the elliptical for unlimited distances. The step machine, doubles tennis. The only thing we tell folks to avoid is repetitive high impact activities, because that theoretically can decrease the longevity of the prosthesis. And what we want is to operate on you and have you be good forever.
Prakash Chandran: Now I think that's the perfect place to start wrapping up. We have covered a lot around what makes a good hip or knee replacement candidate, what they can expect during surgery and afterwards. Is there any. Anything else that you wanted to share for our listeners, and especially maybe focus on those that maybe don't meet the criteria that you mentioned, but kind of want to turn things around. Any final parting words for those people and beyond?
Dr Sumon Nandi: Yeah, absolutely. That's a very important point, so what I would say is if you have hip or knee pain, come see us at the University of Maryland Faculty Practice. We will listen to you. And what you have been experiencing, we will examine you very carefully and thoroughly. We'll look at your imaging, your x-rays and your MRIs, and we'll come up with a comprehensive treatment plan for you and we'll answer all your questions. And what's particularly important is if you don't need surgery, that is what we will tell you. We will tell you. You are not gonna benefit from surgery and or you don't need surgery. We're not gonna, just because you walk into our office, drag you kicking and screaming and, and screaming into the operating room.
So now if you do need surgery, of course we'll take outstanding care of you. We take care of the most complex cases in the region, so that informs our practice of more routine problems like arthritis. So that by taking care of the most complex cases, we're very well equipped to take outstanding care of you if you have a more routine issue like hip or knee arthritis. And we'd be happy to do so. For patients, a again, to answer your question, who perhaps may not need surgery. There are a whole host of interventions that we can institute to make you feel better and for patients who do need surgery, but maybe need some medical optimization. We've got a multidisciplinary team available who can help get you ready for surgery so that we can once and for all take care of your problem and get you feeling better.
Prakash Chandran: Dr. Nandi, thank you so much for your time today. I truly appreciate
Dr Sumon Nandi: Thank you so much to both you and your listeners.
That was Dr. Sumon Nandi, an associate professor and chief of adult reconstruction in the Department of Orthopedics at the University of Maryland School of Medicine and Hip and Knee Surgeon at University of Maryland Medical System. Find more shows just like this one at umms.org/podcast. Thank you for listening to Live Greater a Health and Wellness podcast, brought to you by the University of Maryland Medical System. We look forward to you joining us again.