Sir John Charnely invented the first successful hip replacement in 1960, and for this contribution he became a knight! The first modern knee replacement was performed in 1968. Total hip replacement and knee replacement have become the most successful procedures invented by man. Patients whose pain is not controlled with exercise, weight loss, or anti-inflammatories can now undergo hip or knee replacement and reasonably expect relief of their pain and the ability to return to sports such as tennis, golf, and bicycling. Modern total hip and knee replacements are expected to last nearly 20 years, and most patients are living the rest of their lives without having the replacements wear out or fail.
Patients frequently ask me when they should consider joint replacement surgery, and the answer if fairly simple. You should have it done if you are healthy enough to undergo the surgery, and if it causes you pain or limits your ability to exercise. Until recently, all total hip and knee replacements required a several day stay in the hospital. However, we have now learned that there is a substantial risk to staying in a hospital. Hospital acquired infections and hospital medical errors can and do occur, and result in thousands upon thousands of lives lost each year. Not only do patients who have to stay in hospitals frequently find it difficult to sleep since they are not in their own bed, but, nurses and technicians are frequently waking them up to draw blood or check them in some way. Our body is a sitting duck for the dangerous resistant bacterias (such as MRSA) that hospitals harbor. Lastly, many patients find that hospital food doesn’t facilitate a good appetite to help speed their recovery.
Over the last few years, a few surgeons such as myself have begun to perform total hip and knee replacements and send the patients home the same day. This has now become possible though several advances including the use of a new medication tranexamic acid which limits bleeding. Less bleeding means greater safety less pain and less complications. Another advance is called Exparel, which is a new local anesthetic that can help control surgical pain for up to four days! Lastly, we have learned that patients recuperate faster when they start walking sooner, so patients who have surgery as an outpatient are assisted out of bed within the first couple hours and can start their recovery sooner.
In summary, many patients who need hip and knee replacement can now have their surgery and safely go home the same day!
Adam Bright MD
Past President, Florida Orthopedic Society
Assistant Professor, Florida Sate College of Medicine
Board Examiner, American Board of Orthopedic Surgery
private practice, 19 years, Sarasota, Florida
Schofield, Hand, and Bright Orthopedics, PLLC