Patient Resources

The typical complications of any surgical procedure include bleeding, infection, anesthesia-related complications and blood clots. Significant bleeding during a primary joint replacement is extremely rare. In more complex, revision surgery bleeding to the point of requiring transfusion is unusual.

Any surgical wound can become infected. Fortunately, infection rates are extremely low, particularly in healthy, well-nourished individuals. The risk of infection is minimized by the absence of morbid obesity, smoking, alcoholism or uncontrolled diabetes.

A fracture can occur during an orthopedic procedure or in the postoperative period, although this is unusual. Modern-day hip and knee replacements should typically last for at least 25-30 years; they may loosen over time, but this is uncommon.

Blood clots (DVTs) may form in the leg veins following hip or knee replacement. Patients' blood is routinely thinned using one of a number of agents for 10-14 days post-surgery. Patients are rapidly mobilized and walking within a few hours of surgery. This rapid mobilization as well as the use of compression stockings and venous compression devices have dramatically reduced the incidence of blood clot. Pulmonary embolism is a rare but serious complication of DVT.

Modern-day hip replacements are almost universally made of titanium and titanium alloys for both the stem and the socket. The bearing materials are generally vitamin E soaked, cross-linked polyethylene as well as zirconium reinforced ceramic. This combination of materials will function typically without deterioration for 25-30 years or more.

Total knee replacements are typically made of titanium, cobalt chrome and vitamin E soaked cross-linked polyethylene.

A straightforward hip or knee replacement takes somewhere between 30 and 45 minutes for the surgical procedure.

Most patients will receive a regional anesthetic. The majority of patients will also receive intravenous sedation that promotes a twilight type of relaxation, making them unaware of the procedure in process.

Typically, hip replacement surgery is minimally painful, and many patients don't require narcotics for their postsurgical pain. Knee replacement patients are pain-free for 24-36 hours post-surgery, after which pain will begin to increase. This pain is minimized by using a multi-drug regimen to prevent pain at multiple levels.

Hip and knee replacement patients planning to be discharged later that same day will receive a short acting anesthetic and frequent physical therapy. By 4:00 pm or 5:00 pm, they have typically been up, walking safely and comfortably, and able to negotiate stairs independently and are discharged at 4:00 pm or 5:00 pm. If, for any reason, a patient is insecure or unable to leave the hospital confidently, they are welcome to stay for the night.

Patients who do not desire or are not candidates for a same-day procedure will spend 1 or 2 days in hospital for a hip replacement; 1 to 3 days for a knee replacement. Patients undergoing bilateral (double) knee replacements or revision hip or revision knee replacement will generally stay 3 days in hospital.

Making plans for when you leave the hospital is a very important part of your recovery. Your healthcare team will work with you, your physician, and your family to help develop a comprehensive discharge plan. In this way, you, with your family, can make arrangements for leaving the hospital prior to your surgery. Dr. Hartzband requires that all patients have someone with them for the first three days.

Discharge planners at the hospital will send a physical therapist to your home 3-5 days a week for the first two weeks, as well as a visiting nurse. Patients are seen for their first follow-up visit two weeks after their procedure at the Hartzband Center. At this time, the patient will be referred for outpatient physical therapy if necessary.

Hip and knee replacement patients are typically walking within a few hours of the procedure's conclusion.

Most people are able to resume driving between 2- and 6-weeks post-surgery. It is important that you regain muscle control and have a clear head before you consider driving.

The vast majority of joint replacements performed today should last 25-30 years or more. As bearing surface materials have evolved, they have become much less subject to early failure and much more tolerant of intense physical activity.