Have medications and physical therapy done little to relieve your joint pain? Are you hoping to find a way to get back to the things you love without having to worry about pain? Total joint replacement might be the next step, but it’s a step you shouldn’t take without asking some important questions first.

Ravi Bashyal, MD, Orthopaedic Surgeon, specializing in minimally invasive hip and knee replacement surgery at NorthShore's Orthopaedic and Spine Institute, answers questions on total joint replacement surgery, from what makes someone a good candidate to recovery, rehabilitation and beyond: 

Who is a good candidate for joint replacement surgery?
Total joint replacement surgery is an excellent option for patients who have "worn out" their hip or knee joint, found little relief from conservative management options such as injections or medications, and who feel that their worn-out joint is significantly impacting their ability to enjoy their daily activities and life.

Are there minimally invasive options for total joint replacement?
Yes. There are many new techniques and implants that allow total joint replacements to be done now in a much less-invasive fashion than in the past.  These innovations can allow for shorter surgical times, lower complication rates and faster recovery. Talk to your surgeon about his/her personal approach, and how you might fit into this as an individual patient.

What should a total joint replacement patient do prior to surgery?
There are numerous steps one should complete prior to a joint replacement surgery:

First and foremost, meet with an orthopaedic surgeon to make sure you are a good candidate for this type of surgery. He or she can talk to you about possible risks, recovery times and patient outcomes. Also, make an appointment with your medical doctor and any other specialists (i.e. cardiologist) to make sure you are medically cleared to safely proceed with surgery.

Attend a class regarding joint replacement at the NorthShore Total Joint Replacement Center. This is an excellent opportunity to participate in a program focused on hip and knee replacement. You'll have a chance to meet with nurses, physical therapists, social workers, and other team members that will explain the ins and outs of what to expect before, during and after your surgery and during your hospital stay.

Make a pre-operative appointment with your surgeon and his/her team. This will give you a chance to review what you have learned during the pre-operative process, discuss any questions/concerns that may have come up, and to feel comfortable and confident going into your surgery.

What can a patient do to help to ensure the best possible outcome?
Become a partner in your care. The Total Joint Replacement Center at NorthShore is there to guide patients from beginning to end, from pre-op to rehabilitation. Patients are encouraged to communicate with their surgeon but also with our highly trained orthopaedic nurses and staff throughout the process. We feel that it’s important for our patients to have a thorough understanding of what to expect before, during and after surgery.

How long should you expect to be in the hospital after a total joint replacement?
Most of our hip-replacement and knee-replacement patients are ready to be discharged 2-3 days after their operation. Some patients are even ready to go home the same day or the day after. Many of our patients go directly home after surgery with in-home nursing and therapy arranged by our social work team, while others elect to go to an inpatient rehab center prior to going home. Ask your surgeon what to expect, and discuss with him/her what would work best for your individual situation and preference.

Wait, go home the same day?
The team at NorthShore Orthopeadic and Spine Institute continue to work toward improving patients experience with minimally invasive, outpatient surgery (same-day discharge) for those candidates who qualify. The outpatient surgery for hip and knee replacement surgery is shown to limit the use of opioids, decreased pain during recovery and rapid recovery with excellent long-term results.

While recovery time varies case by case, what timeframe for recovery should a patient of total joint replacement expect?
Recovery is different for everyone. With our use of minimally invasive techniques and advanced post-operative care, many patients are recovering at a much quicker pace than 10 or 15 years ago. We have many patients back to work and activities within a few weeks. Of course, this is subject to individual recovery times, and the specific activities that each patient will return to after surgery. A discussion with your surgeon about your recovery is an important part of the pre-operative process.

What about long-term? How long should someone expect an implant to last?
Innovations in joint replacement technology have dramatically increased the longevity of many types of implants. Many currently available implants can survive for 20 or more years, and even if these devices "wear out," currently technology allows us to replace only the worn-out part without having to re-do the entire operation or replace all the parts.