Joint Replacement FAQ's
- What is total joint replacement?
- Am I a candidate for joint replacement?
- What is anterior approach to hip replacement?
- Am I a candidate for the anterior approach?
- What is a ConforMIS custom knee replacement?
- Is joint replacement surgery safe?
- How long will a replacement joint last?
- What are the major risks of joint replacement surgery?
- Is there an age limit for joint replacement surgery?
- Which tests will I need before joint replacement?
- Should I start or stop any medications?
- What are my options for anesthesia?
- How long will the surgery take?
- Will I be in much pain after surgery?
- How long will I be in the hospital?
- Will I need someone to stay full time with me when I go home?
- Will I need pain medicine after I’m discharged?
- How long will I need to use my walker or crutches?
- When can I go up and down stairs?
- When can I drive?
- When can I return to work?
- How often will I need to see my surgeon?
- When can I resume sports activities?
- When will I be able to engage in sexual activities after surgery?
You do not need a referral to schedule an appointment.
Here is check list for your initial consultation
- Driver’s License or a valid ID
- Insurance information
- Referral Letter (if required)
- Reports, X-rays, MRIs, CT scans etc. and any other relevant information
- List of medications (if any)
We encourage you to come to your initial consultation with a written list of questions to ensure you don’t forget to ask them when you are seeing the doctor.
Your medical file is handled with the utmost respect for your privacy. Our staff is bound by strict confidentiality requirements as a condition of employment regarding your medical records. We will not release the contents of your medical file without your consent.
If you have shortness of breath or chest pain, call 911 immediately or go to the emergency room. For other urgent questions/concerns, call (202) 787-5601 for assistance.
Joint replacement is surgery to replace damaged and worn out cartilage on a major joint in the body. It is done using an artificial joint made of metal, ceramic and plastic. Total joint replacement can effectively recreate the function of the joint.
This determination can only be made after a thorough evaluation by your surgeon and involves considering your symptoms, prior treatments, imaging and medical status and social situation.
The anterior approach, also known as minimally invasive hip replacement, is a method of approaching the hip joint through the front of the thigh. This minimized damage to the muscles/tendons and involves a much smaller incision than other approaches. This can result in reduced pain and shortened recovery times.
The overwhelming majority of patients can have their hip replacement performed safely through the minimally invasive anterior approach. However, there are rare situations due to anatomy or prior surgery in which the surgery is best performed with an alternate approach.
ConforMIS is a true customized knee replacement Both the femoral and tibial components are uniquely designed for each patient and each knee. No two are alike. Our femoral and tibial implants are individually sized and shaped to fit to each patient’s unique anatomy, offering potential advantages over with "off-the-shelf" knee implants. Ask Dr. Melvin whether you are candidate.
As a very common medical procedure, joint replacement can be performed safely. On an annual basis, almost 300,000 patients undergo hip replacement surgery, and almost 600,000 patients undergo knee replacement surgery in America. Any risks will be thoroughly reviewed with Dr. Melvin prior to surgery.
Failure mechanisms for a joint replacement are variable, however, a modern hip or knee implant typically will not fail from "wearing out" for greater than 20 years. It may be shorter or longer depending upon the activity of the patient.
While most joint replacement surgeries are performed without incident, joint replacement carries risk of infection, blood loss, fracture, nerve or blood vessel damage, continued pain, stiffness, plastic wear, limb length discrepancy, anesthesia risk and other imponderables. Many of these risks can be lessened through patient optimization and peri-operative medication and protocols. Dr. Melvin will discuss the risks and any concerns you may have.
Joint replacement surgery has no age limit. It simply requires that you be in good health to undergo surgery.
Prior to surgery, blood work, EKG, urinalysis, blood typing and/or infection screening may be required. Most patient will be evaluated by a medical doctor prior to surgery and occasionally, specialty evaluation may also be required.
This is a matter to be discussed with Dr. Melvin and/or your primary care physician or specialist.
In most cases, patients receive spinal anesthetic for joint replacement surgery with a local anesthetic block placed in the joint. In some cases, patients may receive general anesthetic. These options can be discussed with Dr. Melvin and the anesthesiologist prior to surgery.
Joint replacement surgery can take anywhere from one to three hours or more. This depends on the level of complexity in the surgery.
Dr. Melvin utilizes a multi-modal analgesic regimen which is very effective in minimizing surgical pain. Most patients experience mild discomfort during the first days following surgery, but this can actually be an improvement over the the pain the patient experiences from their osteoarthritis, rheumatoid arthritis and/or avascular necrosis. Most pain will resolve within the first two to three weeks following surgery.
Following joint replacement, patients are typically in the hospital for 1-3 days following surgery. However, for some patients, joint replacement can be safely performed as an out-patient procedure. The complexity of the surgery and the exact issue being addressed are factors that contribute to the length of your hospital stay.
It is ideal to have a friend or family member stay with you for the first several days after you get home. If this is not an option, it is wise to ensure that someone checks on you daily to help with anything you may need. Additionally, the hospital social worker may be able to arrange in-home services or assistance.
Many patients will require a short course of narcotic pain medication to supplement acetaminophen and NSAIDS. However, some patients will manage to avoid narcotics all together. While a short course of narcotic medication is usually prescribed, in general, Dr. Melvin recommends minimizing or avoiding narcotic medication. Discuss your expectations with him before surgery to help develop a personalized pain control plan.
Certain patients will require the use of a walking aid following surgery. This is often needed for only several days to weeks before patients can walk independently. This matter can be discussed with Dr. Melvin.
Most patients can ascend and descend stairs before leaving the hospital or surgery center.
For safety purposes, patients must wait several weeks before driving a car. However, many patients can return to driving before that depending upon their recovery. It also depends on which hip or knee was replaced. It is important that you wait until discussing your return to driving with Dr. Melvin.
While most patients wait four to six weeks before returning to work, it can be significantly sooner. It all depends on the rate of recovery and the nature of your job. You and Dr. Melvin will map out a plan to get you back to work as soon as possible.
Follow-up appointments vary from patient to patient. Dr. Melvin will typically first see the patient at 10-14 days from surgery, but will see a patient after surgery at any time if there is a question or concern. Contact his office for any questions.
Patients will begin light exercise during the recovery process soon after surgery. Most patients can return to mild sports activities within 6-8 after surgery and begin to ramp up their activity from there. Longer term recommendations will vary depending upon the exact type of surgery.
Patients are able to resume sexual activity when it feels comfortable. In general, they are only restricted by position limitations posed by their physical therapist.