Factors That Influence When To Have A Joint Replacement

Joint replacement surgery can be the final treatment approach for people with various forms of degenerative arthritis. Selecting the right time to have a joint replacement can prevent the need for another replacement later and avoid premature surgery or complications in some people.

Type Of Arthritis

Although joint replacements may be done for any form of arthritis, the outcomes for severe osteoarthritis are generally better than for people with severe inflammatory arthritis. A major problem that occurs with inflammatory arthritis is the underlying problem is ongoing and is not solved simply be replacing a damaged joint. Since people with inflammatory arthritis can have any number of joints affected, this can contribute to problems after surgery. Having limited mobility after a joint replacement can increase your risk of blood clots and the development of scar tissue. If your hands and wrists are painful or deformed, this will make using assistive devices to help with walking difficult or impossible. The medications used to manage inflammatory arthritis can cause bone loss or increase your risk of infection, which further complicates a joint replacement.

Severity Of Arthritis

It is difficult to gauge the severity of arthritis because what is seen on x-ray does not always match what the person is experiencing. The best candidates for joint replacement are those with radiographic evidence of severe arthritis. For years before the joint reaches this level of degeneration, people may experience major limitations in their mobility and chronic pain. This adds hurdles when a joint replacement is delayed after many years of limited mobility. People may have become sedentary and have gained weight, which can make surgery more risky and contribute to a harder recovery. Surgeons may need to weigh the difference between self-reported severity and radiographic severity when deciding whether continuing with non-surgical treatments are the better option.

Patient Age

Patient age can be a major influence when deciding the timing of a joint replacement. This does not mean young or middle-aged people do not have joint replacements or are excluded from the procedure. Generally, surgeons prefer to perform joint replacements when the surgery is expected to last the remainder of the person's life. All joint replacements have an expected lifespan before they may experience failure and need to be replaced again. Replacing a joint replacement can be difficult because scar tissue formation and other obstructions may have developed over the years, making it harder to remove the old replacement joint. Additionally, there could be weakening of the bone that supports the replacement and it may not be suitable to handle another replacement.

When a joint replacement occurs is not an easy decision for surgeons. There are several variables that not only affect whether a surgeon agrees to the procedure, but also affect the outcome of surgery.