Who Should Consider Total Joint Replacement Surgery?

Written By: Robert M. Shalvoy, MD Orthopedic Surgery & Sports Medicine Care New England Health System on November 22, 2022


Who Should Consider Total Joint Replacement Surgery?
The decision to undergo Total Joint Replacement Surgery should be collaborative - between you and your doctor. If you have severe joint pain and stiffness that limits your day-to-day life, and physical therapy isn’t working, it may be time to inquire about Total Joint Replacement Surgery.
For this article, we will discuss who is a good candidate for surgery, what you can expect after surgery, complications, and the process to follow if you decide Total Joint Replacement Surgery is the best option for you.
When Should I Consider Surgery:
Every patient is different. So, there are several factors a doctor will consider before recommending a total joint replacement. According to the OrthoInfo.org, patients who best benefit from this surgery would answer “yes” to some or all of these questions:
  • Is the joint pain or stiffness so severe it makes daily activities - like walking or getting in and out of chairs - difficult?
  • Do you have significant pain in your joint when you’re simply resting?
  • Do you have swelling or inflammation that doesn’t get better with rest, physical therapy or medicine?
  • Is there a deformity to the joint (e.g., bowing in or out at the knee)?
Am I Too Old for Joint Replacement Surgery?
This is a question frequently asked by those considering Total Joint Replacement Surgery. While it’s true - age is an important factor of your health, it isn’t the only thing that determines if joint replacement is for you. Your physician will look at your overall health before recommending Total Joint Replacement Surgery.
Some of the considered factors include:
  • Blood test results
  • Physical strength
  • Bone density
  • Diet
  • Lifestyle
  • Age
Expectations vs. Reality
While joint replacement surgery is one of the most successful and rewarding medical experiences – you shouldn’t expect a miracle. Yes, most patients see a dramatic reduction in joint pain and stiffness after surgery, but it won’t allow you to do more than you could do before the pain or arthritis developed. Overdoing it could speed up the normal wear of the new joint and the pain can return.

So, here are some dos and don’ts after Total Joint Replacement Surgery:

  • Do – Try low-impact sports and activities. Take walks and light hikes. Go swimming. Try ballroom dancing or take up golf. Everything in moderation, of course.
  • Don’t – Participate in high-impact activities. Avoid running, jogging or anything else that puts significant pressure on the new joint.

Your new joint could last up to two decades when cared for appropriately.

Complication Concerns
While rare, complications can occur when undergoing Total Joint Replacement Surgery. So, if you’re considering the procedure, it’s important to be aware of what could go wrong.

First, let’s put things into perspective, OrthoInfo reports the complication rate after total knee replacement is less than 2%. That’s the good news. However, developing an infection or blood clot is possible. That’s the bad news. Infections can occur in the wound and may develop within days, weeks or even a year after your surgery. Most minor infections can be treated with antibiotics. However, more serious infections could lead to the removal of the replacement. Blood clots are considered one of the most common complications of total joint replacement surgeries. If not treated right away these clots can be life-threatening. The good news is there are steps you can take to prevent clotting – like elevation, circulation exercises and medication.

It’s important to speak with your doctor about these complications and if you might be at a heightening risk of developing one of these issues.
What is the Process?
Before undergoing Total Joint Replacement Surgery it’s important to know what you’re getting yourself into. It’s not as simple as waking up one day and deciding to have surgery.

Let’s go through the checklist:

  • Joint pain is impacting your day-to-day life.
  • Physical therapy and medication aren’t helping.
  • Your doctor determined you are a good candidate for Total Joint Replacement Surgery.
  • You are not expecting surgery to be a miracle fix.
  • You’re aware of the complications.

Now what? There are several steps a patient must complete before, during and after surgery to ensure things go as smoothly as possible.


Pre-Surgery:

  • Once your doctor determines Total Joint Replacement Surgery is for you, you’ll set up a ‘Preoperative Assessment.” This is a house-inspection of sorts. An Orthopedic Care Liaison will come to your home and determine if there are any obstacles you may face after surgery- things like stairs, a steep driveway, or area rugs. They may also recommend some post-op assistive devices to help you bathe, use the bathroom or dress after surgery.
  • You will then have an appointment with your physical therapist who will evaluate your physical readiness for surgery.
  • Testing is another important step in the pre-surgery process – including lab work, EKGs, and X-rays.
  • You may want to consider a pre-surgery class to ensure you and your caregiver are prepared for life after surgery.


Day of Surgery:

  • Now is the time to speak with your surgeon and ask any last-minute questions. Your anesthesiologists will confirm which anesthetic best meets your individual needs. Then it’s time for surgery.

Post-Surgery:

  • Your recovery begins at the hospital. You’ll stay for a day or two. During this time your physical therapist will get to work- helping you to regain the use of your new joint.
  • Then, you’re headed home. A specialist will visit you at your house to continue working the joint, showing you exercises that will help to regain your strength and get you back to your normal activity level.


Now, you’re ready for the final step: outpatient physical therapy. Once the surgeon gives the “all clear,” you can transition to an outpatient clinic to continue physical therapy. This will help to increase the range of motion and strength of your new joint while helping to lower your pain so you can get back to your independent life.

Learn More about Total Joint Replacement Surgery and Start the Process
Care New England provides several joint replacement surgeries. Our team of expert nurses, doctors, and surgeons are ready to help you every step of the way - from the preparation process before surgery, your surgery, hospital stay and your post-discharge care. Our program is designed with your safety and satisfaction in mind to get the best possible outcome.

For information about Total Joint Replacement Surgery and to schedule an appointment Click Here.