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March 18, 2019

Out of Joint: Joint Pain

Out of Joint: Joint Pain

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Joint pain usually occurs as a result of trauma or arthritis and, depending on the severity, can require a knee or hip replacement

The most common causes of joint pain and subsequent replacement are trauma and arthritis, a condition that affects around 10 million people, says the NHS. According to Arthritis UK, more than 30 million working days are lost because of arthritis and other musculoskeletal conditions each year, with many sufferers giving work up entirely because of the condition. In cases where arthritis is severe, hip or knee replacements may be necessary to regain mobility and improve quality of life.

Hip replacement

Hip replacement procedures are most commonly carried out in people between the ages of 60 and 80, and involve replacing a damaged hip joint with a prosthesis. Hip replacement surgery is only offered if all other methods of treatment, including physiotherapy or steroid injections, have been exhausted. The surgery, which is usually carried out under anaesthetic or epidural, takes around 60 to 90 minutes to complete. 

Recovery

Recovery post-op tends to be quite demanding and requires dedication to a regimented routine to heal well. NHS Choices states that a walking aid (such as crutches) will be necessary for four to six weeks following the procedure. Patients may be required to participate in an exercise programme designed to help improve joint mobility. Patients are usually able to resume normal activities within two to three months. 

Potential risks

While the risk of complications following hip replacement is relatively low, these can include injuries to the blood vessels and nerves, increased risk of fracture, dislocation of the hip joint and infection. 

Knee replacement

Also referred to as arthroplasty, knee replacement surgery becomes necessary when the joint is damaged to the point that normal mobility is significantly reduced and the area is painful when resting. While the most common reasons for knee replacement surgery is osteoarthritis, gout, haemophilia, bone dysplasias and rheumatoid arthritis are listed among the common causes for knee joint damage. There are two main types of knee replacement surgery: total knee replacement (TKR), whereby both sides of the knee joint are replaced; and partial knee replacement (PKR), whereby just one side of the joint is replaced. Which procedure you will need will depend on the severity of damage. 

Recovery

Hospital stay time can vary, but typically lasts between three to five days. Walking aids may be required for up to six weeks following surgery. Full recovery can take up to two years, with some patients still reporting pain even after this time period.

Potential risks

The risks associated with arthroplasty include infection, stiffness of the wound, ligament or artery damage, blood clots, deep vein thrombosis and fracture. Complications tend to be quite rare, however, as knee replacement surgery is a very common procedure. 

98% 

Osteoarthritis was the main indication for surgery in this percentage of knee replacement patients in 2015

Source: State of Musculoskeletal Health 2017, Arthritis UK

This article was originally published in Live to 100 with Dr Hilary Jones. Read the digitial edition, here.