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Is Knee or Hip Replacement Right for you?

Your Joint Replacement Questions Answered


If you’re suffering from pain and loss of function in your hips or knees, we have the resources you need to learn more about symptoms, non-surgical treatments, joint surgery options, total joint replacement, and recovery. People often put off joint replacement surgery for many reasons. Not wanting to live life to the fullest, isn’t one of them.

Our Frequently Asked Questions have all of your answers and information you need to know when deciding if joint replacement surgery is for you.

 

Want some alternatives to surgery? Download the guide. 

Your Pain Doesn’t Wait Until You Decide

 

As hip and knee arthritis worsens, the stiffness of the arthritic joints also worsens.  We know that you want to get back to the life you love. We also know that you have a lot of questions about joint replacement surgery.

Nearly every knee and hip surgery we do, the patient says they wish they had done it sooner. They can enjoy activities they had left behind, they can do their daily tasks and sleep without pain. They can go about their day not worrying about how and when to manage their pain for any upcoming outing or vacation they may have planned.

 

“For about nine out of every ten people who have had a hip or knee joint replaced, the new joint is still working well after twenty years.”

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Meet The Doctors

Dr. Scott Nodzo

Dr. K. Keely Boyle

Dr. Scott R. Nodzo, M.D. Completed his doctorate of medicine at the Buffalo School of Medicine and Biomedical Sciences University.

Dr. Scott R. Nodzo, M.D. completed an orthopedic surgery residency at the University of Buffalo School of Medicine and Biomedical Sciences in 2015.

He also completed an adult reconstruction and joint replacement fellowship at the Hospital for Special Surgery, New York, NY in 2016.

Dr. K. Keely Boyle, M.D. completed medical school at The George Washington University School of Medicine and Health Sciences, Washington, DC in 2014.

Dr. K. Keely Boyle, M.D. completed an adult reconstruction and joint replacement fellowship at the Hospital for Special Surgery, New York, NY in 2020.

She also completed an orthopedic surgery residency at the State University of New York, University at Buffalo NY in 2019.

Dr. Scott Nodzo

Dr. Scott R. Nodzo, M.D. Completed his doctorate of medicine at the Buffalo School of Medicine and Biomedical Sciences University.

Dr. Scott R. Nodzo, M.D. completed an orthopedic surgery residency at the University of Buffalo School of Medicine and Biomedical Sciences in 2015.

He also completed an adult reconstruction and joint replacement fellowship at the Hospital for Special Surgery, New York, NY in 2016.

Dr. K. Keely Boyle

Dr. K. Keely Boyle, M.D. completed medical school at The George Washington University School of Medicine and Health Sciences, Washington, DC in 2014.

Dr. K. Keely Boyle, M.D. completed an adult reconstruction and joint replacement fellowship at the Hospital for Special Surgery, New York, NY in 2020.

She also completed an orthopedic surgery residency at the State University of New York, University at Buffalo NY in 2019.

A center of excellence

Comprehensive care right here. 

Summit Healthplex
6934 Williams Road, Suite 600
Niagara Falls, NY 14304

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Frequently Asked Questions

Full vs Partial Knee Replacement

Partial Knee Replacement

In the past, partial knee replacement was for patients over 60 years old whose ligaments were in good shape, had little knee deformity and could move their knee pretty well. Today, the procedure is being done on younger patients who have pain and other symptoms in one part of the knee.

Partial Knee Replacement

In the past, partial knee replacement was for patients over 60 years old whose ligaments were in good shape, had little knee deformity and could move their knee pretty well. Today, the procedure is being done on younger patients who have pain and other symptoms in one part of the knee.

Total Knee Replacement

This procedure has been revolutionary to orthopaedics giving many patients the ability to return to function and enjoy their lives with implants lasting about 10-15-years. While the surgery and recovery are longer, the lifetime of the implants is much greater than in partial knee replacements.

Important For Both

Both partial and total knee replacements can be highly successfully for patients who are good candidates. It is important to discuss the risks and benefits of each type of surgery with your surgeon so that your expectations
are in line with the procedure you elect to have.

Remember that both of these procedures are replacements, and you should follow the activity restrictions your surgeon provides you.

Neither procedure is designed to hold up to the rigors of high-impact sports.

Total Hip Replacement

The first step when making the decision about hip replacement is to meet with your surgeon to see if you are a candidate for total hip replacement surgery. Even if the pain is significant, and the X-rays show advanced arthritis of the joint, the first line of treatment is nearly always non-operative. This includes weight loss if appropriate, an exercise regimen, medication, injections, or bracing. If the symptoms persist despite these measures, and with corroborating X-rays, then you may consider surgery.

 

How Long Will the New Joint Last?
A common reply to this question is that total joint replacement lasts approximately 15-20 years. A more accurate way to think about longevity is via the annual failure rates.

Most current data suggest that both hip and knee replacements have an annual failure rate between 0.5-1.0%. This means that if you have your total joint replaced today, you have a 90-95% chance that your joint will last 10 years, and an 80-85% that it will last 20 years. With improvements in technology, these numbers may improve.

Despite such improvements it is important to maintain long-term follow-up with your surgeon to assure your replacement is functioning appropriately.

How Long Will the New Joint Last?
A common reply to this question is that total joint replacement lasts approximately 15-20 years. A more accurate way to think about longevity is via the annual failure rates.

Most current data suggest that both hip and knee replacements have an annual failure rate between 0.5-1.0%. This means that if you have your total joint replaced today, you have a 90-95% chance that your joint will last 10 years, and an 80-85% that it will last 20 years. With improvements in technology, these numbers may improve.

Despite such improvements it is important to maintain long-term follow-up with your surgeon to assure your replacement is functioning appropriately.

Are All Hip Replacement Implants the Same?
Most implants today have become more similar than different as surgeons and manufacturers have determined which designs work best. One variable that still remains is the bearing surface. The bearing surface is the ball and liner that attach to the stem and cup that fix to the bone.

The ball can be composed of either metal (cobalt chromium alloy) or ceramic, and the liner can be made of plastic (polyethylene), metal, or ceramic. The ball and liner can then be used in different combinations and are named for the respective ball liner combination (metal on poly, ceramic on poly, ceramic on ceramic, etc.).

In 2015, the vast majority of bearings utilized a polyethylene liner with either a metal or ceramic head, with other combinations being used with less frequency. You can discuss these differences with your surgeon to determine which implant is best for you.

Are Surgery and Recovery Painful?
Pain following total hip replacement has come a long way over the last 10-15 years with increased use of regional nerve blocks, spinal blocks, and various other modalities used for pain control. Total hip replacement is generally considered to be less painful than total knee replacement.

Early range of motion and rapid rehabilitation protocols are also designed to reduce early stiffness and pain, making the procedure in general much less painful than in years past. You may have relatively mild pain following the procedure, or you may have a more difficult time than others. Everyone is unique and handles and perceives pain differently.

What is Minimally Invasive Surgery?
Minimally invasive surgery is a term that describes a combination of reducing the incision length and lessening tissue disruption beneath the incision. This includes cutting less muscle and detaching less tendon from bone. There have also been advancements in anesthesia and pain management during and after surgery. All of these practices allow you to feel better, have less pain, and regain function faster than in the recent past. While there may be some early advantages to minimally invasive surgery, as long as the components are placed correctly, traditional surgery ultimately leads to similar outcomes by three months post-operatively.
What is the "Approach?"
The way a surgeon gains access to the hip during hip replacement surgery is referred to as an “approach.” There are various types of approaches named according to the direction that the surgery is performed.

The most common approach today is referred to as the “posterior approach,” which is done from the back of the hip. Some more recent improvements to this approach (small incision and less tissue trauma) have been called “mini posterior approach.” Another currently popular approach is known as the “anterior approach,” which is performed from the front of the hip. The lateral approach is less frequently used but a viable approach for the surgery.

How Big Will My Scar Be?
The size of the incision can vary and depends on several factors that include the size of the patient, the complexity of the surgery, and surgeon preference. Most studies have shown that smaller incisions offer no improvement in pain or recovery and may actually worsen the surgeon’s ability to adequately perform the procedure.
Will I Need General Anesthesia?
While general anesthesia is a safe option, both hip and knee replacements can be performed under regional anesthesia. Choices for regional anesthesia include spinal anesthesia, epidural anesthesia, or one of a variety of peripheral nerve blocks. Many surgeons and anesthesiologists prefer regional anesthesia because data shows it
can reduce complications and improve your recovery experience with less pain, less nausea, less narcotic medicine required
How Long Will I Stay at the Hospital?
You will likely stay in the hospital for one to three days depending on your rehabilitation protocol and how fast you progress with physical therapy. This is highly dependent upon your condition before surgery, your age, and medical problems which can influence your rehabilitation. A safe discharge plan will be arranged for you by the orthopaedic team.
How Long Does it Take to Recover?
The majority of people who undergo total hip replacement are able to participate in a majority of their daily activities by six weeks. By three months, most people have regained much the endurance and strength lost around the time of surgery and can participate in daily activities without restriction. While daily activities have resumed, it is important to avoid high impact activities to give you the best long-term outcome with your hip.
How Long Will I Need Physical Therapy?
Initially, you will receive some physical therapy while in the hospital. Depending on your preoperative conditioning and support, you may or may not need additional therapy as an outpatient. Much of the therapy after hip replacement is walking with general stretching and thigh muscle strengthening, which you can do on your own without the assistance of a physical therapist.

Total Knee Replacement

The first step when making the decision about knee replacement is to meet with your surgeon to see if you are a candidate for total knee replacement surgery. Even if the pain is significant, and the X-rays show advanced arthritis of the joint, the first line of treatment is nearly always non-operative. This includes weight loss if appropriate, an exercise regimen, medication, injections, or bracing. If the symptoms persist despite these measures, and with corroborating X-rays, then you may consider surgery.

How Long Will It Last?
A common reply to this question is that total joint replacement lasts 15-20 years. A more accurate way to think about longevity is via the annual failure rates. Most current data suggest that both hip and knee replacements have an annual failure rate between 0.5-1.0%. This means that if you have your total joint replaced today, you have a 90-95% chance that your joint will last 10 years, and an 80-85% that it will last 20 years. With improvements in technology, these numbers may improve.
How Long Does A Knee Replacement Last?
A common reply to this question is that total joint replacement lasts 15-20 years. A more accurate way to think about longevity is via the annual failure rates. Most current data suggest that both hip and knee replacements have an annual failure rate between 0.5-1.0%. This means that if you have your total joint replaced today, you have a 90-95% chance that your joint will last 10 years, and an 80-85% that it will last 20 years. With improvements in technology, these numbers may improve.
What Types of Implants Will I Get?

The orthopaedic implant industry has developed a number of innovative technologies in an effort to improve the outcomes of total joint replacement surgery. 
Here are specific implant design terms:
• Gender-specific: This refers to a modified implant design that accounts for average anatomic differences between men’s and women’s knees. Most manufacturers have incorporated similar modifications in their newer designs, which allow for more sizing options so that the prosthesis can be more accurately fit to the patient’s native anatomy and recreate the natural function of the knee.
• Rotating platform: This refers to a plastic bearing that independently rotates on a metal tray on which it is seated. More often, the plastic bearing locks into the metal tray – referred to as a “fixed bearing.” Some theoretical advantages to the rotating platform concept when it was initially designed was that it could reduce the wear of the plastic bearing, reduce the rate of loosening of the metal parts, and better replicate how a patient’s knee works (kinematics). Most current data shows that after five to ten years in use, there does not appear to be any difference between rotating platform and fixed bearing designs in any of these outcomes.

Will My Surgeon Use a Computer or Robot During Surgery?
Despite a substantial amount of direct-to-consumer marketing, the best approach is to discuss this topic with your surgeon. You may want to know if they use one of these technologies, why they have chosen to do so, and what their experience has been in using it.
Is Knee Surgery and Recovery Painful?
Pain following total knee replacement has come a long way over the last 10-15 years with increased use of regional nerve blocks, spinal blocks, and various other modalities used for pain control. Total hip replacement is generally considered to be less painful than total knee replacement.

Early range of motion and rapid rehabilitation protocols are also designed to reduce early stiffness and pain, making the procedure in general much less painful than in years past. You may have relatively mild pain following the procedure, or you may have a more difficult time than others. Everyone is unique and handles and perceives pain differently.

Can I Walk After Surgery?
Most surgeons and hospitals today emphasize getting you out of bed quickly. Most people are walking with the assistance of a walker on the day after surgery and using a cane or nothing at all by two to three weeks.
How Long Will I Need Physical Therapy
Most people who have had a total knee replacement require outpatient physical therapy following surgery. A skilled therapist can accelerate the rehabilitation as well as make the process more efficient with the use of dedicated machines and therapeutic modalities. Depending on your condition before surgery, physical therapy is beneficial for up to three months and rarely longer. The amount of therapy needed depends upon your condition before surgery, motivation, and general health.

About Osteoarthritis

Osteoarthritis (OA) is a common disorder that affects the joints and is caused by a loss of cartilage. Cartilage is the covering over the ends of bones that serve to provide a smooth gliding surface. When this cartilage surface is lost or destroyed, the underlying bone becomes exposed, causing pain when the joint moves or immobility.

Do I Have Osteoarthritis?
If you have osteoarthritis, you generally complain of pain related to activity. As the disease progresses, you might feel pain when you’re at rest and asleep at night. Additional symptoms often include joint stiffness and deformity often limiting your joint function and quality of life. In some individuals, osteoarthritis progresses slowly and can be managed for years with non-operative care. In other individuals, osteoarthritis can progress rapidly and cause severe pain – sometimes prompting the need for surgery when other measures fail to control the symptoms.
Do I Have Osteoarthritis?
If you have osteoarthritis, you generally complain of pain related to activity. As the disease progresses, you might feel pain when you’re at rest and asleep at night. Additional symptoms often include joint stiffness and deformity often limiting your joint function and quality of life. In some individuals, osteoarthritis progresses slowly and can be managed for years with non-operative care. In other individuals, osteoarthritis can progress rapidly and cause severe pain – sometimes prompting the need for surgery when other measures fail to control the symptoms.
Causes
The cause of osteoarthritis is unclear, but several factors often contribute to its development including obesity, genetics, trauma/ injury, instability, and age:
• The global rise in obesity correlates with a significant rise in the frequency of arthritis, particularly in the knee joint.
• Genetics clearly plays a role and has been correlated with osteoarthritis especially in the joints of the hand and wrist.
• Trauma and injury can result in damage to the cartilage, and poor alignment of the bones can contribute to the development of osteoarthritis.
• Instability of the joints related to poor ligaments or weakness can also lead to cartilage loss and ultimately osteoarthritis.
• Age has been associated with osteoarthritis. Although the frequency of OA increases with age, it does not occur in all individuals and should not be considered inevitable.
Should I See a Doctor?
If you are experiencing joint pain, it is important for you to discuss this with your doctor. A careful history, physical exam, and x-rays of the affected joint are the main ways your doctor makes an accurate diagnosis of
osteoarthritis.

Treatment will be based on how far the disease has progressed and how bad and how long your joint has hurt.

It is important to understand that not all hip and knee pain is osteoarthritis, and there are other diagnoses and treatment options depending on the underlying cause of your pain.

Is There a Cure?
At this time there is no cure for osteoarthritis, and all of our non-operative measures are targeted towards treating your symptoms. Despite recent claims of injections that can “cure” your osteoarthritis, we currently have no disease modifying agents for osteoarthritis of the hip and knee.

Even though there is no cure for the disease, we can treat the symptoms you’re experiencing and provide significant pain relief and improvement in function. It is important to understand the extent of your osteoarthritis and how this relates to your symptoms and treatment options.

A center of excellence

Comprehensive care right here. 

Make An Appointment

Summit Healthplex
6934 Williams Road, Suite 600
Niagara Falls, NY 14304