Mobility relies on the body’s two largest joints – the hips and knees. What can you do when pain sets in, and when is it time for surgery? We asked orthopedic surgeon Matthew Brown, MD, of St. Luke’s Orthopedic Care, who is fellowship trained in adult joint reconstruction.
Q: What are the possible causes of hip and knee pain?
Dr. Brown: Osteoarthritis is one of the main causes. Arthritis can be caused by wear and tear, genetics, and trauma.
Q: What are the signs of hip and knee pain that would require a visit to the orthopedic surgeon?
Dr. Brown: If the pain is tolerable and goes away, it’s something you can just keep an eye on. If the pain is persistent and limiting your quality of life for more than a week or two, that’s when you should go to the doctor to find out what the problem is.
Q: What are the signs that you may need a hip or knee replacement procedure?
Dr. Brown: The good news is you never have to have your hip or knee replaced. It’s entirely up to the patient. My philosophy for treating patients with hip or knee arthritis is that first we try non-operative treatments, such as anti-inflammatory medications either over the counter or prescription strength. Next we can try injections; corticosteroids or lubricating injections. If those non-operative treatments are not helping the patient to enjoy the quality of life they want or need, only then do we talk about joint replacement surgery. The patient gets to decide when they want to have their hip or knee replaced.
Q: Talk about St. Luke’s orthopedic treatment philosophy.
Dr. Brown: The reason I chose St. Luke’s is because I wanted to find a practice that focused on patient care before anything else. That’s my experience with St. Luke’s. The patient always comes first and we do what’s right for the patient. It matches my philosophy of treatment.
Q: Does joint replacement remove arthritis?
Dr. Brown: Joint replacement does get rid of arthritis. We remove the damaged cartilage and a small amount of bone that is underlying the damaged cartilage. We then replaces the damaged bone and cartilage with metal, plastic or ceramic.
Q: What can a patient expect following such surgery?
Dr. Brown: Patients recover differently from hip replacement and knee replacement. Typically, hip replacement is a little bit easier to recover from in terms of rehabilitation and the amount of time to return to normal function. Patients who have their hip replaced typically feel as though their joint is back to normal.
Patients who undergo knee placement require more rehabilitation for recovery, but it’s a very good surgery to help eliminate pain, restore function and correct deformity.
Q: What is an anterior approach hip replacement, and what are the benefits compared to a posterior approach?
Dr. Brown: An anterior approach means the incision is in the front compared to the posterior approach, where the incision is in the back. Although the data is inconclusive, some surgeons believe the anterior approach allows patients to recover slightly faster.
Q: How long does a hip or knee replacement last?
Dr. Brown: We don’t know how long they last because we don’t have data forecasting into the future for modern implants. However, we expect modern implants that we’re using now for joint replacements to last 20-30 years.
Part of how long they last is how well patients take care of them. Activities we typically recommend for patients after a joint replacement are walking, bike riding, golfing, doubles tennis, gardening, and other similar activities. Activities we typically don’t recommend for patients following joint replacement are high impact activities like repetitive running, basketball, or jumping activities. They place more stress on the joint replacement. Like anything man-made, it eventually wears out.
Q: Knee and hip replacement surgery has been around for 50 years. Talk about the advancements and what patients can expect following the procedures.
Dr. Brown: That’s a great question. I think a lot of the material used to make the actual implants are relatively similar to what they were 50 years ago. The things that have really changed more than the implant materials are the surgical techniques and the rehabilitation protocols, which allow patients to recover faster and get back to the things that they enjoy.
Q: Why should a patient choose St. Luke’s Orthopedic Care?
Dr. Brown: I think you should choose St. Luke’s for your joint care because we are dedicated to treating everyone as an individual and we have a team in place that is dedicated to getting the best possible outcome for every patient.
Q: Why did you choose orthopedic surgery:?
Dr. Brown: I actually was a government major in college and did finance for a year. During that year I had an accident that required surgery and I got interested in surgery. Then I went back to school to do the pre-med requirements and went to medical school.
I see surgery as a means to getting people back to doing the things they enjoy, and that’s what appealed to me.