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Should I Have Joint Replacement? My RA Checklist

Have you considered joint replacement? Did you factor in your age when making the decision? Did your doctor give you a speech about joint failure and longevity?

Is there a perfect time for surgery?

A friend of mine has a knee that is hurting so badly that she can barely tolerate it. But after her appointment to discuss options, she told me she would wait because she is only in her early 50s and she may need additional procedures by her mid 70s.

I told her of my experience with my right hip, which I had replaced in my mid 50s. I told her the doctor warned me that the new hip might not be functional for the rest of my life. He said it had an average life expectancy of 20 years, making it likely I would need a new one installed before the end of my life.

A very personal decision

Her initial thought was to wait, yet she can hardly walk. So she asked me why I chose to do my right hip so young.

For me, at least, it was not early. I asked my doctor why I would wait. Was he suggesting that I forget something I could do to give me back a much better quality of life in exchange for surgery again in 20 years? If I sat at home in my chair waiting until I was in my 70s to have the hip replacement, how likely was I to make it to my 70s? Not very, I wagered.

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These decisions are personal, and no decision suits every situation or person. But for me, it was not even a narrow escape. My right foot had turned completely out, which meant my foot was nearly aligned 90 degrees with my body. I was having great difficulty walking, and even sitting was painful.

Know the risks of waiting

I know people who continue to put it off. Some become almost immobile in the process. I have a friend who has needed a knee replacement for over 15 years now. She told me she was waiting until she was “a little older.”  Today she is out of shape and confined to her house, and the surgeon will not perform her surgery until she loses weight and does some physical therapy. I hate this situation for this kind lady. She has withdrawn from friends, and the last time I talked to her, she still said she was not old enough. Yet here she is in her early 70s.

My joint replacement checklist

Here is my check list that I used prior to joint replacement.

  1. Did it hurt bad enough for surgery? My hip certainly did. While no one wants to have surgery, some things are worse the longer we put them off.
  2. Are you restricted from doing things you want to do? I was having difficulty riding my bicycle. I did not want my hip to stop the activity I loved so much.
  3. How is your physical health other than joint pain? You may need to do some things before a surgeon will operate. Putting effort into whatever your doctor asks you to do to prepare for surgery is essential. This might include losing weight, having diabetes under control,  quitting smoking, etc. I had to reach an A1C of less than 7.0 to be approved. I was already well below that, so it was not an issue.
  4. Do you have a post-surgery helper? Immediately after surgery, you may require some help. Make sure your spouse or partner is up to the task, and if not, consider a short stay in a rehab facility to get over the hump.  My stay at the rehab center lasted exactly 3.5 days.  For me it was 3.5 days too long.   For Sheryl, I think it was 40 days too short.  We had different aims.  Of course, I was correct. (or as has been pointed out - not)
  5. You'll need to plan ahead. If you need dental work, a colonoscopy, or other procedures, they are sometimes paths for an infection that can harm joint replacement surgery.
  6. Consider attending a program like the University of Utah Joint Academy.  This is a free program for people considering joint replacement. You will have to watch some advertisements with each video, but they are worth watching. Likely, your joint replacement center has a similar program.

Are you ready for or considering joint replacement surgery? If you are ready, when is the surgery scheduled? If you are holding off, what is your reason?

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