Hip & Knee Replacement in the Long Term

Antibiotics are not needed for patients with total joint replacements having dental work. See this position statement from The Canadian Orthopedic Association (COA), The Canadian Dental Association (CDA), and The Association Of Medical Microbiology And Infectious Disease (AMMI) Canada.

Most modern hip and knee replacements last longer than you might think. Although there are no guarantees, reports show that on average, most hip and knee replacements last 15 to 20 years, with many (58 per cent) lasting for 25 years.

Evans JT, Evans JP, Walker R et al. How long does a hip replacement last? A systematic review and meta-analysis of case series and national registry reports with more than 15 years of follow-up. Lancet. 2019;393:647-54.

Cook R, Davidson P, Martin R; NIHR Dissemination Centre. More than 50% of hip replacements seem to last 25 years. BMJ. 2019 Dec 31;367:5681. doi: 10.1136/bmj.l5681.

After a few years, you will know your joint replacement and how it feels. If you experience new issues, such as buckling (giving way), new pain, new swelling, new clicking OR the behaviour of your joint replacement changes in any way and you’re not sure why, you can call the Advanced Practice Provider Team at 416-967-8526 to discuss your symptoms. They can help you figure out if you need to come back for a check-up of your joint replacement. You can also book an appointment in your surgeon’s review clinic (without needing a new referral if it’s for the joint they replaced).

Examples of when to book an appointment include:

• If you are experiencing new, ongoing pain in your replaced joint with activity, that is not relieved with rest and medication.
• If your joint feels “unstable” or “buckles” during activity (walking, hiking, climbing stairs)

If you experience new unexplained swelling, redness or bruising around the replaced joint and/or fevers, sweats or chills for no other known reason.

If the fall causes significant pain, difficulty putting weight through your leg, a feeling of instability, significant bruising and/or swelling, you should visit your local ER.

If you fall, but can get up and keep going, then continue to monitor your symptoms. If they last for more than two weeks or seem to be getting worse, and you are having difficulty doing your usual activities, please give us a call to book a review of your joint replacement.

NOTE: if you had your surgery less than six weeks ago, please contact your surgeon’s office and let them know you have had a fall.

You have numbness around your scar because tiny skin nerves were cut when your incision was made. Skin (cutaneous) nerves give you some of the feeling in your skin (sensory) but do not work your muscle (motor) or affect your strength. Your body will do its best to try to fill in the gaps in your sensation, but many people who have joint replacements (or any surgery with a long scar) are left with some numbness at or around their scar.

You should generally be careful about activities that are high impact (e.g. running or jumping) or that put you at high risk of falling. Activities that require heavy lifting or extreme twisting of your joint (e.g. some yoga positions) may also be hard on the replaced joint.

For more details on safe long-term activity, please consult the Canadian Orthopaedic Foundation’s booklet on maximizing activity after hip or knee replacement

If you still have questions, please contact your surgeon’s office for more guidance.

Your body knows how to heal itself, and a visible scar is a normal part of your healing from surgery. In fact, your scar is changing and still maturing up to 18 months after your surgery. Keep in mind, you can never get rid of a scar altogether; only help its appearance somewhat.

The way your scars heal is mostly determined by your genetics.

• Avoiding direct exposure to UV light or using high SPF sunblock on the scar will help keep it less visible.
• Massaging the scar with non-irritating oil or cream will help the appearance and flexibility of the scar. The following document from Leeds Teaching Hospitals (NHS) gives excellent information on taking care of a surgical scar

If your scar is overly sensitive, you might find desensitization techniques such as those described by the Leeds Teaching Hospitals (NHS) useful