"Just because you can have surgery doesn't mean you should have surgery," says Blair Ashley, MD, an orthopaedic surgeon and joint replacement specialist at Main Line Health, regarding how to deal with joint pain. "There's a difference between being a surgical candidate and surgery being the recommended initial treatment option for you. One person's X-rays may look worse than someone else's, but the severity of their pain may differ for a variety of reasons. Not everyone who meets surgical criteria will opt to get a hip replacement right away."
When patients come to Dr. Ashley, they're usually in pain—the kind of pain that makes life increasingly difficult and uncomfortable. Often, it's hip or knee pain, sometimes in patients who've never had surgical treatment while in others the pain is because of a joint replacement implant and possible complications, such as:
- Loosening of implant
- Implant wear
If you used to be able to jog and now you can barely walk a block, or you used to get relief from over-the-counter (OTC) medications but they no longer seem to work, or you find yourself having to modify aspects of your life—pulling away from things you used to be able to do with ease—it might be a good time to see a joint replacement specialist.
How to deal with joint pain depends on variety of factors
Ashley takes a variety of factors into consideration with an eye on improving quality of life while carefully weighing whether surgery is the best option for her patients.
"When a patient who's had a previous joint replacement comes to me, there's some symptomatic issue that brings them—usually, they're still having pain. But I don't do revisions on joint replacements without identifying the underlying cause of their pain and having a clear diagnosis indicating their condition would likely improve with surgery."
When surgery is the best treatment available for a patient, surgical procedures like joint replacements and revisions are performed with less and less recovery time, thanks to advances in technology and technique. Ashley uses advanced robotic technology which allows for more precise and less invasive procedures that allow patients to return home faster.
"But that doesn't mean these are surgeries without risk," she cautions.
If I get both of my knees replaced, will they feel the same?
"Joint replacements can be like children," says Ashley. "They may have the same parents but can have very different personalities."
A patient who has a double-knee replacement may have one knee that's simply easier than the other. Recovery may be smoother and faster, for no particular reason.
One aspect of Dr. Ashley's expertise is her commitment to helping patients understand what to expect before and after surgery. Both knee and hip replacements, for example, are elective surgeries, meaning a patient chooses to have the surgery rather than the surgery being medically mandated. Ashley helps prepare patients who may have a variety of conditions, from diabetes to high body mass index (BMI), ensuring certain numbers are achieved before surgery can be performed, in order to achieve the best possible outcomes.
"Patients should never feel pressured on their first visit to sign up for surgery," says Ashley. "I would rather patients come to me before going to Dr. Google because we always have a few good tricks up our sleeve before surgery may be needed."