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Joint Replacements: Risks and Benefits

While joint replacement has relieved pain and improved mobility for millions of people over the last 30 years, some individuals who have actually not had any major complications are still not happy with their results. It has been my experience that most of the disappointments in joint replacement are created by unrealistic expectations. Although a certain percentage of joint replacement patients may say that their knee is as "good as new", the fact is that no replaced joint is really as good as a normal unoperated joint. Everyone who has a joint replacement risks such complication as death from medical problems, infection, nerve injury, unanticipated fracture, stiffness, leg length inequality, and persistent pain and swelling. For knee replacement patients some feeling of clicking or noise in the knee, areas of numbness on the anterior aspect of the knee, incomplete motion in the knee, persistent swelling and feelings of tightness or laxity in the knee are common complaints. In hip replacement patients dislocation, feeling of leg length inequality, persistent posterior hip pain due to back problems, and lateral hip pain due to tendinitis are commonly reported.

Most patients who have hip or knee replacement have reached a point where they are in almost constant pain and have very limited function. If you have not reached that point, probably you should not have the operation. Results which create only minor inconveniences should be kept in perspective.

The companies which make joint replacements recognize it as a very lucrative business and naturally want to sell as much of their product as they can. In the last few years radio and television advertisements have becomes more common. Most of those offer better results and less pain. Over the course of my career I have seen numerous "improvements" which actually resulted in serious failure. The latest and most advertised is not always the best. There are at least a dozen hip and knee replacements on the market today which, if done properly, give patients the opportunity for very satisfactory results. No one is better than the other.

Doctors who specialize in knee replacement have spent many years studying the problems and the implant options. If you trust your physician, allow him to make the decisions regarding the type prosthesis he uses for you. If you do not trust your doctor's judgment, I suggest that you change doctors.

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