TOTAL JOINT REPLACEMENT, INDICATIONS AND EXPECTATIONS

In the early years of joint replacement, the indication for surgery was intractable pain not relieved by conservative measures. As joint replacement has become more common, pain remains the primary indication, but patients have become less tolerant of activity limitations and therefore are looking to joint replacement to improve function. Authors have documented that patients undergoing joint replacement have multiple expectations, including relief of pain, improvement in function, and improved psychosocial well being. As a result of the explosion in information on the internet, the patients’ expectations have risen to include, a short recovery period, minimal postoperative pain, and a return to most activities. These elevated expectations have led patients to underestimate the challenges involved in the process of joint replacement and to overestimate outcomes. The baby boomer generation is defined as Americans born between 1946 and 1964, includes 78 million Americans or 28% of the United States population. As patients turn to joint replacement at younger ages the question of activity after joint replacement is raised. A recent survey of the Hip and Knee Society as well as the American Association of Hip and Knee Surgeons reveal that orthopedic surgeons specializing in joint replacement let their patients return to cycling, hiking, walking, and doubles tennis. In addition to the above, down hill skiing, low impact weight lifting and rowing are also allowed. Activities that are discouraged include, high impact activities such as running, soccer, and basketball.