Potential Problems After Hip & Knee Joint Replacement Surgery

Joint replacement surgery is a big deal.

There's a lot of work that goes on in the operating room.

But the good thing is that surgeons have become very skilled in these surgeries.  They're considered among the best orthopedic surgeries every performed.

I treat a ton of THA (total hip arthroscopy) and TKA (total knee arthroscopy).  99% of my patients do very well and say they wish they would have done the surgery earlier. 

The other 1% you ask?  They're usually the people that were in poor health to begin with and weren't compliant with their exercises.

However, that's not to say it's an easy road to full function.

Many patients I work with have predictable impairments after these surgeries.  The ones that correct these usually return to full recreational activities, better than before the surgery.  The ones that don't, still do well, but don't fully get back to their recreational activities.

In other words, it's correcting the cause and result of the injury prior to the total joint replacement that dictates outcome for the high level clients.  The surgery fixes what's broken.  It doesn't fix why it broke or the result of moving with pain for months/years.

In a study in 2005, Bhave found the following common problems post-op.  These are problems I often see in the clinic and need to be corrected.

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A Note on Surgeons and Expectations

I've worked with some great surgeons.  They perform phenomenal interventions that drastically improve people's lives.  They take people who can't move and are on their way to severe morbidity and early mortality and give them back their functional life.  They do some powerful work.

That said...

It's important to know what they're selling.  And we all sell.  Especially surgeons.

If Ben & Jerry's Ice Cream was labeled as, "enjoy this dessert that will help make you fat, increase inflammation, cause heart disease and metabolic syndrome with long term use, and destroy your teeth", then it might not as be a top seller.  Or maybe it would?  People still buy cigarettes...but I digress..

(side note: I love Ben & Jerry's Ice Cream.  It is wonderful in small doses)

My point is that surgeons are the same way.  Not as many people would go through surgery if they said, I can save your hip or knee, but you're going to be in a lot of pain for 2 weeks, have difficulty walking and climbing stairs for 4-8 weeks, you'll have to work to return to sport for 6 months, and it'll probably be a year until you aren't aware of it.

That wouldn't be a good sell.

Again, the point of this is not to say joint replacements are bad.  They're not.  They're a modern medical miracle.  It's just to say expectations need to be managed (since it is a predictor of outcomes)

Another Note on Surgery

In the above studies there is a percentage of patients with malalignment.

This is very rare with good surgeons (probably less than 1% with the best surgeons).

If your surgeon performs a ton of replacement surgeries each year, has good outcomes, and a positive reputation in the community, then you likely have nothing to worry about.

The above statistic includes the general surgeons in rural areas that aren't specialists.

So make sure you find a good surgeon.  Ask your friends.  Ask a physical therapist in the community.


Sometimes knowing the problem before it arises can prevent it, or at least reduce its duration.

Getting an assessment before the replacement puts you ahead of your peers.

Furthermore, working to fix these impairments puts you in a position to return to the full retirement life you had in mind.

If you are unsure about these impairments or want to ensure a full recovery after your joint replacement, give us a call here in Asheville.