By Debra Johnston, MD
Almost every workday, a few of us doctors congregate in the hospital cafeteria for lunch. Often we are joined by a medical student or two, doing their rural rotations. Our conversations may span a variety of topics, but when the students are with us, we particularly relish discussing the changes we’ve seen over our careers.
Recently, inspired by the student going into orthopedics, our trip down memory lane involved hip and knee replacements. As a student myself, I was enthusiastic to do my orthopedic rotation. I’d made a detailed model of a hip prosthesis in one of my undergraduate courses, analyzing stresses and failure points, and I was eager to see how those ideas played out in the operating room. One look at the instruments laid out on that sterile field, and I got a cold dose of reality. They looked like things that should be used on airplanes, not the delicate human body!
As a student in the 1990s, I learned that hip replacements reliably lasted about 10 years. When my orthopedic residents learned that Heisman trophy winner Bo Jackson had a hip replacement at 30, and gone back to professional sports, they seemed aghast (to be fair, none of us knew any details). Not only was he young, but the impact of his athleticism would put significant stresses on that prosthesis, all but guaranteeing it would fail sooner rather than later. Redoing a joint replacement was, and still is, a tricky proposition.
In those days, getting a hip or knee replacement involved long stays in the hospital, and possibly a discharge to the nursing home for ongoing rehabilitation. You might not even get out of bed for a day or two! It was common to need transfusions. It was common to develop blood clots. Pain could be significant. Major muscles and tendons were cut, so recovery was slow. Still, most people ultimately told me they were glad they’d had it done.
Today, thanks to advances in surgical techniques and pain control options, patients are likely to go home with their new knee or hip the same day it is put in. Make no mistake, recovering from the procedure is still a lot of work! And recovering at home presents some logistical challenges not present in the hospital. Will you need to climb stairs to get to the bedroom or the bathroom or the kitchen? How will you bathe? How will you get to physical therapy? Who will help you get that ice machine filled, set up, and then emptied? Recovery still takes longer than most people expect, and that new joint still isn’t perfect.
Nevertheless, most people still tell me it was worth it
Dr. Debra Johnston s a Family Medical Physician at Avera Medical Clinic in Brookings, SD. She serves as a volunteer host for the Prairie Doc® team, which is currently celebrating its 25th season of providing health education based on science and built on trust. Follow us on Facebook, Instagram, YouTube, and TikTok to stay connected. Our programming includes the medical Q&A show On Call with the Prairie Doc® (most Thursdays at 7pm on YouTube, and Facebook), along with two podcasts and a weekly radio program (Sundays at 6am and 1pm on SDPB).