Arthritis Symptoms and Joint Replacement

Hip and knee replacements are some of the most common surgical procedures, with over 1 million Americans undergoing joint replacements each year. Antonia F. Chen, MD, MBA, describes common arthritis symptoms, and treatment options including joint replacement surgery. Dr. Chen is a Mass General Brigham orthopedic surgeon and director of arthroplasty research at Brigham and Women's Hospital.

What is arthritis?

Both osteoarthritis and rheumatoid arthritis are conditions that can affect your joints and cause joint pain, stiffness, and swelling. Over time, this can cause cartilage damage. Cartilage is a smooth tissue that protects the movement of the joint. As arthritis progresses, the cartilage continues to break down, causing more pain and reduced range of motion. “While we can't cure arthritis, there are definitely ways that we can treat the pain associated with arthritis,” says Dr. Chen.

What are common arthritis symptoms?

Common symptoms of arthritis include:

• Swelling

• Stiffness

• Pain

• Limited range of movement

Managing arthritis pain

There are nonsurgical options available if you want to reduce the pain associated with arthritis. Eating healthy foods and losing weight can be a good place to start. "One pound off the body is 4 pounds off the hip and knee. I always tell patients to celebrate when they take 1 pound off, because that’s 4 pounds off of all their joints. This makes them feel better and can help them move better too," says Dr. Chen.

Other non-surgical treatment options include:

• Over-the-counter medications, like Tylenol or anti-inflammatories (such as ibuprofen), to manage the pain

• Joint injections like steroids or hyaluronic gel

• Low-impact strength training to strengthen the muscles to support your joints

Arthritis and joint replacement

“If your joint pain persists after trying these options, and you can't do your daily activities, it might be time for you to get your joint replaced,” says Dr. Chen.

The most common arthritis joint replacement procedures are:

• Hip replacement

• Knee replacement

• Partial knee replacement (depending on where your arthritis is located)

Hip replacement surgery

If you have hip arthritis, the cartilage in the ball and socket joint wears away. During a hip replacement, your surgeon makes an opening from the front, the side, or the back of your hip. They remove the ball and resurface the socket. They then place a new socket, liner, ball, and stem in your hip.

Knee replacement surgery

If you have knee arthritis, the cartilage between your thigh bone, shin bone, and kneecap wears away. During a knee replacement, your surgeon makes an opening to the front of the knee. They remove the damaged cartilage, replace it with metal, and add a plastic insert in the middle of the joint that allows your knee to glide smoothly. Depending on where your arthritis is located, your surgeon also may remove the back part of your kneecap and replace it with plastic.

Joint replacement surgery recovery

Everyone's recovery is different, but most patients can walk with an assistive walking device immediately after their surgery. These devices can include:

• Walkers

• Canes

• Crutches

“The most important thing to do is to move as much as possible after surgery,” Dr. Chen says. “Walking is a great option. Not only does it make your mobility better, but it also reduces your risk of blood clots.”

Following surgery, you need to do exercises either on your own or with a physical therapist. A physical therapist can develop a routine targeted to your needs to help you recover from your surgery.

Your muscles and tissues need time to heal after surgery, and it can take up to 1 full year for a recovery. “A joint replacement can be a life-changing event. It can give your mobility back and allow you to do your favorite activities,” says Dr. Chen.