Information Source on Joint Replacement



Joint Replacement Surgery

Be an Informed Consumer - Ask Questions Before You Have Joint Replacement Surgery. Learning about your operation will help you make better decisions about your health care.

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If you facing surgery . . . you are not alone. Millions of Americans have surgery each year. Most operations are not emergencies. This means you have time to ask your surgeon questions about the operation and time to decide whether to have it or not. The information presented here does not apply to emergency surgery.

The most important questions to ask about elective surgery are why the procedure is necessary for you and what alternatives there are to surgery. If you do not need to have the operation, then you can avoid any risks that might result. All surgeries and alternative treatments have risks and benefits. They are only worth doing if the benefits are greater than the risks.

Your primary care doctor, may be the one who suggests that you have surgery and may recommend a surgeon. You may want to identify another independent surgeon to get a second opinion. Check to see if your health insurance will pay for the Joint Replacement Surgery and the second opinion. If you are eligible for Medicare, it will pay for a second opinion. You should discuss your insurance questions with your health insurance company or your employee benefits office.

Overview for Joint Replacement

Before you have Joint Replacement surgery, as your surgeon the following 12 questions and the reasons for asking them. The answers to these questions will help you be informed and help you make the best decision.

Your doctors should welcome questions. If you do not understand the answers, ask the doctors to explain them clearly. Patients who are well informed about their treatment options are more satisfied with the outcome or results of their treatment.

1. What Joint Replacement operation are you recommending?
Ask your surgeon to explain the joint replacement surgical procedure. For example, if something is going to be repaired or removed, find out why it is necessary to do so. Your surgeon can draw a picture or a diagram and explain to you the steps involved in the procedure.

Are there different ways of doing the joint replacement operation? One way may require more extensive surgery than another. Ask why your surgeon wants to do the joint replacement operation one way over another.

2. Do I need the operation?
There are many reasons to have surgery. Some operations can relieve or prevent pain. Others can reduce a symptom of a problem or improve some body function. Some surgeries are performed to diagnose a problem. Surgery also can save your life. Your surgeon will tell you the purpose of the joint replacement procedure. Make sure you understand how the proposed joint replacement operation fits in with the diagnosis of your medical condition.

3. Are there alternatives to joint replacement surgery?
Sometimes, surgery is not the only answer to a medical problem. Medicines or other nonsurgical treatments, such as a change in diet or special exercises, might help you just as well or more. Ask your surgeon or primary care doctor about the benefits and risks of these other choices. You need to know as much as possible about these benefits and risks to make the best decision.

One alternative may be "watchful waiting," in which your doctor and you check to see if your problem gets better or worse. If it gets worse, you may need surgery right away. If it gets better, you may be able to postpone surgery, perhaps indefinitely.

4. What are the benefits of having the joint replacement operation?
Ask your joint replacement surgeon what you will gain by having the operation.

Ask how long the benefits are likely to last. For some procedures, it is not unusual for the benefits to last for a short time only. There might be a need for a second operation at a later date. For other procedures, the benefits may last a lifetime.

When finding out about the benefits of the joint replacement operation, be realistic. Sometimes patients expect too much and are disappointed with the outcome, or results. Ask your doctor if there is any published information about the outcomes of the procedure.

5. Are there risks from the joint replacement operation?
All operations carry some risk. This is why you need to weigh the benefits of the operation against the risks of complications or side effects.

Complications can occur around the time of the operation. Complications are unplanned events, such as infection, too much bleeding, reaction to anesthesia, or accidental injury. Some people have an increased risk of complications because of other medical conditions.

In addition, there may be side effects after the joint replacement operation. For the most part, side effects can be anticipated. For example, your surgeon knows that there will be swelling and some soreness at the site of the operation.

Ask your surgeon about the possible complications and side effects of the joint replacement operation. There is almost always some pain with surgery. Ask how much there will be and what the doctors and nurses will do to reduce the pain. Controlling the pain will help you be more comfortable while you heal, get well faster, and improve the results of your operation.

6. What if I don't have this joint replacement operation?
Based on what you learn about the benefits and risks of the operation, you might decide not to have it. Ask your surgeon what you will gain or lose by not having the operation now. Could you be in more pain? Could your condition get worse? Could the problem go away?

7. Where can I get a second opinion?
Getting a second opinion from another doctor is a very good way to make sure having the joint replacement surgery is the best alternative for you. Many health insurance plans require patients to get a second opinion before they have certain non-emergency operations. If your plan does not require a second opinion, you may still ask to have one. Check with your insurance company to see if it will pay for a second opinion. If you get one, make sure to get your records from the first doctor so that the second one does not have to repeat tests.

8. Check Surgeon's experience in doing the joint replacement surgery?
One way to reduce the risks of surgery is to choose a surgeon who has been thoroughly trained to do the procedure and has plenty of experience doing it. You can ask your surgeon about his or her recent record of successes and complications with this procedure. If it is more comfortable for you, you can discuss the topic of surgeons' qualifications with your regular or primary care doctor.

9. Where will the joint replacement surgery be done?
Most surgeons practice at one or two local hospitals. Find out where your operation will be performed. Have many of the operations you are thinking about having been done in this hospital? Some operations have hipher success rates if they are done in hospitals that do many of those procedures. Ask your doctor about the success rate at this hospital. If the hospital has a low success rate for the operation in question, you should ask to have it at another hospital.

Until recently, most joint replacement surgery was performed on an inpatient basis and patients stayed in the hospital for 1 or more days. Today, a lot of surgery is done on an outpatient basis in a doctor's office, a special surgical center, or a day surgery unit of a hospital. Outpatient surgery is less expensive because you do not have to pay for staying in a hospital room.

Ask whether your joint replacement surgery will be done in the hospital or in an outpatient setting. If your doctor recommends inpatient surgery for a procedure that is usually done as outpatient surgery, or just the opposite, recommends outpatient surgery that is usually done as inpatient surgery, ask why. You want to be in the right place for your operation.

10. What kind of anesthesia will be used?
Anesthesia is used so that surgery can be performed without unnecessary pain. Your surgeon can tell you whether the operation calls for local, regional, or general anesthesia, and why this form of anesthesia is recommended for your procedure.

If you decide to have an operation, ask to meet with the person who will give you anesthesia. Find out what his or her qualifications are. Ask what the side effects and risks of having anesthesia are in your case. Be sure to tell him or her what medical problems you have including allergies and any medications you have been taking, since they may affect your response to the anesthesia.

11. Recovery Time from the joint replacement surgery?
Your surgeon can tell you how you might feel and what you will be able to do or not do the first few days, weeks, or months after surgery. Ask how long you will be in the hospital. Find out what kind of supplies, equipment, and any other help you will need when you go home. Knowing what to expect can help you cope better with recovery.

Ask when you can start regular exercise again and go back to work. You do not want to do anything that will slow down the recovery process. Lifting a 10-pound bag of potatoes may not seem to be "too much" a week after your operation, but it could be. You should follow your surgeon's advice to make sure you recover fully as soon as possible.

12. Cost of joint replacement operation?
Health insurance coverage for surgery can vary, and there may be some costs you will have to pay. Before you have the operation, call your insurance company to find out how much of these costs it will pay and how much you will have to pay yourself.

Ask what your surgeon's fee is and what it covers. Surgical fees often also include several visits after the operation. You also will be billed by the hospital for inpatient or outpatient care and by the anesthesiologist and others providing care related to your operation.

Surgeons' Qualifications

You will want to know that your surgeon is experienced and qualified to perform the operation. Many surgeons have taken special training and passed exams given by a national board of surgeons. Ask if your surgeon is "board certified" in surgery. Some surgeons also have the letters F.A.C.S. after their name. This means they are Fellows of the American College of Surgeons and have passed another review by surgeons of their surgical practices.

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