Joint Replacement Surgery: An Interview with Dr. Demetri Economedes

Chronic pain in the knee or hip can be debilitating, making it difficult to enjoy an active life, perform daily tasks, or even get a good night’s sleep. When joint pain is prolonged, it can seriously diminish an individual’s quality of life. If you’re experiencing conditions like this, they’re likely not just physical. Severe arthritis can also be mentally and emotionally draining.

While a number of non-surgical and minimally invasive orthopaedic procedures are available to address knee and hip pain, some individuals are unable to get relief from these treatments. If you have reached this level, it may be time to explore joint replacement. Joint replacement surgery is an involved form of intervention, but it could bring pain relief in ways that other options cannot deliver.

Dr. Demetri Economedes is a board-certified orthopaedic surgeon at Cary Orthopaedics specializing in hip and knee replacement. In this interview, Dr. Economedes shares his expertise about partial and total joint replacement surgeries and answers patient questions.

What is the difference between a partial and total joint replacement?

Partial joint replacement really only pertains to knee replacement surgery. The knee is divided into three compartments; medial (inside), lateral (outside) and patellofemoral (kneecap joint). If a patient has degeneration in only one compartment and other indications are satisfied, they may be a candidate for partial knee replacement. It should be noted that this should not be viewed as a surgery to “buy time” prior to undergoing total knee replacement. There is very good data that these procedures, when done for the correct indications, will have similar longevity as a total knee replacement. A patient undergoing partial knee replacement can expect a shorter recovery compared to total knee replacement, as the surgery is less invasive. In total knee replacement, as can be assumed by the name, all compartments are replaced.

When should a patient consider joint replacement surgery?

A patient should consider joint replacement surgery if their activities of daily living are altered by the specific joint involved and after they have failed all conservative treatments including oral non-steroidal anti-inflammatories, injections and physical therapy. Additionally, imaging studies, such as X-Ray or MRI, should demonstrate severe arthritis prior to proceeding with replacement surgery.

Is there any age that is too young to consider joint replacement surgery?

The typical age of total joint replacement patients ranges from 50 to 80 years old, but we evaluate each patient individually. Unfortunately, age is a factor. An artificial joint is only as good as the mechanical bearing it contains, and the younger you are at the time the initial surgery occurs, the higher the likelihood of the joint “wearing out.” Younger patients may have to undergo a revision or “repeat” joint replacement surgery in the future. While age by itself is not a contraindication of joint replacement, the patient and his or her surgeon need to discuss the possibility of revision surgery.

Should a younger person on the verge of needing a joint replacement try to delay the surgery until years later?

While delaying surgery could potentially decrease the possibility of a revision procedure in the future, patients should ultimately determine if the time is right for surgery at a younger age. If you cannot participate in your everyday activities because of joint discomfort, and all conservative treatments have failed, it is likely time for an evaluation at the very least.

What is the life expectancy of an artificial joint?

Generally speaking, knee replacements last about 12-15 years, and hip replacements last 17-20 years. However, most studies are demonstrating that the newer liners in hip replacements appear to be wearing out at a much lower rate than previous iterations. Time will tell.

What is an artificial joint made of?

In knee replacements, generally, the femoral (thigh bone) component is made of a cobalt chrome alloy and the tibial (shin bone) component is made of titanium. There is a polyethylene insert (plastic) that goes in between both metal components. In hip replacements, the socket and thigh bone components are made of titanium. The liner is made of polyethylene (plastic), and the femoral head (ball in the ball in socket joint) is made of either metal or ceramic.

What is the typical recovery process?

Over the first 6 to 8 weeks, a patient will be 80% recovered. The remaining 20% will take about one year. Patients typically resume their activities beginning at six weeks postoperatively.

Are there any long-term changes a patient will experience?

We recommend that the patient discontinue any high-impact activities, as this could cause the polyethylene (plastic) to wear at a higher rate, possibly requiring early revision.

Why should a patient get joint replacement at Cary Orthopaedics vs. other practices in the Triangle?

At Cary Orthopaedics, we have specialists in total joint replacement who perform hundreds of these surgeries every year, including revisions. At the same time, we are an independently owned orthopaedic practice (not corporate or hospital owned), so we can provide a more personal level of care. Our physicians and medical staff take pride in developing relationships with our patients – from the initial consultation through attentive, customized care for years to come.

If you are experiencing hip or knee pain, schedule an appointment today with any of our general orthopaedic physicians or with Dr. Economedes for a joint replacement consultation.