Knee and Hip Osteoarthritis, Replacement Surgery

Knee osteoarthritis occurs as a result of the wear and tear of the cartilage structures in the knee. Factors such as genetic predisposition, excess weight, rheumatism, and trauma contribute to the deterioration of the cartilage.

There are two important criteria for knee replacement surgery: 1. If the patient’s pain-free walking distance falls below 300 meters. 2. If nighttime pain progressively increases.

Since our knees bear the body’s weight, patients who lose weight often experience a reduction in pain.

Walking can be beneficial, but walking for more than 45 minutes may do more harm than good. It is recommended to wear orthopedic shoes and walk on flat surfaces.

The surgical procedure itself takes between 45 minutes and 1 hour. Including preparation and recovery time in the operating room, the total duration is approximately 2 to 2.5 hours.

Patients are encouraged to walk the day after surgery.

Patients can start using stairs within one to two days after surgery.

Patients are admitted to the hospital on the day of surgery and typically stay for 2-3 days.

If the prescribed exercises are performed regularly, physical therapy may not be necessary. However, in overweight or elderly patients who are less active, physical therapy may be recommended.

This is not a common situation. However, in patients who are severely overweight, very elderly, or have advanced osteoporosis, or if a fracture occurs during surgery, prolonged difficulty in walking may rarely occur.

Your pain will significantly decrease. As your body adapts to the prosthesis over time, you will eventually have a pain-free knee joint.

It is made of cobalt-chrome and polyethylene infused with vitamin E.

On average, it lasts for 25 years. However, this duration can vary depending on body weight and how the knee is used.

Your height-to-weight ratio is important for surgery. Overweight patients are advised to lose weight. Maintaining an ideal weight after surgery is crucial for knee health and also extends the lifespan of the prosthesis.

Yes, you can. Revision surgeries performed by an experienced team have a high success rate.

Yes, it is recommended to have a caregiver stay with you during your hospital stay.

The incision is approximately 15 cm long. Since aesthetic stitches are used, there is no need for stitch removal. After discharge, dressings should be changed every three days.

Patients are usually admitted to the hospital early in the morning on the day of surgery, and the operation is performed 2–3 hours after admission.

After discharge, your surgical site will be covered with a special waterproof dressing, allowing you to shower as soon as you get home.

Approximately 4–6 weeks after surgery.

If the patient’s overall health condition is suitable, both knees can be replaced simultaneously.

Pain relievers and blood thinners will be prescribed. Your medication will be re-evaluated at your follow-up appointment two weeks later.

The prosthetic material used is compatible with MRI machines, so you can safely undergo an MRI scan.

Hip replacement surgery involves removing the damaged joint surfaces and placing artificial components that will perform the function of the hip joint.

On average, hospital stay after hip replacement is 2–3 days, depending on your overall condition and the surgical technique used. Our preferred tissue-respecting technique allows you to stand and walk on day 1, sit on the toilet and use stairs on day 2, and be discharged walking smoothly with a single crutch on day 3.

In most cases full weight bearing is allowed immediately, but depending on the technique and implant your surgeon may ask you to walk with partial weight bearing for a period of time.

Crutch use is typically required for about 3–6 weeks. This duration may vary based on the surgical approach, the implant used, and your individual health.

To ensure durability and longevity, various metals have been combined with polyethylene and ceramic over the years. Your surgeon will select the most suitable materials for your case.

When inflammation occurs in the hip joint and persists, it leads to destruction (wear) of the cartilage. Cartilage cannot regenerate, so it thins and the underlying bone is exposed and rubs together. This irritates nerve endings, causing severe pain and creaking sounds. Over time movement becomes restricted and leg-length discrepancy may develop.

The main complaint is pain, usually felt in the groin and thigh, and sometimes on the inside of the knee. At first it worsens with activity (walking) and eases with rest. As the disease progresses, the pain-free walking distance shortens and night pain indicates end-stage disease.

Genetics play a significant role in some forms. Other risk factors include prior trauma or accidents, excess weight, heavy labor, hip dislocation, leg-length discrepancy, and femoral head avascular necrosis—which itself can result from steroid use, hip fractures, blood disorders (e.g., sickle cell anemia), or heavy alcohol use.

A diagnosis is typically based on your history and physical exam, and is confirmed by X-ray. In some cases—such as early avascular necrosis—an MRI may be ordered for differential diagnosis.

Painkillers can help in the early stages but are not curative. In advanced stages pain often persists despite medication, and chronic use may harm organs such as the stomach, kidneys, and liver.

Generally, fit individuals with no other joint issues and a normal weight tolerate osteoarthritis better and recover faster after surgery. However, exercise alone cannot prevent osteoarthritis.

Hip replacement is recommended to relieve pain and improve quality of life. It should be considered if pain persists despite conservative treatments (medication, exercise, etc.), interferes with daily activities, disrupts sleep, or impacts social life.

The timing depends on your symptoms and lifestyle. If pain does not significantly affect you, surgery can be postponed. But if pain is present, it’s time to consider surgery. Although more common after age 60, hip replacement can be performed in younger patients when other options fail.

The condition will not improve on its own and cannot be cured by pills or physical therapy. Pain worsens over time, leg-length differences and abnormal gait develop, pain may spread to the back and knees, and medications can cause organ damage. A timely surgery would have been much simpler.

There are two main approaches: conventional (15–20 cm incision) and minimally invasive (smaller incision). The minimally invasive approach may reduce hospital stay and transfusion needs but can increase the risk of implant malposition, dislocation, periprosthetic fractures, and nerve injury due to limited visibility. The primary goal is pain-free function; cosmetic concerns are secondary.

Surface arthroplasty is used in femoral head avascular necrosis when the socket (acetabulum) is unaffected. A metal implant is placed on the femoral head to create a new joint surface, preserving bone stock. Success rates are around 60–70 %, and it allows for future total hip replacement if needed.

Long-term success rates are around 90 %. Most patients are pain-free, walk without crutches, and can perform low-impact activities.

Like any body structure, a prosthesis has a lifespan. Depending on use, materials, and surgical quality, most hip implants last 20–25 years without issues.

A revision surgery replaces the old implant with a new one. Although more extensive than the primary operation, revision outcomes are generally good.

No surgery is risk-free. Main risks include infection, blood clots (embolism), bleeding, anesthesia-related or medication-related complications, dislocation, implant loosening, and periprosthetic fractures. The overall complication rate is about 5 %, and most can be prevented with proper pre- and postoperative care (blood thinners, compression stockings, antibiotics, etc.).