Dr. Chris Pelt, a University of Utah orthopedic surgeon, talks about what patients can expect after a major joint replacement.">

Aug 16, 2016 — With the latest techniques and implants, younger people than ever before are replacing their joints with very few restrictions. Dr. Chris Pelt, a University of Utah orthopedic surgeon, talks about what patients can expect after a major joint replacement.

Interview

Dr. Miller: Can you do everything you always wanted to do after your knee or hip replacement? We're going to talk about that next on Scope Radio.

Announcer: Access to our experts with in-depth information about the biggest health issues facing you today, The Specialists with Dr. Tom Miller is on The Scope.

Dr. Miller: Hi. I'm here with Dr. Chris Pelt. He's an orthopedic surgeon in the Department of Orthopedics here at the University of Utah. Chris, what do you tell your patients after they've had a knee or hip revision or replacement? Can they do just about anything that they used to do or wanted to do but couldn't because of pain or limited range of motion?

Dr. Pelt: So, patients will undergo hip and knee replacements at younger ages than ever before today.

Dr. Miller: What is an average age, by the way?

Dr. Pelt: So, the average age is actually around the mid-50s, whereas, if you think about the 1960s, '70s, and '80s, when joint replacement was in its infancy, the average hip replacement or knee replacement would be done on patients in their upper 60s, 70s, and 80s, and that age has been pushed down further and further as our outcomes have improved with joint replacement surgery, and patients today are more active at a . . . later into life with higher intensity activities, and they really want to be able to do those things that they've always loved doing later into life, and so . . .

Dr. Miller: Well, I remember there used to be more restrictions, or at least thought to be restrictions, on what activities could be done following a joint replacement, but that's changed a little bit. That thinking has changed with the new, I guess, prosthetic devices. Is that right?

Dr. Pelt: Our implant technology has definitely improved over the years. Our bearings are wearing at a lower rate and lasting longer now, and, like I said, we're doing them in younger and younger patients who want to be more active. So, we used to tell patients that they should be more sedentary, that they should avoid doing certain activities, and as time has progressed, we've pretty much relaxed most of those restrictions on our patients. We have patients that snow ski 300 days out of the year if they can. They will . . .

Dr. Miller: What about playing tennis or racquet sports?

Dr. Pelt: They love to do it, and they will do it, and we tell them it's okay. There are some . . .

Dr. Miller: And they shouldn't worry that they're going to wear down that prosthetic joint?

Dr. Pelt: I don't think so, and if it did, there may a revision option available for them in the future, but we really haven't seen significant failures of our implants due to patients being more active. In fact, if anything, I think an overall patient's outcome is improved when they're more healthy and active into their later years as opposed to being sedentary. So, I would encourage most patients to be more active and do those fun things that they want to do, so, golfing, tennis, hiking, skiing.

Dr. Miller: Running is maybe one you're not so clear about?

Dr. Pelt: Running is the one activity I might tell a patient that if they did that as their activity of choice for exercise, that perhaps they could choose a lower impact activity.

Dr. Miller: Cycling?

Dr. Pelt: Cycling, swimming, elliptical, any of these would be lower impact and perhaps a little bit easier on the implant. But ultimately, we do have patients that still love to run. They run whether they're playing basketball or racquet sports, like you mentioned.

I've done a hip replacement on an 80-year-old woman who enjoyed running marathons, and she had come in to see us at our six-week appointment and had already run a half marathon, which is a little bit premature. We do have to let the implants grow into the bones, but people want to be active, and they will do things. When they feel better after having their arthritis pain relieved by the surgery, they will become active again, and we want to encourage them to do that.

Dr. Miller: So, if you're getting an implant, let's say at the age of 50, how long if you're still cycling or skiing might that implant last?

Dr. Pelt: We expect 15 years on the average for a knee replacement and maybe 30 years for a hip replacement, even when a patient's really active. The differences there have to do somewhat with the type of bearing, where a hip replacement is sort of a round against round, versus a round against flat bearing of a knee replacement. But many knee replacements we see back in follow-up at 20 plus years, still doing quite well, and many of these patients have been active for much of their lives.

Dr. Miller: Do you see the technology evolving in the future, where the implants will last even longer eventually?

Dr. Pelt: Yeah. I believe it's coming out soon. I mean, there's new improvements. May not be in the next 5 years, but perhaps in the next 10 years we'll see some improvements for longer-lasting bearings in implants as surface coatings and the types of materials that we're using start to improve. The bearings that we use may evolve slowly and continue to show improvements.

Announcer: Interesting, informative, and all in the name of better health. This is The Scope Health Sciences Radio.