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Move What Moves YouYour guide to knee and hip pain relief

Joint pain can put the brakes on a lot of life’s more enjoyable activities. Because it often worsens slowly over time, you may not even notice at first that you’ve been limiting your participation in activities as your pain increases.

• Do you rely on your spouse to walk the dog because extra walking isn’t worth the discomfort?

• Have you given up a regular golf date or a favorite hobby because of pain when you move?

• Is planning a vacation trip unappealing because of the amount of walking involved?

• If you forget something upstairs, does the thought of having to climb back up to retrieve it discourage you?

• Are you waking up at night because your knee or hip hurts?

You may feel your options are becoming more limited due to uncomfortable movement, and pain may be draining some of your enthusiasm for staying active — often a key to a longer, healthier life.

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Exceptional care and convenience

As the No. 1 hospital in Oregon, OHSU’s partnership with Tuality Healthcare brings world-class care to a convenient location for you.

Our hip and knee experts use minimally invasive joint replacement surgery techniques backed by leading-edge research and technology. Our goal is to restore your full range of movement, reduce your pain and help you quickly recover from surgery.

High surgical volumes and unparalleled expertise

Our fellowship-trained joint replacement surgeons have performed thousands of surgeries in their combined careers.

“Fellowship-trained” means they’ve had extensive additional training in hip and knee replacement. Since they’ve performed so many surgeries, they have in-depth experience with routine and complex surgeries.

Convenient care in your community

OHSU hip and knee surgeons have clinics in three locations around Portland to make your pre- and postoperative visits convenient for you. We can usually schedule a joint evaluation within a week of your call.

Latest joint replacement innovations

Our joint replacement surgeons are constantly testing and developing new procedures and artificial joints. We use surgical technology that has been proven to show benefits for patients.

Best possible care before and after your procedure

Our anesthesiologists, pain specialists, physical therapists and nurses help shorten your hospital stay and speed your recovery.

Fast facts about joint replacement

• More than 7 million Americans have had hip or knee replacements.*

• Nearly half of American adults develop knee osteoarthritis in at least one knee in their lifetime, according to the Centers for Disease Control.

• About 87 percent of knee replacement operations are to relieve symptoms caused by osteoarthritis.*

• Almost 70 percent of hip replacement operations are to relieve symptoms of osteoarthritis. About 10 percent of hip replacements are to treat a hip fracture.*

• According to the American Academy of Orthopedic Surgeons, serious complications occur in less than 2 percent of cases.

* S O U R C E : American Joint Replacement Registry

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Are you a candidate for joint replacement?

If your joint pain is preventing you from doing the activities you enjoy or tasks you need to complete, it’s time to get an evaluation.

You may be able to get enough relief from physical therapy, diet, exercise, medication, steroid injections or other minimally invasive approaches to get the quality of life you desire. However, if these conservative methods are unsuccessful or the arthritis increases, joint replacement surgery is a highly effective way of reducing joint pain and helping improve mobility and quality of life.

You could be a candidate for total joint replacement if:

• Your pain and loss of mobility affects your ability to function in your daily life.

• Conservative methods don’t relieve your pain/swelling. • Imaging (such as X-rays) shows advanced arthritis or other

joint problems. • You are healthy enough to undergo surgery and participate in

rehabilitation.

How did I get here?

The most common causes of joints not working properly are osteoarthritis (caused by wear-and-tear) and rheumatoid arthritis (an autoimmune disorder). While nobody is certain what causes arthritis, several factors may play a part, including:

• Family history • Overuse

or repetitive minor injuries • Trauma or major injury • Increased body weight

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What is total hip replacement? The hip joint connects the upper end of your thigh bone (femur) to the hip (pelvis). A “ball joint” on the end of your femur fits into the socket of the hip. Both ends are covered in cartilage (a smooth lining that protects the joint).

When the cartilage in your hip wears out, the bones can rub together, causing hip pain.

During hip replacement surgery, the worn-out or damaged cartilage is removed from the hip joint and upper thigh bone, and replaced with artificial parts. This restores the smooth surface of your hip joint and helps it move without pain.

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What is total knee replacement? Your knee joint is made up of:

• The lower end of the thigh bone (femur). • The top of the shin bone (tibia). • The knee cap. • Cartilage (a smooth lining that protects the joint).

When cartilage wears out, the bones rub against each other and can cause pain in your knee.

During total knee replacement surgery, the worn-out or damaged cartilage is removed and replaced with metal and plastic parts. This restores the smooth surface of your knee joint and helps it move without pain.

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Getting going again You will be up and moving right after your joint replacement surgery. In fact, a physical therapist will have you walking the same afternoon as your surgery. At OHSU, we use rapid recovery protocols, and moving after surgery is an important part of a quick, successful recovery.

The other key is reducing or avoiding the use of opiates. Instead, we use a variety of other medications to reduce swelling and pain. By following these two methods, data show people have fewer problems and get back to their normal lives quicker.

Many joint replacement patients go home the same day as the surgery with an at-home exercise plan. Knee patients start physical therapy about a week after surgery. By the end of therapy, there are generally no restrictions on activities, and you can return to your favorite pastimes, such as golf, tennis, hiking and more. Most of your healing will happen within three months, however, you may continue to improve for up to a year after surgery.

Precautions for high-impact activities

You may want to give contact sports (tackle football, basketball) a miss, but many other high-level activities, such as skiing or tennis, are possible after hip or knee replacement. You’ll need to use caution and learn the correct postures for activities that involve strength and flexibility training.

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W H E N C A N I … ?

Climb stairs? Many patients can climb stairs before leaving the hospital.

Drive?Depending on the type of vehicle and which leg (right/left) some patients can return to driving in one to two weeks, while others need up to six weeks before driving.

Go back to work?Depending on the type of activities you do on the job and the speed of your recovery, it may take from several days to several weeks before you are able to return to work.

Start low-impact fitness/athletics?

You can try swimming, distance walking, hiking, bicycle riding, golfing and other low-impact sporting activities after a few weeks of rehabilitation and recovery.

Take an airplane flight? You can travel on an airplane six weeks after you surgery.

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Frequently asked questions about joint replacement

What will my evaluation include?

Your joint specialist will review your personal medical history with you and complete a physical exam. You may need to get an X-ray of your joint.

How long will my new joint (hip or knee) last?

The average life span of these medical implants varies depending on your age, weight, activity level and overall health. We will work with you to pick the best implant that meets your goals and activity level.

Will my health insurance provider pay for this?

Private insurance varies. It’s important to review your benefits plan to understand your deductible, which providers are in your insurance network and covered services. Medicare typically pays 100 percent of inpatient charges related to a procedure and the hospital stay once you’ve reached your deductible. Medicare typically pays 80 percent of the outpatient service charges (such as physical therapy) for its members.

Does OHSU offer private rooms?

Yes, joint replacement patients have private rooms at both our Marquam Hill and Tuality hospitals to reduce the risk of infection and to allow nurses and other members of your medical team to provide you with the very best care.

How many physical therapy sessions will I need?

You will receive some physical therapy during your time in the hospital. Most hip replacement patients do not need formal physical therapy; however, this is available as needed. Most knee replacement patients will have four to six weeks of physical therapy at an outpatient clinic.

I’m worried about taking opioids and narcotics; is that what I’ll need?

At OHSU, we use a variety of pain control methods to avoid or limit the use of opiate pain medicines. This strategy involves less invasive surgical procedures, improved patient education, and combining anti-inflammatory and nonnarcotic medications.

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Frequently asked questions about joint replacement

Will I need help at home?

Yes. We recommend that all patients have someone available to assist them for the first two weeks after surgery.

Will I need a walker, crutches or cane?

We recommend all patients begin by using a front-wheeled walker immediately following surgery. Patients generally progress from a walker to a cane to walking solo.

Will my new knee or hip set off security sensors when traveling?

Security devices may or may not detect the metal alloy in the medical implants used in joint replacement. Inform the security agent you have a metal implant.

Will I have a scar?

If you have a knee replacement, surgical scars vary in length, but our surgeons will make it as short as possible. It will be straight down the center of your knee. There are a number of different techniques used for hip replacement surgery and the type of technique will determine the exact location and length of the scar.

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Thomas Huff, M.D. ↗

Ryland Kagan, M.D. ↗

Thomas Kowalik, M.D. ↗

Kathryn Schabel, M.D. ↗

Meet our surgeons

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Schedule an appointment

OHSU Center for Health & Healing Map ↗

Orthopaedic Clinic3303 S.W. Bond Ave., 12th floorPortland, OR 97239

Surgeons at this location:• Thomas Huff, M.D.• Ryland Kagan, M.D.• Kathryn Schabel, M.D.

OHSU Beaverton Map ↗

Orthopaedic Clinic15700 S.W. Greystone CourtBeaverton, OR 97006

Surgeons at this location:• Ryland Kagan, M.D.• Kathryn Schabel, M.D.

Portland and Beaverton

503-418-8889www.ohsu.edu/totaljoint

Hillsboro

503-844-8219www.tuality.org/ortho

OHSU Tuality Healthcare Map ↗

Orthopedics and Physical Medicine Clinic1200 NE 48th Ave., Suite 1100Hillsboro, OR 97124

Surgeon at this location:• Thomas Kowalik, M.D.

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OHSU3181 S.W. Sam Jackson Park Rd.

Portland, OR 97239www.ohsu.edu

OHSU accepts most health plans. OHSU is an equal opportunity, affirmative action institution.