Anthony Lapinsky, MD, is a board-certified and fellowship-trained orthopedic surgeon with Advanced Spine and Orthopedics in Gilford and Rochester, New Hampshire. Dr. Lapinsky has over 25 years of expertise in contemporary orthopedic care, specializing in surgeries for degenerative and traumatic conditions, including minimally invasive robotic-assisted joint replacement, comprehensive fracture management, and spine care.
Here, Dr. Lapinsky answers some common questions about what to expect from total joint replacement surgery:
Q: What is an orthopedic surgeon?
A: Orthopedic surgeons, also known as orthopedists, specialize in preventing, diagnosing, and treating injuries and disorders associated with bones, joints, ligaments, tendons, muscles, and other areas of the musculoskeletal system. Some orthopedic surgeons treat a wide range of conditions and others specialize in certain areas. Common orthopedic ailments include:
- Sports-related injuries
- Neck and lower back pain
- Trauma, including fractures
- Osteoarthritis
- Congenital defects
- Scoliosis
Q: What is a total joint replacement?
A: Total joint replacement, also called total arthroplasty, refers to the surgical removal of a body’s natural joint. The surgery typically takes a few hours, as worn or damaged bone and cartilage of the joint is surgically replaced with an artificial prosthetic implant that is made of titanium, cobalt-chromium alloys, plastic, or ceramic. Total joint replacements are possible for both hinged joints like the knee and ball-and-socket joints like the hip and shoulder. The hip and knee joints are the most commonly replaced, followed by joints in the shoulders, elbows, ankles, and wrists.
Q: What would lead an orthopedic surgeon to recommend a total joint replacement?
A: Total joint replacement usually is recommended when non-surgical treatments like physical therapy and medication fail to adequately address a patient’s symptoms. Often, people experience symptoms like:
- Severe pain or swelling in or around the joint
- Reduced range of motion in the joint
- Instability or loss of balance
Patients who suffer from progressive osteoarthritis or rheumatoid arthritis often benefit greatly from total joint replacement. In these cases, the protective cartilage that cushions a joint begins to degenerate or may be damaged by inflammation. The result can be painful, with the bones of the joint either rubbing together or even becoming fused together. Total joint replacement often is the best solution to help alleviate this severe discomfort.
In addition to arthritis, total joint replacement may be recommended following a severe injury or accident, such as a sports-related fracture, severe fall, or a vehicle accident.
Q: What joints do you perform total joint replacement on and do you offer minimally invasive options?
A: Most commonly, total joint replacements are performed on the knee, hip, and shoulders, though other joints can be replaced, as well. Whenever possible, surgery is done as a minimally invasive procedure, meaning the surgeon makes one or more small incisions near the joint and uses a robotic device to guide specialized surgical tools using a sophisticated computer. This helps protect the surrounding tissue and exposes the joint by temporarily moving tendons and ligaments, without the need to cut through them. The artificial joint used in minimally invasive is identical to the joint used in traditional joint replacement surgery.
Additional benefits of minimally invasive robotic surgery include:
- Greater precision in positioning the replacement joint
- Faster, less painful recovery time
- Lower risk of infection
- Less loss of blood
- Decreased hospital stay
Q: Are there alternatives to surgery?
A: The majority of patients initially diagnosed with mild to moderate joint pain will first be prescribed physical therapy and/or medication to help address their discomfort. For many, this alleviates or minimizes their pain, allowing their natural joint to continue functioning for months or years to come. When pain increases or the joint is more severely damaged, total joint replacement surgery may then be recommended.
Q: Generally, what are the risks of total joint replacement?
A: In general, total joint replacement surgeries are considered lower risk but, like all surgeries, there are some potential complications to consider, including:
- Risk of infection
- Blood clots
- Damage to surrounding nerves or arteries
- Improper positioning of the prosthetic device
- Issues with wound healing after surgery
In addition, minimally invasive total joint replacement surgery may not be an option for all patients. Candidates best suited for minimally invasive surgery are those who are in good overall health, not overweight, and are motivated to follow through with post-surgical physical therapy. Patients who are obese, had prior surgery on the same joint, or who have other health-related conditions, like diabetes, may not be recommended for total joint replacement.
Q: What is recovery like from a total joint replacement?
A: It can take several weeks to a few months to fully recover from total joint replacement surgery. Recovery time is different for everyone and depends on which joint was replaced, your normal level of activity, your age, and your overall health. Your care team will give you specific rehabilitation instructions based on the type of joint replacement you have, but recuperation may include:
- Icing your joint for about 20 minutes a few times a day to reduce pain and swelling
- Elevating your joint
- At-home exercises to help reduce stiffness and build strength around your new joint
- Physical therapy to further enhance recovery
Most patients find that their quality of life improves immensely following total joint replacement surgery, allowing them to continue living a healthy, active lifestyle.
Dr. Lapinsky welcomes new patients at Advanced Spine and Orthopedics, with locations in the Lakes Region and the Seacoast.
To schedule a consultation with Dr. Lapinsky, call (603) 522-6163.