Q: Are there new methods for controlling the pain of total hip and knee surgery?

A: Total knee and total hip replacements are two of the most successful procedures in all of medicine.  However, many patients with arthritis are very concerned about pain after surgery and even more about the pain of recovery.

There ARE newer approaches to limit pain before, during, and after surgery.

1. An exercise program PRIOR to surgery, designed for the individual patient.
2. Using oral pain and anti- inflammatory medicine BEFORE surgery to block pain sensation nerves even before the operation.
3. Regional anesthesia during surgery which can completely block pain after surgery for 24 hours as oral medications are restarted.
4. Using local anesthesia injection to further block pain fibers just before the surgical incision is made.
5. Injection of longer acting local anesthesia into the lining of the new joint at the end of surgery.
6. A steady level of oral pain and anti-inflammatory medication after surgery until no longer needed.
7. Starting appropriate exercises and walking-immediately after surgery.

Other factors reducing the level of discomfort after joint surgery:

1. Minimally invasive surgical methods.
2. Not damaging tissues below the skin.
3. Not cutting into or detaching muscles and tendons.
4. Using computer navigation to size and implant the artificial joint parts as accurately as possible.
5. Afterwards, using a HOME based exercise program which encourages patients to be independent of “physical therapy”, work at their own pace, and avoid being pushed to the point of pain.

In all, joint replacement surgery can be a more comfortable experience than in the past, at the same time relieving chronic arthritic pain and disability.