FAQ - If your question is not answered above or see it listed here please email me with the link provided so I can answer and update this section.

Knee Replacement

  • I read your protocol but I am allergic to ___. Can I still have surgery?


  • We have alternative medications for antibiotics and pain control. We will be able to find something that will suit you and still accomplish the protocol listed above.




I had a bad experience with a spinal anesthesia before, do I have to do it?


  • No you don’t. You should play an active role in your care. That said, I strongly believe that a spinal anesthesia is a key part of accelerating early recovery and limited nausea and pain after surgery. A bad experience before does not mean you will have a bad experience this time around.




Why do I have to do all of these tests?


  • We need to make sure your health is as optimized as possible for surgery. Although the advancements we have made over the past 5-10 years are great. This is still a big surgery that carries with it risk. If we can reduce your risk even small amount it is worth it.




Why does my weight (BMI), diabetes control or nicotine use matter?


  • All of these are independent risk factors for infection and other complications. They are also things that can be modified to reduce your risk. If you get an infection it will require further surgery to fix, it is not something I take lightly.




I had a lot of pain with my knee replacement in 2007, what you described sounds very different.


Absolutely. Multimodal pain control, new implant technolog and less invasive surgical technique have made this surgery much different than it was even just 10 years ago. These advancements have turned a surgery that required a 3-5 day hospital stay into a same day or overnight procedure.




I had to donate blood before my knee replacement in 2007, will I have to do that?


  • No. We use a medication called tranexemic acid that helps reduce blood loss during and after surgery. Our techniques are also more minimally invasive. I have not needed to transfuse a primary hip or knee replacement since these changes.




From what material are the parts made?


  • From what material are the parts made? The femoral component is made from a cobalt-chromium alloy. The tibial component is titanium. The plastic spacer is made from a ultrahigh molecular weight, highly crosslinked polyethylene.




What is a partial knee replacement?


  • This is a procedure where we only resurface one of the three compartments of the knee. The other two compartments are untouched. This means you can keep your ACL and PCL which are crucial to normal knee kinematics. The recovery is also much quicker.




Am I a candidate for a partial knee replacement?


  • If you have arthritis and symptoms isolated to one compartment of your knee then it is possible. I would need to examine your knee and see your xrays before recommending this or not




How long will a total knee replacement last?


  • Registry data and a conservative estimate would tell us that 90% of knee replacements are working at 15 years. This is also data on knee replacements performed 15-20 years ago. With our new materials and technology I would expect them to last longer. That said there is still a risk for failure of the implant for several reasons. The parts can come loose from the bone, it can become infected and require removal, knee can be very unstable and require revision. If you get through the first 2 years without an issue, I would expect it to last you a very long time.




How long will a partial knee replacement last?


  • A partial knee replacement fails at a higher rate than a total. Either you can develop arthritis in the two compartments that were not operated on or the parts can come loose from the bone. I would apply the same thoughts of 90% of knee replacements lasting 15-20 years and expect a partial to last 10-15 years if there are no early issues such as infection.




I had a knee replacement and it is painful or I’m having a problem with it, can you fix it?


  • If there is a mechanical cause for the pain or problem, then often yes. If there isn’t a mechanical cause such as the parts coming loose from the bone, infection or instability, revision surgery may not help. I perform most of the revision surgeries for Strand Orthopaedics and feel comfortable taking care of these issues. Unfortunately, the best chance at an optimal result is a successful first surgery.




Do you do same day knee replacement?


  • Yes, all the technical details are the same. If you can get around safely the afternoon of surgery then you can go home. We can also perform this in the surgery center if you wish.




When can I go back to work?


  • Depends on your work. For sedentary jobs you could go back as early as 2 weeks. For office jobs that require walking and stairs more like 6 weeks. For heavy labor perhaps 12 weeks. Ultimately, when you feel able, I will support you returning to work.




What activities should I avoid after surgery?


  • You can do whatever is comfortable for you. I recommend you avoid repetitive impact activities such as running or jumping. Double tennis and skiing are acceptable.




What kind of stitches do you use?


  • For knee replacements, I use staples in addition to the deep sutures. I do this because the front of the knee sees a lot of stress during knee flexion. Staples are stronger and make sure the incision stays closed.





After Surgery

My dressing is full of fluid, what should I do?


  • Call the office, we will bring you in to examine the wound. I recommend that you avoid the emergency department. Remember, me or my team are the only ones who remove the dressing. Normal bandage - this is a picture of a normal postoperative drainage. I am not worried about this. Dirty bandage - this is a picture of more than normal postoperative drainage. Please call the office to have your bandage changed and wound evaluated.




My pain is not controlled?


  • Are you taking the medicines as prescribed? Most of the time, this is from a misunderstanding of which medications to take. Make sure you are taking the Tylenol, Naproxen, Tramadol and Oxycodone as listed. If you, call the office and we can make changes to your medicines




Medicine X makes me itch.


  • Medicine X makes me itch. Very common with narcotic medicines. Either reduce the dosage or stop taking this medicine. We can also prescribe Benadryl to help. Call the office to inform use ether way




I am nauseated.


  • I am nauseated. Also common with narcotic medicines. Try to reduce the oxycodone or stop taking it, keep light food on the stomach. We can also prescribe medicines to help with this





Hip Replacement

I read your protocol but I am allergic to ____. Can I still have surgery?


  • We have alternative medications for antibiotics and pain control. We will be able to find something that will suit you and still accomplish the protocol listed above.




I had a bad experience with a spinal anesthesia before, do I have to do it?


  • No you don’t. You should play an active role in your care. That said, I strongly believe that a spinal anesthesia is a key part of accelerating early recovery and limited nausea and pain after surgery. A bad experience before does not mean you will have a bad experience this time around.




Why do I have to do all of these tests?


  • We need to make sure your health is as optimized as possible for surgery. Although the advancements we have made over the past 5-10 years are great. This is still a big surgery that carries with it risk. If we can reduce your risk even small amount it is worth it.




Why does my weight (BMI), diabetes control or nicotine use matter?


  • Why does my weight (BMI), diabetes control or nicotine use matter? All of these are independent risk factors for infection and other complications. They are also things that can be modified to reduce your risk. If you get an infection it will require further surgery to fix, it is not something I take lightly.




I had a lot of pain with my hip replacement in 2007, what you described sounds very different.


  • Absolutely. Two of the biggest advancements in hip replacement have been the use of multimodal pain control instead of large doses of narcotics and the anterior approach. These advancements have turned a surgery that required a 3-5 day hospital stay into a same day or overnight procedure.




I had to donate blood before my hip replacement in 2007, will I have to do that?


  • I had to donate blood before my hip replacement in 2007, will I have to do that? No. We use a medication called tranexemic acid that helps reduce blood loss during and after surgery. Our techniques are also more minimally invasive. I have not needed to transfuse a primary hip or knee replacement since these changes.




Why is the posterior approach bad?


  • It’s not bad. In fact I use this approach for almost all of my revision surgeries and for particularly complex deformity cases. It is an approach that can be extended up into the pelvis or well down into the femur which makes it easier to perform big revision surgeries. Unfortunately, you cut through the gluteus muscle, take down the important stabilizing structures of the hip and dislocate the hip as part of the procedure. This causes more pain, longer recovery and puts you at risk for dislocation. In a revision setting, I accept this as the cost of doing business. For a native hip that needs a hip replacement, the anterior approach avoids these issues. I offer the anterior approach to 95-99% of my primary hip replacement patients.




From what material are the parts made?


  • From what material are the parts made? The cup is made from a porous titanium. Your bone will actually grow into the pores to provide long lasting fixation. The plastic liner is a highly crosslinked ultrahigh molecular weight polyethylene. The stem that goes into the femur is also porous titanium. The femoral head is made from a special durable ceramic called Biolox Delta.




How long will it last?


  • Registry data and a conservative estimate would tell us that 90% of hip replacements are working at 15 years. This is also data on hip replacements performed 15-20 years ago. With our new materials and technology I would expect them to last longer. That said there is still a risk for failure of the implant for several reasons. The parts can come loose from the bone, it can become infected and require removal, the hip can dislocate multiple times and require revision. If you get through the first 2 years without an issue, I would expect it to last you a very long time.




Do you do same day hip replacement?


  • Do you do same day hip replacement? Yes, all the technical details are the same. If you can get around safely the afternoon of surgery then you can go home. We can also perform this in the surgery center if you wish.




I read that the anterior approach is more challenging or harder to perform is this true?


  • It is definitely more technically challenging than the posterior approach. It takes me slightly longer to perform a hip replacement this way. However, I feel the benefits to my patients outweigh the additional technical demand. Also there is a learning curve with the anterior approach. The first 50 anterior hip replacements performed by a surgeon take longer and have a higher complication rate. Fortunately, I learned this procedure in fellowship and I am hundreds of hip replacements beyond this point.




Am I too old to benefit from the anterior approach?


  • Am I too old to benefit from the anterior approach? No. In fact, I believe the more deconditioned the patient the more benefit they get from avoiding unnecessary muscle damage.




Am I too old for a hip replacement?


  • Age is one of my lesser concerns. I worry more about your medical health and how it is being managed. Despite your age, if you desire to continue living an active life that is otherwise limited by your hip pain, you may be a candidate. We would also ask your primary care physician for their opinion on the subject.




When can I go back to work?


  • Depends on your work. For sedentary jobs you could go back as early as 2 weeks. For office jobs that require walking and stairs more like 6 weeks. For heavy labor perhaps 12 weeks. Ultimately, when you feel able, I will support you returning to work.




How much weight can I put on my hip replacement?


  • How much weight can I put on my hip replacement? As much as you can comfortably tolerate. It will support your full weight immediately.




Are there really no hip precautions?


  • Are there really no hip precautions? I can cross my legs? Yes, I test the stability of the hip replacement in the operating room. If there is a stability issue, I will fix it at that time. That said, it is still possible to dislocate your hip if you try hard enough. If you feel pain or a very tight pulling sensation with extreme motions, avoid this.




What activities should I avoid after surgery?


  • What activities should I avoid after surgery? You can do whatever is comfortable for you. I recommend you avoid repetitive impact activities such as running or jumping. Double tennis and skiing are acceptable.




What kind of stitches do you use?


  • I use sutures that are placed under the skin and that will dissolve with time. There is also a sterile glue that I place over the wound to limit drainage. You will not need sutures removed.




I had a hip replacement and it is painful or I’m having a problem with it, can you fix it?


  • I had a hip replacement and it is painful or I’m having a problem with it, can you fix it? If there is a mechanical cause for the pain or problem, then often yes. If there isn’t a mechanical cause such as the parts coming loose, infection or being positioned incorrectly, revision surgery may not help. I perform most of the revision surgeries for Strand Orthopaedics and feel comfortable taking care of these complex issues. Unfortunately, the best chance at an optimal result is a successful first surgery.





Dr. Justin Brothers performing hip replacement and knee replacement in Myrtle Beach, South Carolina. Need help with your hip or knee pain, contact Justin Brothers, orthopedic surgeon located in Myrtle Beach, SC. Justin Brothers is a knee and hip surgeon performing in the area of Myrtle Beach, South Carolina. Hip pain and knee pain can be solved by visiting Justin Brothers in Myrtle Beach, SC. Hip pain, hip surgery, knee pain, knee surgery, hip replacement surgery, knee replacement surgery in Myrtle Beach, SC. Justin Brothers, Dr. Justin Brothers can help your knee and hip pain today.

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