Advanced joint care in Port St. Lucie
At St. Lucie Medical Center, we offer complete joint care services for patients with acute and chronic diseases or injuries in the joints. The joints are critical to your everyday function, so when joint pain persists, it can become debilitating. Our orthopedists and joint experts are here to put an end to your joint pain through individualized care and a full spectrum of treatment options.
To learn more about our advanced joint care services, please call our Consult-A-Nurse® team at (772) 742-9060.
We offer full-service orthopedic care at the Orthopedic and Spine Institute at St. Lucie Medical Center, including treatment options ranging from physical therapy to injections and even joint replacement surgery. Our joint care offerings expand into total joint replacement, including both hip and knee replacement surgery.
One of the most common causes of joint pain and loss of mobility is the wearing away of the joint’s cartilage lining. When this happens, the bones rub against each other, causing significant pain and swelling. Without cartilage, there is no shock absorption between the bones in the joint, which allows stress to build up in the bones and contributes to pain.
The most common causes of joint pain include:
- Osteoarthritis (OA)—This type of arthritis is characteristic of the breaking down of both cartilage and bone. This process leads the bones to rub against one another, causing pain and stiffness.
- Osteoporosis—This condition causes the bones to become more porous and fragile over time, ultimately increasing a person's risk for a fracture. Osteoporosis does not have any associated symptoms—many people do not know they have it until a fracture is sustained.
- Rheumatoid arthritis (RA)—This condition causes thickening and inflammation of the tissue that forms the inner lining of a joint (called the synovium). It can result in cartilage loss, pain and stiffness.
- Post-traumatic arthritis—This form of arthritis may develop following an injury to the joint where the bone and cartilage do not heal properly. This results in irregularities in the joint, leading to more wear and tear.
- Avascular necrosis—This condition results from deprivation of its normal blood supply, which results in weakening and potential collapse of the bone's structure.
- Paget's disease—This condition is a bone disease (often occurring in the hip) in which bone formation speeds up,causing the shape and density of the bone to change.
Treatment options for joint pain
There are a variety of treatment options available to manage joint pain. Treatment options will vary depending on the severity of your pain and level of immobility. Treatment options may include:
- Medications—There are a number of medications that can be prescribed to treat the pain and stiffness associated with arthritic joints. Medications may include non-steroidal anti-inflammatory agents (NSAIDS) and/or corticosteroids.
- Physical therapy—Physical therapy may be used to increase the strength of surrounding tendons and ligaments in a joint to create superior support for a diseased or injured joint.
- Joint fluid supplements—Joint injections are a pain treatment option that may provide temporary pain relief. This option treats the symptom, not the underlying problem with the joint, and relief will vary in length from patient to patient.
- Joint replacement—Joint replacement involves removing a diseased or damaged joint and replacing it with prostheses. Treatment may include a partial (part of the joint is removed and replaced) or total (all of the joint is removed and replaced) joint replacement surgery.
Total joint replacement surgery
At St. Lucie Medical Center, we perform both hip replacement and knee replacement procedures. Total joint replacement is usually reserved for patients who have severe arthritic conditions. Most patients who have artificial hip or knee joints are 55 years old or older, however, with new advances in artificial joint technology, the operation can be performed on younger patients.
Circumstances vary, but you may be considered a candidate for joint replacement if:
- Functional limitations restrict not only work and recreation, but also the ordinary activities of daily living.
- Pain is not relieved by more conservative methods of treatment, such as medications, physical therapy, using a cane or by restricting activities.
- Stiffness in the joint is significant.
- X-rays show advanced arthritis or other problems.
Preparing for joint replacement surgery
Prior to joint replacement surgery, a range of diagnostic tests will be performed to ensure your health and viability for surgery. These tests may include:
- Routine blood test
- Physical examination
- Electrocardiogram (EKG)
- Chest X-ray
Your orthopedic surgeon will determine what tests are needed prior to surgery.
Preparation for your procedure begins weeks before the day of your surgery. Preparation may include:
- Begin exercising under a physician’s supervision—It is important to be in the best possible overall health prior to your procedure to help promote the best surgical experience. Increasing upper body strength is important because of the need to use a walker or crutches after hip or knee replacement. Strengthening the lower body is also key because increasing leg strength before surgery can reduce recovery time.
- Have a general physical examination—If you are considering total joint replacement, you should be evaluated by your primary care physician to assess your overall health and identify any medical conditions that could interfere with surgery or recovery.
- Have a dental examination—Although infections after joint replacement are not common, an infection can occur if bacteria enters your bloodstream. Therefore, dental procedures such as extractions and periodontal work should be completed before joint replacement surgery.
- Stop taking certain medications—You will be advised by your orthopedic surgeon which over-the-counter and prescription medications should not be taken before surgery.
- Stop smoking—This is a good idea at any time but particularly before major surgery to help reduce the risk of postoperative lung problems and improve healing.
- Lose weight—If you are overweight, losing weight prior to surgery will help reduce stress on the new joint.
- Arrange a preoperative visit—Your preoperative visit provides an important opportunity to meet with healthcare professionals at the hospital to discuss your personal hospital care plan, including anesthesia, preventing complications, pain control and diet.
- Evaluate postoperative needs for at-home care—Every patient who undergoes total joint replacement will need help at home for the first few weeks, including assistance with preparing meals and transportation.
The day of surgery
On average, joint replacement surgery lasts one to two hours. On the day of your joint replacement procedure, the following tasks, protocols and procedures will be completed:
- Arrive at the hospital at the appointed time
- Complete the admission process
- Assessment of vital signs and general health
- Meet with anesthesiologist and operating room nurse
- Start IV (intravenous) catheter for administration of fluids and antibiotics
- Transportation to the operating room
- Perform joint replacement surgery
- Transportation to a recovery room
- Monitoring of vital signs until condition is stabilized
- Transportation to individual hospital room
- Monitoring of vital signs and surgical dressing
- Orientation to hospital routine
- Evaluation by physical therapist
- Ingest diet of clear liquids or soft foods, as tolerated
Expectations after surgery
Most patients spend a total of four days (including the day of the surgery) at the hospital. It is important to note that each patient experience differs, and you will be discharged when you have achieved the goals outlined by your orthopedic surgeon.
On the first day after your surgery, you may get out of bed and begin physical and occupational therapy, typically several brief sessions a day. Usually a case manager is assigned to work with you as you move through your rehabilitation routines. As the days progress, you should become more independent using two crutches or a walker.
Discharge from the hospital will depend, to some extent, on your progress in physical therapy. The physical therapist will likely give you a list of activities, exercises and instructions when you leave the hospital, and you may also have the assistance of an occupational therapist or nurse to help with special needs. You may need a walker and/or crutches for about six weeks, then you may use a cane for another six weeks or so.
After joint replacement, acceptable physical activities should:
- Not cause pain, including pain felt later
- Not jar the joint, as happens with running or jumping
- Not place the joint in the extremes of its range of motion