05/2017 KIPLINGER’S PERSONAL FINANCE 67elderly patients, the replacement will
likely last them the rest of their lives.HOW TO KNOW WHEN IT’S TIME
Two elements must come together for
your surgeon to recommend a total joint
replacement. First, an x-ray of the joint
(an MRI is rarely required) has to show
substantial damage from an underly-
ing disease, such as arthritis, or an in-
jury. Second, the damaged joint has to
routinely cause marked pain and limit
your activities. Age is never the major
factor. Replacement may be the right
choice for younger people because it
will relieve them of pain or allow them
to do more of what they want. And pa-
tients in their nineties who are healthy
can also undergo the procedure safely.
Everyone has a different tolerance
for pain, as well as different expecta-
tions for their level of activity. If the
pain and limitation you experience
are more nuisance than hardship,
then you’re probably not ready for
joint replacement. “Surgery has a
very, very good likelihood of making
you better and a tiny chance of making
you worse. Your symptoms must be
sufficient for you to take the chance
of getting worse so you can get better,”
says Dr. Mark I. Froimson, president
of the American Association of Hip
and Knee Surgeons. “We want pa-
tients to say, ‘I must do this. I have to
do this,’” says Dr. William Jiranek, the
association’s immediate past presi-
dent, in Richmond, Va. (For alternative
treatments, see the box on page 69.)
If you do qualify for a replacement,
keep in mind that the longer you wait
and the more inactive you become,
the more your muscles will weaken.
“You’ll have a bigger hill to climb after
surgery,” says Froimson, of Lavonia,
Mich. You can begin rehab exercises
before surgery to start rebuilding mus-
cles. “Do what you can, but don’t suf-
fer,” he says.
Christopher Jorgensen of Smith-
town, N.Y., had both knees replaced
in August 2016. Jorgensen, 52, played
basketball and lacrosse beginning
in his youth and injured the ligamentsin both knees in a motorcycle accident
in 1990. Over the years, he developed
arthritis in both knees and had multi-
ple arthroscopic procedures, in which
the surgeon uses a fiber-optic camera
inserted through a small incision to
diagnose and repair any damage.
Although his doctor recommended
that he have his right knee replaced,
Jorgensen put it off until he experi-
enced a moment of truth: He was offi-
ciating a college lacrosse game and
realized that to avoid pain he was
walking; he couldn’t run to keep up
with the action. “That was the mo-
ment I said enough is enough,” he says.
Jorgensen thoroughly researched
prospective surgeons and choseMY STORYAt Last, I Am Pain-Free
I suffered with knee pain for years as the result of an
injury in my teens, an active lifestyle, a love of physi-
cal labor and a few extra pounds in middle age. In
my late forties, arthroscopy cleaned up the torn car-
tilage in my left knee but failed to provide much re-
lief. I dosed myself with naproxen and used walking
sticks periodically. I always loved walking and hiking,
but because going even short distances caused pain,
I increasingly avoided those activities. By my mid
fifties, I limped and, to my horror, became bow-
legged as both knees degenerated with osteoarthri-
tis. I imagined that I would need knee replacements
someday, but I put it off. My parents were aging, my
kids were growing, and I was scared.
Then, at Thanksgiving 2013, when I was 57, my right hip just “went.” I’d previously suf-
fered aches and the odd twinge, but this was unendurable pain, and it didn’t go away. I be-
gan walking stiff-legged, like a penguin. An x-ray showed that I had end-stage arthritis in
my hip, and the joint was bone on bone. My orthopedist referred me to a hip specialist,
who recommended a hip replacement. I scheduled the surgery for after the holidays,
booked my sister to help, took my required and very reassuring joint-replacement class,
and got my pre-op physical.
My surgery took less than two hours, and I went home after two nights in the hospital.
On my first night home, I climbed the stairs and slept in my own bed. My quick recovery so
astonished me that, at my six-month post-op visit, I asked my surgeon if he would simulta-
neously replace (a bilateral replacement) both knees. He agreed because I was relatively
young, healthy and clearly motivated. Six months later, my surgeon performed the surgery
in just a few hours, and the result was equally astonishing.
Now, I am pain-free. I can do everything I want to do, and I happily take walks and hikes
with my husband and children. I feel young. PATRICIA MERTZ ESSWEINDr. Steven Haas, chief of knee services
at the Hospital for Special Surgery,
in New York City. Jorgensen insisted
that Haas fix both knees at once to
avoid a year-long delay between the
two surgeries. Within three months
of surgery, he resumed a normal gait.
In late February, he successfully offi-
ciated his first lacrosse game. And
after years of being unable to play
basketball one-on-one with his son,
he not only has resumed playing but
also consistently wins. “He’s a new
man,” says his wife, Lindsey.FIND THE RIGHT DOCTOR
To start your search for the right sur-
geon, ask your general practitionerLISE METZGER