Joint replacement myths and facts

The rules have changed.

Joint replacement myths and facts
Get the 411 on joint replacement from a doctor who knows. (For Spectrum Health Beat)

“You’d be shocked at how many patients come in thinking they’re too young for knee or hip replacement surgery,” said C. Christopher Sherry, DO, an orthopedic surgeon and joint replacement specialist with Spectrum Health Medical Group.

Some patients get this notion from their doctors. Others pick up the idea from friends who remember the conventional wisdom of 30 years ago—that you need to be older than 50 to qualify for joint replacement.

That’s simply not the case anymore, according to Dr. Sherry. It’s one of six common myths about joint replacements that he’d like to see dispelled.

Myth No. 1: If you’re under 50, you’re too young to have a joint replaced.

Fact: Doctors today don’t use a specific age to determine whether a patient is a good candidate for hip or knee replacement surgery. Instead, the decision depends on the levels of disability and pain the patient is experiencing.

“In the 1970s and ’80s, the parts used for joint replacements had limited life spans,” Dr. Sherry said. “Now that technology is advancing, we have better longevity of replacement parts, so we’re much more comfortable putting them in younger patients.”

Patients with severe arthritis, for example, shouldn’t have to suffer through years of debilitating pain just because they’re young, Dr. Sherry said. “Making them wait isn’t in their best interest.”

This first myth is closely related to a second.

Myth No. 2: Replacement joints wear out in 10 years or less.

Fact: Thanks to improvements in materials and surgical techniques, today’s knee and hip replacements can last up to twice as long as comparable replacements did in decades past.

“The components we’re using have improved significantly,” said Dr. Sherry. “We’re seeing an 85 percent success rate at up to 20 years—and as technology improves, we’re hoping to pass that 20-year mark.”

People are often relieved to hear this because they want to stay active as they age.

“Patients’ expectations are changing,” Dr. Sherry said. “They want to be able to do whatever they want to do.”

Myth No. 3: If you have a joint replaced, you’ll be saying goodbye to sports.

Fact: Rather than drastically limiting patients’ activities, joint replacements make it easier for people to be active in low-impact sports.

“The goal of surgery is to get patients back to their normal activities, like playing golf and tennis,” Dr. Sherry said. “Our goal is a painless joint with good functionality.”

It’s the high-impact sports like basketball and long-distance running that patients should avoid, he said, because these activities decrease the life of replacement joints.

Myth No. 4: Joint replacement surgery means a long hospital stay.

Fact: Twenty years ago, it was normal to spend up to 10 days in the hospital after joint replacement surgery, but today the average is two to three days.

“With improvements in technology and patient care, hospital stays are significantly shorter than in the old days,” Dr. Sherry said.

Most of Dr. Sherry’s patients at the Center for Joint Replacement at Spectrum Health Blodgett Hospital stay less than two days after hip or knee replacements, with a large percentage going home the day after surgery. Some patients return home the same day as surgery.

“We’re getting patients up and walking sooner—even on the day of surgery,” he said. “And we’re getting them home sooner, which is a better environment for recovery.”

Myth No. 5: You should wait as long as possible before having a joint replaced.

Fact: Waiting too long can make things worse.

“If your pain is so great that it’s hindering your ability to walk, then you’re not keeping your muscles and your extremities strong, and you could be hindering the recovery process,” Dr. Sherry said. “Waiting until the last possible moment isn’t good for you.”

Rather than waiting for their mobility and quality of life to decline, Dr. Sherry encourages patients to have their knee or hip replacement sooner. This will likely improve their outcomes.

Myth No. 6: Joint replacement surgery is highly invasive.

Fact: “Some patients think that we remove the entire knee in a knee replacement … but we’re actually taking a minimal amount of bone” before inserting the new parts, Dr. Sherry said. In knee replacement surgery, these parts consist of a metal cap for the femur, a metal base plate on the tibia and a piece of plastic in between, acting as cartilage.

Surgeons today are also using less-invasive techniques and smaller incisions to perform replacements.

So, although joint replacement is major surgery, the scope is limited, Dr. Sherry said. “It’s much less invasive than many patients think.”

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Think you might have a food addiction?

There’s help available to conquer cravings—once and for all.

Think you might have a food addiction?
Think a moment about whether this is a treat or an addiction. (For Spectrum Health Beat)

Do you regularly eat to the point of feeling sick?

Do you eat—especially junk food—to escape your troubles?

Do you hide food or sneak snacks in secret?

If so, you could suffer from food addiction. If you do, don’t hide behind your shame or guilt, because there’s plenty of help available.

Even if you’re not sure, it’s still a good idea to seek help, according to Sarah Flessner, a registered dietitian with Spectrum Health.

“If someone feels like their relationship with food is a problem, then it is, and you don’t need to meet a clinical definition in order to get help,” Flessner said.

Flessner defines food addiction as excessive eating behaviors that have reached the point of having a negative impact on your life—emotional, social or psychological.

“Food addiction can fall into the same category as other addictions such as drugs and alcohol,” Flessner said.

People can, in fact, develop a dependency on some foods—usually those with high sugar and high fat—in the same way they do with drugs, cigarettes or alcohol. It’s possible, Flessner explained, because foods trigger the same reward center in our brains, giving us a high.

“When we eat excessive amounts of food high in sugar, fat or salt, it releases higher amounts of serotonin in our brain, which gives us a good feeling and leaves us wanting to repeat that feeling over and over with food,” she said.

The result: an addiction.

And with any addiction, Flessner said, may come negative social impacts such as feeling isolated, avoiding interactions with family and friends, depression, anxiety, poor performance at work or school, marriage and family problems, or poor self-esteem.

Food addiction often results in obesity, but not always. And not everyone who’s obese is a food addict, Flessner is careful to note.

“There’s a lot that plays into being obese—genetics, level of physical activity,” she said. “There are people who can be addicted to food who are not overweight because they are compensating in other ways.”

So, what are some solutions to overcoming food addiction?

1. Deal with the emotions that trigger the addiction.

Shawn Hondorp, PhD, a clinical psychologist at Spectrum Health who specializes in food addiction, said if people have tried initial strategies to overcome food addiction on their own, but continue to fall back into their old habits, that’s a good time to get professional help from a psychologist.

“It’s important to know what’s driving the addiction,” Dr. Hondorp said. “Usually there are emotions the addiction is covering up, and understanding those is typically needed for long-term success.”

2. Get a dietitian’s help to develop a healthy eating plan and make better food choices.

Flessner said she helps patients learn—or remember—the basics of healthy eating.

“If they are feeling nourished and eating enough healthy foods, then they are going to be less likely to overeat high-sugar and high-fat foods,” Flessner said.

She typically starts with asking people to keep a food log, noting what they eat and when. This might show patterns of when they’re likely to overindulge.

Flessner and Dr. Hondorp agree that while some patients benefit from eliminating trigger foods from their diet, others do not. Some find the approach of legalizing all foods helpful, because when they’re given permission to eat them, their desire decreases.

“I give people a choice,” Dr. Hondorp said.

3. Connect with others.

“We all need accountability,” Flessner said. “Definitely identify a support person—a friend or family member—or find a support group online.”

Dr. Hondorp said groups like Overeaters Anonymous or Food Addicts Anonymous can be helpful for some, but others find that these programs are too restrictive and fuel feelings of shame and further addiction.

“It’s important to find the accountability that works for you,” Dr. Hondorp said.

4. Believe in yourself.

People often have beliefs they need to challenge in order to conquer food addiction.

“We all have beliefs about ourselves, about relationships, about work, and beliefs specific to our relationships with food,” Dr. Hondorp said. “We need to identify the beliefs that are not helpful and replace them with beliefs such as, ‘I am a good person and I am worthy of love,’ or ‘I can do this.’”

She also encourages people to picture the goal they’re working toward.

“Visualize yourself behaving and feeling the way you want to,” she said. “Ask yourself, ‘How would you act in certain situations around food?’ Figure out what you do want, not what you don’t want. Focus on the way you want to be in life.”

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