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Dr. Yuri Klassov

Orthopedics Joint Replacement

5.0

Dr. Yuri, a professional in the field of orthopedics, his opinion is comprehensive regarding all the matters in which I was treated, thorough and reliable. His opinion was given only days after he reviewed my entire medical file, and he noted in the opinion the dates, medications, and treatment methods in which I took part. In short, he professionally and indisputably summarized my medical condition

Languages: Hebrew, English, Russian

Insured by: Private visit

Hospitals: Assuta

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Languages: Hebrew, English, Russian

Insured by: Private visit

Hospitals: Assuta

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Rekha Fraer Street 9, Beer Sheva

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General information about Orthopedics Joint Replacement

Joint replacement surgery is a procedure in which worn or damaged parts of a joint are replaced with artificial components, with the aim of reducing pain and improving movement and function. The most common procedures are knee replacement and hip replacement, and in many cases the reason for surgery is cartilage wear (osteoarthritis).

The decision to replace a joint is not based on age alone, but mainly on the degree of pain and its impact on quality of life and daily functioning. Surgery is usually considered when the pain is significant and makes activities such as walking, climbing stairs or sleeping difficult, when conservative treatments have not provided sufficient relief, and when imaging shows significant joint wear.

Before reaching surgery, various treatments can be tried, depending on the condition and the cause of the pain, including physiotherapy, tailored physical activity, weight loss if needed, medications, injections and supportive aids.

Types of joint replacement

Total knee replacement – in this surgery, the damaged joint surfaces are replaced with artificial components. It is a common procedure in cases where the wear involves extensive parts of the knee.

Partial knee replacement – when the wear is limited to a specific area of the knee, in suitable cases it is possible to replace only the damaged part and preserve the healthy parts of the joint.

Hip replacement – in this surgery, the damaged parts of the hip joint are replaced with artificial implants. There are several surgical approaches, including the anterior approach, and the choice of approach depends on the patient's characteristics and the surgeon's judgment.

Robotic-assisted joint replacement – in some surgeries, robotic systems can be used to assist the surgeon in planning the operation and in the precise positioning of the joint components. It is important to emphasize that the robot does not perform the surgery independently, but serves as an aid to the surgeon.

Frequently asked questions about Orthopedics Joint Replacement

How do you choose a surgeon for joint replacement?

Joint replacement is usually a planned surgery, so it is worth taking the time to choose a surgeon and ask all the important questions before making a decision. It is recommended to find out the surgeon's experience with the specific type of surgery you need, which hospitals they operate in, what other treatment options were considered before surgery was recommended, and what the rehabilitation process is expected to involve. You can also ask about the course of the surgery, the expected length of hospital stay, restrictions during recovery and the estimated time until returning to activity.

When is it time for joint replacement surgery?

There is no one answer that fits everyone, but there are some clear signs. According to the American Academy of Orthopaedic Surgeons, the recommendation for surgery is based on the severity of pain and degree of disability, not on age. Surgery is usually considered when pain interferes with daily activities, conservative treatments - physiotherapy, exercise, weight loss, medications, injections and braces - no longer help, and moderate to severe wear is visible on imaging tests.

Is there an age that is too early or too late for joint replacement surgery?

There is no absolute age or weight limit. Most knee replacement patients are between 50 and 80, but the surgery can succeed at any age, and each patient is evaluated individually. [In a study](https://www.arthroplastyjournal.org/article/S0883-5403\(99\)90002-5/fulltext) that followed patients over age 90, significant pain relief and improved quality of life were found — with most complications stemming from their pre-existing medical condition rather than the surgery itself. In younger patients, a key consideration is the lifespan of the artificial joint: the younger the patient at the time of surgery, the greater the likelihood that revision surgery will be needed in the future.

How long does an artificial joint last?

In most cases - many years. Reviews published in The Lancet found that about 82% of total knee replacements and about 70% of partial knee replacements last 25 years. For hip replacements, about three-quarters last 15 to 20 years, and slightly more than half last 25 years. These data reflect implants placed decades ago. Materials have improved since then, and revision rates for newer implants are estimated to be lower. Excessive load and excess weight may accelerate implant wear.

What is the difference between a total and a partial knee replacement?

In a partial replacement, only the worn area of the knee is replaced, and the healthy parts are preserved. It is suitable only when the wear is limited to one area of the joint. The advantages of partial replacement: faster recovery, less pain and swelling after surgery, and easier rehabilitation. Many patients also report that the knee feels more natural. On the other hand, the likelihood of another surgery in the future is slightly higher than with total replacement.

What does rehabilitation look like after joint replacement?

The answer depends on the type of surgery and the patient's condition. In hip replacement, for example, patients can usually be discharged home after about 48 hours. Recovery lasts 6 to 10 weeks, during which physiotherapy exercises continue. Patients usually return to normal daily functioning and light office work within 3 to 6 weeks. In partial knee replacement, the hospital stay is even shorter, and sometimes not required at all. Return to routine is faster than with total replacement. After discharge from the hospital, rehabilitation can take place at home or in an inpatient rehabilitation setting, as needed and subject to health fund approval. In home rehabilitation, a physiotherapist comes to the patient's home — at Leumit, for example, the first treatments take place within 24 hours of arriving home. When inpatient rehabilitation is required, the decision is made by a specialist in rehabilitation or geriatrics, in coordination with a health fund representative, and the referral is made using Form 17. In orthopedic rehabilitation after hip or knee replacement, the minimum stay is usually two weeks.

What are the risks of joint replacement surgery?

The complication rate is low. [According to Ichilov Medical Center](https://www.tasmc.org.il/proceduresindex/procedures/orthopedics/hipreplacement/), in hip replacement the risk of complications is about 1% to 2% — that is, one to two out of every hundred surgeries. Possible complications include infection, bleeding, fracture around the implant, dislocation of the artificial joint, nerve damage and anesthesia-related complications.