The two most common total joint replacement procedures are total knee and total hip replacements.

The most common reason for total knee and total hip joint replacement is osteoarthritis.

50% of people above 50 years of age will develop osteoarthritis. Most of these people will not need total joint replacements and can be controlled through rehabilitation including physiotherapy and aquatic therapy. Custom foot orthotics, custom osteoarthritis unloader braces, viscosupplementation injections, glucosamine and medication can help alleviate the pain of osteoarthritis and allow the joints with osteoarthritis to function longer before requiring total joint replacement. Most of our patients with osteoarthritis of the knee or hip are leading active lives without the need for total joint replacements.

There are many types of procedures involved in total knee joint and total hip joint replacements depending on the joint involved, the age of the patient and the post operative activity demands. Most joint replacements should last 10-15 years or more depending on the demands placed on the joint replacements. For this reason it is recommended that total joint replacement surgery be delayed until later years where it is unlikely that breakdown of the total joint replacement will occur.

It is important to exhaust all rehabilitation options including physiotherapy, aquatic therapy, osteoarthritis unloader braces, orthotics and other measures mentioned above prior to contemplating total joint replacements. We have seen drastic improvements in patients with our rehabilitation interventions allowing them to continue for several years at an active level beyond the time that a total knee or total hip replacement was being entertained.

In some cases it may be necessary to go ahead with a total joint replacement. The surgical techniques for total knee and total hip joint replacements have been greatly perfected over the years. Total joint replacement surgery produces excellent results in the appropriately selected individuals. Improved success with total joint replacement depends on the preoperative strength, education and motivation of the patient and the post operative rehabilitation.

The factors affecting total joint replacement success are what we deal with at the Toronto Centre for Sports Medicine. All aspects of osteoarthritis are taken care of from the initial assessment for osteoarthritis of the hip or knee to planning rehabilitation including physiotherapy, aquatic therapy, osteoarthritis unloader braces, orthotics, viscosupplementation and medication. When necessary a referral to a joint replacement surgeon or service can be arranged.  Since we do not perform total joint replacements ourselves, patients can be assured that joint replacement surgery will be suggested only when appropriate. When total joint replacement is deemed necessary a preoperative joint replacement rehabilitation program and pain control measures are instituted to allow for as normal a life as possible while waiting for the total hip or total knee replacement procedure. Other services such as help with weight loss, cardiovascular conditioning and psychological preparedness for a total joint replacement are also available at our centre.