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The Doctor is in: Q&A 8/3/2014

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Q: I had a hip joint replaced in January 2014.

When I try to jog, it is painful. Will I eventually be able to jog for a reasonable amount of time? I am 73 years old.

– Robin

A: Yes you will, Robin. I think it is great that you are eager and ready to start running again. Typical recovery from a hip replacement is three to six months to feel normal but can be up to one year to resume all activities. Your muscles will heal enough to return to running if that is your goal.

You can ease into your program by walking and running slowly, and back off when and if you feel pain.

However, the longevity of your joint replacement is dependent upon your bones growing securely into your new hip implant.

The biggest deterrent to that occurring is impact loading. Running is a very high impact activity, in contrast to walking, biking or swimming.

While you will be able to run in the future, you should consider that it could decrease the long-term results of your new hip.

Listen to your body and take cues on how to proceed.

Q: I was visiting relatives out of town and blew out my knee. I went to the emergency room, was treated and told by the orthopedic surgeon that I will need knee replacement surgery and can do this as an outpatient. I am healthy, 44 and have been a marathon runner for nine years. What is the difference as an outpatient procedure? Is it the anesthesiology? Cost to me? Cost to doctor? Recovery time? I want to run again more than anything.

– Timothy

A: Knee replacement for a healthy person, a runner

44 years old, can be performed as an outpatient, but I would not recommend it for my patients. I don’t think you have anything to gain by having this particular surgery as an outpatient, but everything to lose.

Simply put, inpatient means you stay overnight in the hospital at least one evening, whereas outpatient means you are sent home that same day.

Inpatient surgeries are performed in a hospital, and outpatient surgeries are performed in both a hospital and free-standing surgery center.

While similarities for an inpatient versus outpatient knee replacement will include the anesthetic and surgical technique by your surgeon, there are notable differences in an inpatient versus outpatient experience. For the complexity of a knee replacement, a hospital environment offers patients important resources on site, should an unexpected medical emergency arise, that a surgery center does not.

These include a blood bank and medical specialists including a cardiologist. Advanced post-operative care and pain management for a knee replacement are required for several days.

As an outpatient, one shifts this care and responsibility from hospital trained staff to family members or friends at home. For some patients, going home immediately after surgery may sound preferable, but as a surgeon I don’t think it is best. With a hospital stay, patients will see me multiple times and I will continue to oversee their recovery.

Fees can vary so it’s important for you to ask as many questions as you can and if possible, and research your options based on your insurance provider, if you have one.

Surgery can be life-changing, but there may be other options to try before having surgery. Get all the information and help you need when making this big decision. Good luck!

Dr. Darryl Tannenbaum is a board certified orthopedic surgeon with Columbus Regional Health’s Joint and Spine Center and Southern Indiana Orthopedics.

He is a graduate of Harvard Medical School and completed his orthopedic surgery residency at University of Michigan.

Tannenbaum has run in more than 20 races, completing the six World Major Marathons in places that include Boston, Berlin, London and Tokyo. He hopes to complete a marathon on every continent and plans to run one in Antarctica in March.

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