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The Replacements

The Replacements


The need for joint replacement surgery is becoming more common as people lead increasingly longer and more active lives. This type of surgery is also predicted to rise as America’s largest living age group, the Baby Boomers, continue to age.

There were approximately 200,000 hip replacements and 450,000 knee replacements performed in 2005. John Tiberi, MD, orthopedic surgeon on staff at Torrance Memorial Medical Center and with South Bay Orthopaedic Specialists, says that according to one study, these numbers are expected to grow to 572,000 for hips and 3.48 million for knees by the year 2030.

Shoulders, knees and hips can require replacement for a variety of reasons. According to Nicholas Silvino, MD, orthopedic surgeon on staff at Torrance Memorial Medical Center and with South Bay Orthopaedic Specialists, “The shoulders are not weight-bearing joints (like the hips and knees), and arthritis is not too common there. So unless there is a genetic predisposition for a particular shoulder disorder, shoulders typically need replacement due to trauma (injuries) to cartilage surfaces, the rotator cuff or from repetitive force activities.”

In contrast, a vast majority of the time, the hips and knees need replacement due to osteoarthritis (commonly known as the “wear-and-tear” arthritis). Todd A. Shrader, MD, orthopedic surgeon on staff at Torrance Memorial and with Torrance Orthopaedic & Sports Medicine Group, also points out, “If someone has trauma like a dislocated hip, a fracture or other injury to a joint, they can be more likely to get arthritis in it.”

HIP REPLACEMENT: Now for the younger folks

hip replacement

Late last year, Laura Just had right hip replacement surgery. She knew it was time. She was unable to do her yoga, Pilates, bike rides and even had trouble walking up and down the Strand.

“I felt much older than I was,” says Just. “After one day of skiing in Mammoth I was barely able to walk back to the condo. I thought I was stuck for the rest of my life without being able to do my favorite activities.”

Dr. Shrader performed Just’s surgery using an anterior approach (versus posterior). This meant cutting through the front of the hip rather than the back or side—avoiding cutting through the healthy glute muscle.

“It allowed me an amazing recovery time. I was walking the same day of surgery,” says Just. She was walking up stairs only 12 hours post-surgery and was released from the hospital in just 48 hours.

Dr. Shrader says that patients may be hesitant to see a surgeon, thinking that the doctor may recommend surgery right away. He says that certainly there are cases where a patient’s joint condition is so extreme that the only option at that point may be surgery. However, some patients can be treated with other modalities first, such as physical therapy, medications and injections.

He says that many times patients ask him, “How will I know if it’s time to have surgery?” He replies to them, “You will know when it’s time.” It becomes a quality of life issue—for example, when a patient can no longer walk.

“If your quality of life is altered and you are missing out on activities due to a bad hip, don’t wait!” advises Just. “I no longer feel left out of conversations about sports or activities with the many active folks living in the South Bay. This is a 30-year-hip, I have regained a full life with it.”

THE SHOULDER: A lifelong athlete shrugs off any idea of giving up sports

shoulder replacement

Kent Wyatt, a retired high school physical education teacher and coach, has been active all of his life. Born in California, his family moved to the beach when he was 4 years old. He grew up swimming in the ocean and surfing. He continued to surf for decades and played volleyball, both of which require high-intensity use of the shoulders. He was also active at work and coached volleyball, cross-country and wrestling.

Wyatt began to have shoulder discomfort that progressed to severe pain and limited range of motion in both of his shoulders. Over time, he says, he realized that his right shoulder was just “worn out” from all the years of his athletic activities. He also experienced an injury to his left shoulder while coaching wrestling.

Wyatt ended up having both shoulders replaced, six months apart, at Torrance Memorial. His surgeon was Dr. Silvino.

“Dr. Silvino is an excellent surgeon and is very easy to communicate with. He explained the shoulder replacement procedure thoroughly, and I was thrilled to share what my goals were post-surgery,” says Wyatt. He adds that before his surgery, he experienced extreme pain in both of his shoulders. Now he lives virtually pain-free.

Wyatt’s advice for anyone who is having joint replacement surgery: “Physical therapy is hard work but worth it.” His rehab took approximately three to four months for each shoulder.

He says to make sure to discuss with your surgeon what your goals are after the surgery. If you want to resume a particular sport, let your surgeon know beforehand so you know what to expect afterwards.

Dr. Silvino agrees that it is important to discuss your goals with your surgeon before having any joint replacement surgery. “For maintaining the longevity of the implant, you must protect the socket, specifically the implant-to-bone interface,” says Dr. Silvino regarding shoulder replacement surgery. Therefore, certain sports or activities may not be advised after surgery.

“My quality of life has greatly improved since having my shoulder surgeries,” adds Wyatt. He transitioned from surfing to stand-up paddleboarding about three years ago. He also enjoys playing an occasional family game of volleyball with his kids and grandkids—activities he enjoys thanks to his replacement surgeries.

REPLACING A REPLACEMENT: Resuming the role of gym rat

knee replacement

Ernest (Sonny) Moreno has been athletic all of his life. He has made it a priority to stay in shape.

Now retired, he worked 20 years in route sales for a bottled water company.

About 10 years ago he began to experience problems with his left knee. Over time he underwent four different surgeries for his knee, the last of which was a partial knee replacement approximately four years before.

Last spring, he began to have swelling in his knee and increasing pain. His mobility and ability to pursue his favorite activities decreased. In total, he experienced about five months of pain.

That’s when he met Dr. Tiberi and says he immediately felt comfortable. “We had good chemistry and just clicked.”

Dr. Tiberi states that Moreno had developed arthritis in another part of his knee, and his partial replacement was not adhering well (coming loose). He now needed a complete knee replacement.

Moreno had his surgery at Torrance Memorial last fall. He says he was able to walk the same day of the surgery and go home the next day. “I’m extremely happy with Dr. Tiberi’s work and think the nursing staff was great!”

Since then, Moreno has resumed his athletic activities. He has a home gym and works out two hours a day, five days a week, doing a combination of cardio exercises and weights. He spins (stationary bike) two times a week and uses a tread climber and lifts weights three times a week. On weekends he pursues outdoor activities with his wife.

PARTIAL KNEE: A swimmer’s “kneed” to dive back in

partial knee replacement

Michelle Cahill has been a lap/pool swimmer ever since she can remember. She has also worked as a longshoreman for 15 years— a physically demanding job much different from her previous work in sales.

About three years ago, Cahill began experiencing pain in her left knee. She says she was diagnosed with a meniscus problem and underwent surgery for it.

During the surgery to repair her meniscus, it was discovered by her surgeon that she also had arthritis in part of her knee, the extent of which was not visible on her preoperative tests. A few months after healing from her meniscus surgery, she had partial knee replacement surgery to the affected area of her left knee.

Cahill participated in physical therapy for approximately six to eight months after surgery. She believes her rehab may have taken a bit longer than other people due to the nature of her job. As a longshoreman she is on her feet a lot, climbing the steps of her truck many times each day as well as loading and unloading ship containers.

Although Cahill hopes that she never needs another surgery, she is pleased with her initial experience. She is now 100% pain-free and has resumed all of her previous activities. She continues to lap swim for 45 minutes three days a week, walk for 30 minutes two times a week, and enjoys off-roading in ATVs in Arizona with her family.


To avoid getting to the point of joint replacement surgery, there are some steps you can take to protect your body. “Pay attention to injuries,” advises Dr. Silvino. If your pain persists, see your doctor. Many times, having a problem diagnosed and treated may help prevent larger problems later.

“If you’ve already had an injury or a problem, get medical advice about your activities and body mechanics, and do your physical therapy,” says Dr. Shrader. “Those things work together to prevent re-injuring the same area.”

The reasons people develop osteoarthritis are multi-faceted. Some people may have a genetic tendency to develop osteoarthritis, and increasing age can also raise the risk.

We have no control over either; however, obesity can increase a person’s risk of developing osteoarthritis. Maintaining a healthy weight for your height and body frame is helpful in reducing your risk and good for your overall health.

Categories: Feature,Health Tip

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