If you've ever been told you need orthopedic surgery, your first instinct might be to put it off.

But Dr. David Homesley of Novant Health Orthopedics & Sports Medicine - Cotswold said there's never been a better time to have a joint replaced or repaired.

Patients recover faster, spend less time in the hospital and are much more involved in their own healing than they were when he first started practicing medicine 30 years ago.

As Novant Health Charlotte Orthopedic Hospital celebrates 50 years of caring for patients, Homesley reflected on how dramatically orthopedic surgery has transformed — and how those advances have improved the patient experience.

Here are six ways orthopedic care has changed in the last half century, and why today's patients recover faster, return to activity sooner and have better outcomes than ever before.

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1. Patients are part of the care team

Thirty years ago, success depended largely on what happened in the operating room. Today, recovery begins well before surgery.

Doctors now encourage patients to improve their health beforehand by quitting smoking, managing diabetes, losing excess weight when appropriate and building strength.

"We want patients to be physically and mentally ready for surgery," Homesley said.

Patients are also expected to play an active role afterward by staying ahead of pain, getting up and moving early and actively participating in physical therapy. This preparation improves recovery and lowers the risk of complications, including infection.

2. Recovery starts sooner than ever

Not long ago, patients often spent several days in the hospital after a hip or knee replacement. Today, many go home the same day. Others stay just one night. The procedure itself hasn't changed dramatically. What's changed is how care teams help patients manage pain.

Instead of relying heavily on narcotics, today's approach combines medications that reduce inflammation, minimize bleeding and control pain more effectively — with fewer side effects.

Patients also begin moving much sooner. After a hip or knee replacement, many are standing and walking with a walker within just hours of surgery.

"We want patients safely out of bed, walking and able to get to the bathroom before they go home," Homesley said.

Early movement reduces the risk of blood clots, helps preserve muscle strength and speeds recovery.

3. Healing is a team effort

The surgeon is still central to a successful operation — but no one works alone.

Homesley said today's orthopedic care depends on collaboration among surgeons, anesthesiologists, nurses, physician assistants, physical therapists and many other health care team members.

"We talk much more today about a team approach," he said. "I can't do what I do without everyone else."

Every interaction, from surgery through rehabilitation, helps patients regain independence as quickly and safely as possible.

4. Today's implants are built to last

Joint replacement technology has also come a long way.

In the 1970s, many implants wore out after 10 to 15 years. Metal-on-metal implants introduced years later initially appeared promising, but some patients developed metallosis, a serious reaction caused by microscopic metal particles released from the implant.

Today's implants typically use ceramic and advanced plastic materials, avoiding those complications while lasting an estimated 20 to 30 years.

For patients who already have a metal implant that's functioning well, Homesley said replacement usually isn't necessary. But if an implant becomes painful, make an appointment with your doctor.

5. Smaller incisions aren't the whole story

“Minimally invasive surgery” has become a familiar phrase, but Homesley said it's often misunderstood.

Smaller incisions can reduce recovery time, but making an incision too small may limit the surgeon's view and increase the risk of tissue damage.

"What matters most isn't the size of the incision," Homesley said. "It's how the tissue is treated on the inside."

The goal is to use an incision that's large enough to safely position the implant while minimizing unnecessary tissue disruption.

6. The experience is simply better

Perhaps the biggest difference isn't any single innovation.

It's the combination of better medications, better preparation, earlier movement and a more coordinated care team.

Homesley sees that firsthand when patients who had one knee replaced 20 years ago return for surgery on the other.

Many are surprised by how much easier recovery feels this time — even though they're older.

"It's the same operation," he said. "What's different is the medication, the preparation before surgery and the overall experience."