About Joint Replacement

What is Total Joint Replacement?

Total joint replacement is a surgical procedure in which certain parts of an arthritic or damaged joint, such as a hip, knee or shoulder joints, are removed and replaced with a plastic or metal device called a prosthesis. The prosthesis is designed to enable the artificial joint to move just like a normal, healthy joint.

Hip replacement involves replacing the femur (head of the thighbone) and the acetabulum (hip socket). Typically, the artificial ball with its stem is made of a strong metal, and the artificial socket is made of polyethylene (a durable, medical grade plastic). In total knee replacement, the artificial joint is composed of metal and polyethylene and it is used to replace the diseased joint. The prosthesis is anchored into place with bone cement or is covered with an advanced material that allows bone tissue to grow into it.

In shoulder replacement surgery, the artificial shoulder joint can have either two or three parts, depending on the type of surgery required.

• The humeral component (metal) is implanted in the humerus.
• The humeral head component (metal) replaces the humeral head at the top of the humerus.
• The glenoid compontent (plastic) replaces the surface of the glenoid socket.

Total joint replacements of the hip, knee, and shoulder have been performed since the 1960s. Today, these procedures have been found to result in significant restoration of function and reduction of pain in 90% to 95% of patients. While the expected life of conventional joint replacements is difficult to estimate, it is not unlimited. Today’s patients can look forward to potentially benefiting from new advances that may increase the lifetime of the prostheses.

Who Should Consider Joint Replacement?

Total joint replacement is usually reserved for patients who have severe arthritic conditions. Most patients who have artificial hip or knee joints are over 55 years of age, but the operation is being performed in greater numbers on younger patients thanks to new advances in artificial joint technology.

Circumstances vary, but generally patients are considered for total joint replacement if:

• Functional limitations restrict not only work and recreation, but also the ordinary activities of daily living
• Pain is not relieved by more conservative methods of treatment, such as those described above, by the use of a cane, and by restricting activities
• Stiffness in the joint is significant
• X-rays show advanced arthritis or other problems

Are You Considering Hip Replacement Surgery?

You can now have hip replacement surgery done with an anterior approach.  Benefits include:

• This approach generally allows for a faster recovery time
• Improved mobility
• Less pain because the muscle tissues are not affected in the procedure (in traditional hip replacement surgery the muscles can become damaged).
• Can prevent dislocations
• The incision is at the front of the body, you won’t sit on the sometimes painful wound site.
• Patients can freely bend their hip and bear their full weight immediately or soon after surgery
• Reduced scarring
• Stability of the implant sooner after the surgery
• Larger, heavier patients may be suitable for minimally invasive hip surgery with this technique

Are You Considering Knee Replacement Surgery?

Each patient is unique, but generally candidates for knee replacement surgery have:

• Pain severe enough to restrict not only work and recreation, but also the routine activities of daily living
• Pain that is not relieved by more conservative methods of treatment, such as reduced activity, medication or physical therapy
• Significant joint stiffness and loss of mobility
• X-rays that show advanced arthritis or other degenerative problems

The National Institutes of Health (NIH) has concluded that knee replacement surgery is “a safe and cost-effective treatment for alleviating pain and restoring function in patients who do not respond to non-surgical therapies.” According to the American Academy of Orthopaedic Surgeons, knee replacement procedures have resulted in significant restoration of function and reduction of pain in about 90% of patients.