The general public does not know much about artificial joints and often thinks that during surgery, the joint will be completely removed and fitted with a stainless steel joint, and that the limb will look like a robot after surgery, which is stiff and unnatural. In fact, artificial joint replacement is simply the removal of the worn and damaged joint surface and the implantation of an artificial joint to restore a normal smooth joint surface, just like a dental brace. It is arguably one of the greatest breakthroughs in orthopaedic surgery in this century. It has been used to treat shoulder, elbow, wrist, interphalangeal, hip, knee and ankle joints, but total hip and knee replacements are the most common. The design and materials of artificial joints are the result of the continuous efforts of biomechanics experts, material engineers and orthopedic surgeons. Most of them are made of metal and high-density plastic materials according to the structure, shape, and function of the human joint. The metal types include titanium alloy, cobalt-chromium alloy, and stainless steel, while the plastic material is high-density and wear-resistant polyethylene. In order to keep the joint and the bones together, bone cement can be used to fix the joint or use a hole in the artificial joint to allow the bone to grow in. What are the conditions that require artificial joint replacement? Osteoarthritis is the most common cause of artificial joint replacement. When the arthritis is severe, the cartilage of the joint surface will be severely worn and damaged, or even deformed, which often leads to pain, functional limitations and inconvenience in walking, and conservative treatment is not effective at this time, so artificial joints are the best choice. In other cases, such as rheumatoid arthritis and ischemic necrosis of the femoral head, artificial joint replacement is also often considered in more severe cases. Displaced femoral fractures in the elderly are also an indication for prosthetic joint replacement to avoid future complications of ischemic necrosis of the femoral head and poor fracture healing. After joint replacement, most patients experience less pain or even complete relief, and the function and deformity of the joint can be significantly improved. How long does an artificial joint last? Patients often ask their physicians this question, but there is no certain answer, just like driving a car, if it is used normally without accidents, the car can be driven for a long time, but if it is not cared for and overloaded every day on rugged roads, I believe it will soon die. Generally speaking, 90% of patients can use the car for more than 10 years if they can use it normally. The younger, more active or heavier the patient, the more likely the artificial joint will wear out and loosen, so unless there are special circumstances, physicians will try to wait until the patient is older before performing the joint replacement. Patients are also encouraged to maintain their ideal weight and avoid strenuous exercise to reduce the chance of wear and tear on the artificial joint and its future replacement. How soon can I walk normally after an artificial joint replacement? After the drainage tube is removed (about two to three days), the patient is encouraged to get out of bed, practice walking with a walker or crutches, and start bedside rehabilitation exercises, and can be discharged from the hospital about seven to ten days after surgery. If the joint is fixed by porous fixation, it is usually necessary to use a walker or crutches for six weeks to three months after surgery to reduce the weight bearing on the joint so that the bone can invade the surface of the porous artificial joint and create a strong bond. If the patient is older (generally older than 70 years old), has more lax bones or neurological disorders such as stroke, and needs to get out of bed early, the physician will often use bone cement to fix the artificial joint so that the limb can bear weight immediately after surgery and shorten the time of crutch use. Generally speaking, daily activities can gradually return to normal three months after surgery. Occasionally, patients may still feel slight swelling or numbness in the limb, but as long as there is no increase in pain or inflammation, there is no need to be concerned. What should I be aware of after joint replacement? After joint replacement, patients are advised to return to the hospital for regular checkups and reminded to continue to strengthen their muscles and avoid inappropriate postures and movements. Also, when you visit your physician, tell him or her that you are a patient who has had an artificial joint replacement and that you should be given prophylactic antibiotics to prevent bacteria from entering the joint and causing a serious infection. What are the risks and complications of joint replacement? The anesthesiologist will assess the patient’s physical condition prior to surgery and consult with other physicians if needed to minimize the risk of surgery. The most devastating postoperative complication is infection, which can occur within a few days after surgery or years later. In mild cases, antibiotic treatment is required, while in severe cases, the artificial joint is removed and cleaned, and a new one is implanted after the infection is controlled. Fortunately, it is a rare occurrence, and in the case of total artificial knee replacements, it occurs in about 1% of cases. Other complications can be categorized as follows: Artificial joint loosening This is the most frequent complication of artificial joint replacement. In the case of total artificial knee joints, for example, the chance of loosening after five years of surgery is about 3-5% and is not common. Dislocation of the artificial joint occurs more often in the total artificial hip joint, with an incidence of about 3%, mostly shortly after surgery, and can be reset by the physician’s bare hands, but rarely requires surgical reset. Due to the improvement of the design and material of the artificial joint, the incidence of wear and tear of the artificial joint has been decreasing. Other types, such as vascular and nerve damage, fractures, venous embolism, and joint instability, are rare, although numerous. Through the efforts of countless professionals, artificial joint replacement has become a safe and common orthopaedic procedure. When your joint pain can no longer be controlled with medication or other treatments, a joint replacement by an experienced orthopedic surgeon will relieve most of the pain and allow you to resume a normal daily life.