Arthritis, femoral head necrosis, femoral neck fracture, joint stiffness, and joint dysplasia are extremely common clinical conditions that cause pain, difficulty in movement, deformity, and even loss of function to live on their own. Artificial joints, especially artificial hip and knee joint replacement, are successful operations that can immediately relieve and eliminate joint pain, restore joint function and improve the quality of life of patients.
I. What is an artificial joint?
An artificial joint is an artificial organ designed to save a joint that has lost its function, and it is one of the most effective of the artificial organs. People often think that during the surgery, the joint will be completely removed and fitted with a stainless steel joint, and the limb will be like a robot after the surgery, which is stiff and unnatural. In fact, artificial joint replacement only removes the bone spurs and damaged joint surfaces, and puts in artificial joints like braces to restore the normal smooth movement of the joint.
It is currently used to treat shoulder, elbow, wrist, interphalangeal, hip, knee and ankle disorders, but artificial hip and knee replacements are the most common. Artificial joint surgery is already a very successful and sure operation: it can immediately eliminate joint pain, restore the normal function of joint activities, so that people who have been suffering from joint pain for a long time can get a new life again.
Second, which patients are suitable for artificial joint replacement surgery?
At present, except for acute infectious diseases, active tuberculosis and hematologic diseases, many diseases causing joint pain and serious dysfunction can be treated with artificial joint replacement surgery, mainly including.
(1) Joint deformity or joint destruction caused by osteoarthritis;
(2) Loss of joint function due to ankylosing spondylitis; rheumatoid arthritis;
(3) Severe localized comminuted fractures or traumatic osteoarthritis of the joint;
(4) Loss of function of the joint due to infection, including specific infections;
(5) Advanced aseptic necrosis of the femoral head;
(6) Non-healing femoral neck fractures or delayed healing of femoral neck fractures in the elderly;
(7) Congenital hip dysplasia resulting in joint pain;
(8) Bone tumor in and around the joint site.
C. Why do we need artificial joint replacement?
When there are structural changes in the joint due to various reasons, it is not advisable to use medication alone, because medication can only partially relieve the pain. Artificial joint replacement can achieve the following purposes.
(1) Pain relief: It can relieve pain caused by various reasons;
(2) Stabilize the joint: stabilize the joint instability caused by various reasons;
(3) Correction of deformities: To correct joint deformities at the same time as the artificial joint replacement surgery;
(4) Improve the function of the joint: to restore the normal function of the joint, which is stiff and limited in activity.
Fourth, how to choose a good artificial joint?
When a patient decides to use artificial joint replacement treatment, the question is often raised: what kind of artificial joint is the best artificial joint? It should be said that different patients should choose different artificial joints. Artificial joint prosthesis has very strict requirements on its design, surface treatment, material selection, manufacturing process and packaging; it also needs sufficient clinical practice to confirm the effect of a certain artificial joint. In the current situation, artificial hip and knee joints have become very mature artificial joints, both in terms of the prosthesis itself and in terms of surgical techniques.
Choosing an artificial joint prosthesis is very different from choosing other commodities, because once the artificial joint prosthesis is placed in the body, it is not easy to “replace”, and even if it is “replaced”, the cost is quite large and cannot be measured in terms of money alone.
So how to choose a good artificial joint should be under the guidance of joint surgery experts to make a careful choice.
Fifth, the life of the artificial joint and the effectiveness of treatment?
Patients often ask doctors this question, in fact, it does not have a certain answer, as driving, such as normal use without accident, the car can be driven for a long time; if not to take care of every day overloaded go rugged mountain roads, I believe that soon will be the end of life. The service life of the artificial joint is mainly related to the wear and tear of the joint, the loosening of the prosthesis, the choice of the artificial joint, the surgeon’s surgical technique, the amount of exercise of the patient and his own condition.
The younger, more active or heavier the patient, the more likely the artificial joint will wear out and loosen, so physicians will consider the patient’s age and also hope that the patient will maintain an ideal weight and avoid strenuous exercise in order to reduce the chance of wear and tear of the artificial joint and its future replacement. Quality imported artificial joints, such as the world’s first-class brands: the United States Zimmer, the United States Biomet, the United States DePuy, the United States stryker, the United States Exactech, Germany Aesculape, Switzerland Plus, Taiwan United, etc., generally speaking, if used normally, 90% of patients can use more than 20 years.
Domestic brands such as Beijing Aikang, Beijing Montane, Beijing Prus, Beijing Jinghang, Beijing Chunli, Beijing Tianxinfu, etc. are some of the more excellent products in domestic artificial joints. A successful artificial joint replacement can allow you to live pain-free and meet your daily activities after surgery. The future is bright for patients who choose joint replacement to improve their quality of life and want to be healthy and pain-free in their activities. Because of the certainty and predictability of the efficacy of artificial joint surgery, more and more patients are happy to be treated with artificial joint surgery.
Currently, approximately 550,000 people in the United States alone undergo artificial joint replacement surgery each year, and the trend is increasing each year. With the advent of aging in China, the general improvement of people’s living standard, the increase of economic income, the increase of people’s health care awareness, the implementation of universal health insurance, especially the rapid popularization and standardization of artificial joint technology, the number of cases and success rate of artificial joint surgery in China is rapidly increasing.
Sixth, how long can I walk normally after the artificial joint replacement?
Artificial joint replacement is like eating sugar cane backwards, the sweeter it is, the first few days after surgery is more difficult, after the drainage tube is removed (about two or three days), you can get out of bed, use a walker or crutches to practice walking, and start bedside rehab exercises, generally half a month after surgery can be discharged. If the joint fixation method is biological, a walker or crutches are usually needed for six weeks to three months after surgery to reduce the weight bearing on the joint so that the bone can grow into the surface of the porous artificial joint and create a strong bond.
However, with the development of technology and joint materials, some artificial joints can be moved normally without aids 3 to 6 days after surgery. If the patient is older (generally older than 70 years old), has loose bones or has neurological problems such as stroke, and needs to get out of bed early, physicians will often use bone cement to fix the artificial joint or a large-headed artificial hip 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, the patient may still feel slight swelling and pain or numbness in the limb, but as long as the pain does not increase or inflammation occurs, it is not necessary to pay much attention to it.
7. What are the risks and complications of artificial joint replacement?
The surgeon and anesthesiologist will assess the patient’s physical condition prior to surgery to minimize the risk of surgery. Nowadays, artificial joint replacement is a very common orthopedic surgery in joint surgery and the risk is very low. The main complications include infection, joint loosening, joint wear, deep vein embolism in the lower extremities, pulmonary embolism, cardiovascular and cerebrovascular infarction or hemorrhage, etc. Fortunately, these are rare.
Eight, artificial joint loosening after the treatment
Once the artificial joint becomes infected or aseptic loosening, joint revision surgery is required. There are specially designed joint prostheses and surgical instruments for revision surgery. Revision surgery is more complex than the initial surgery and may involve bone grafting, changing the type of joint prosthesis, or using a special prosthesis. After revision surgery, the vast majority of patients will have a satisfactory outcome.
IX. Post-operative examination of joint replacement
Three months after discharge from the hospital, a review should be made to take X-rays to understand whether the position and stability of the joint prosthesis are good. Six months after the surgery, the patient will be re-examined again, and later on the radiographs will be taken as needed. If there is discomfort, for example, redness, swelling, pain or difficulty in moving the joint, or if the joint is injured due to an accident, go to the hospital in time for examination.
X. Protection after arthroplasty
After arthroplasty, you need to develop good habits of life and activities to maintain the stability of the joint, and learn some simple rehabilitation knowledge and joint rehabilitation exercises. It is important to pay attention to the prevention and control of infections. Infections such as tonsillitis, oral inflammation, skin infections, ringworm, etc. should be treated actively. After surgery, you can do cycling, walking, dancing, swimming and other sports, but running, jumping and other strenuous sports, as well as long-distance walking, climbing, etc. are not encouraged.
XI. Rehabilitation after joint replacement surgery
Rehabilitation exercises are vital to the success of joint replacement surgery. Immediately after surgery, isometric contraction exercises of the affected limb muscles should be performed. If the joint is well positioned and fixed, rehabilitation exercises can be started under the guidance of the doctor and the rehabilitator, including straight leg raising to exercise the quadriceps and walking, stair climbing and so on. Even after complete rehabilitation and discharge from the hospital, regular rehabilitation exercises should be adhered to in general.