“Life is in motion” is a famous assertion made by Voltaire, a French thinker of the 18th century, and it is still an axiomatic statement for our understanding of life. The meaning of “life in motion” is that the development of life lies in motion, and motion is the driving force and source of the development of life. It can be said that without movement, one cannot live. Healthy joints are indispensable for movement, and joint diseases are the enemy of movement. Healthy joints are painless and stable, able to move in a normal range. When joint disease occurs, the joint cartilage and other structures will be destroyed and the joint will lose its function, resulting in pain and deformity, seriously affecting the quality of life. The destruction of articular cartilage and other structures, like the destruction of teeth, can not be regenerated, and can only be replaced by other materials, so artificial joints were born. As people’s demand for quality of life is getting higher and higher and the technology of artificial joints is maturing, more and more joint patients are undergoing artificial joint replacement surgeries. It is reported that in 2011, the number of hip and knee replacement cases in the United States in a year was nearly 1.2 million, which is 24 times more than the data of our country in the same period, while the population base of our country is four times more than that of the United States. As a joint surgeon, I have a responsibility to let more people who have suffered from long-term joint pain (advanced) know about artificial joint technology, so that they can be relieved of joint pain as soon as possible, and return to a healthy and energetic life. What is an artificial joint? Artificial joints (also known as artificial prostheses) are anatomically simulated joints made of various biological materials. Like dentures and artificial blood vessels, artificial joints are artificial organs, and they are the most effective ones. What are artificial joints made of? The material that makes up an artificial joint is a biomaterial, which is a material that can be accepted by the human body and is harmless to the human body. It should be wear-resistant, corrosion-resistant, and biocompatible (non-toxic, non-thermogenic, non-carcinogenic, non-allergenic, non-destructive to surrounding tissues, and non-teratogenic). Since 1822 people have been looking for different materials to replace dysfunctional joints, trying to use materials such as wood, ivory, rubber, glass, pig bladders, etc., but ultimately failing. It was not until 1938 that Smith Petersen, inspired by a dentist, discovered that cobalt-chromium-molybdenum alloys were biologically inert and suitable for the manufacture of artificial joints, and cobalt-chromium-molybdenum alloys are still the main material used in the manufacture of artificial joints to this day. 1951, the Swedish Klaer used bone cement (PMMA) as a fixation material for hip prostheses, and to this day, bone cements are still widely used in the manufacture of artificial joints and replacements. In 1951, Klaer of Sweden used cement (PMMA) as a fixation material for hip joint prosthesis. The design concept of modern artificial joints was formed in the 60s and 70s of the last century, and has been continuously improved and matured. Currently, the main materials used in artificial joints are cobalt-chromium-molybdenum alloys, titanium, titanium alloys, high-tech ceramics, black crystals (zirconium-niobium alloys), polymerized polyethylene, hydroxyapatite, tantalum, and so on. What are the diseases that can be treated by artificial joint replacement? Artificial joints are designed to save joints that have lost their function, so artificial joint replacement is mainly used to treat joint destruction caused by various reasons, such as inflammation, degeneration, osteonecrosis, and bone tumors. Joint disease is a disease with high incidence, especially among the elderly, as the saying goes, “people grow old before their legs grow old”. There are two fixation methods for artificial joints: one is non-cemented fixation (biological fixation), which utilizes the size difference between the artificial joint and the bone bed (the artificial joint is larger than the bone bed by 0.5-1.0mm) to perform compression fixation, and due to the existence of microscopic holes on the surface of the artificial joint, the bones of the bone bed will grow into these holes after a few weeks to lock and fix it; the other fixation method is to install and fix the artificial joint by using the cement to fill in the joint, which is like the principle of grouting. Another fixation method is to install and fix the artificial joint after filling with bone cement, which is like the principle of grouting, and the artificial joint can be fixed firmly after the bone cement is solidified. At present, most of the artificial knee replacements are fixed with bone cement, hip replacements for young patients are mostly fixed with non-cemented bone cement, and hip replacements for senior patients are mostly fixed with bone cement. These two fixation methods have their own advantages and disadvantages, and both are mature fixation techniques. How long can an artificial joint last? People are most concerned about the life span of artificial joints, and they all hope that their artificial joints can be used once and for all. At present, the most mature is artificial knee and hip joint replacement, through the artificial joint registration system in Europe and the United States for decades of statistical analysis of the results, showing that hip and knee replacement after artificial joint prosthesis 20 years survival rate of more than 90%. With the continuous improvement of material science and surgical technology, the service life of artificial joints will become longer and longer. There may come a time when artificial joints are more durable than your own joints, which means there will be no need to be limited by age to have an artificial joint replacement. When can I start using a new artificial joint after surgery? Generally, the artificial joint replacement can be used after anesthesia. Of course, the surgical wound will have varying degrees of pain for a period of time after the surgery, but as long as the pain is strictly controlled, it is possible to start using the new joint for functional exercises at an early stage. What are the misconceptions about artificial joint replacement? Through communication with patients with joint diseases, it is found that many patients have misunderstandings about artificial joint replacement surgery. 1) Thinking that their diseased joints are better than artificial joints, although artificial joints are not as good as healthy joints, they are far better than diseased joints. 2) Thinking that artificial joints are better than healthy joints. 3) Thinking that artificial joints are better than diseased joints. Artificial joint replacement mainly solves joint pain, corrects deformity, and restores movement. 2) Does the artificial joint need to be removed? No, it is a permanent device. 3) Will the human body reject artificial joints and will they rust? No, the artificial joint material has been proven for hundreds of years and has good biological stability. 4) Does artificial joint replacement involve sawing off the entire joint? Artificial joint replacement only replaces some parts of the joint, not the whole joint. As with braces, only 8-9mm of the joint surface is replaced in the knee, and the femoral and tibial ends and ligaments are retained, so the main body of the joint is still the same as the original one. 5) Is there an age limit for artificial joints? The age range for artificial joint replacement in our hospital is 18-103 years old. With the advancement of technology, age is no longer a major consideration, but rather the degree of joint destruction. 6) Will artificial joint replacement lead to paralysis? The cause of paralysis is damage to the nerves of the brain and spinal cord. Joint replacement surgery does not involve these areas and generally does not cause paralysis. What are the risks of artificial joint replacement? Artificial joint replacement is a very successful technique with very few complications overall. Complications can be minimized with a strict understanding of the indications for surgery, a thorough and systematic preoperative assessment of the body’s condition, and good perioperative management. Potential complications include infection (about 1%), deep vein thrombosis, and joint stiffness (caused by poor exercise), etc. For these risks, there are specific guidelines in the industry on how to prevent and treat them. As technology advances, complications will become less frequent. What do I need for an artificial joint replacement? Artificial joint replacement surgery is a technically demanding procedure. In order to minimize complications and increase the success rate and longevity of the prosthesis, it requires a high level of hardware and software. First of all, the surgeon and his entire surgical team are required to have high professionalism and skillful surgical coordination. The surgeon in charge should be strictly trained and certified by the industry. Secondly, the surgical hardware should be up to standard, with a spacious 100-level laminar flow operating room; thirdly, it requires strict post-operative management and rehabilitation guidance; and fourthly, it requires long-term follow-up. Artificial Knee Replacement Osteoarthritis of the knee with severe valgus deformity is completely corrected after surgery Osteoarthritis of the knee with valgus deformity is completely corrected after surgery Artificial Knee Replacement (TKA) is mainly used for the treatment of osteoarthritis of the knee in old age, rheumatoid arthritis, osteoradionecrosis of femoral condyles, gouty arthritis, traumatized arthritis in late stage, and so on. Artificial hip replacement (THA) is mainly used for the treatment of osteonecrosis of the femoral head, hip arthritis, ankylosing spondylitis of the hip, developmental dysplasia of the hip (DDH), and fracture of the femoral neck in the elderly. Other Artificial Joint Replacement Artificial shoulder joint replacement is used to treat advanced shoulder arthritis, proximal humerus fracture in the elderly. Artificial elbow joint replacement is used for osteoarthritis of elbow joint. Rheumatoid arthritis, radial tuberosity fracture that cannot be repaired, etc. Human ankle joint replacement is used for advanced ankle arthritis. Human metatarsophalangeal (interphalangeal) joint replacement is used to treat metatarsophalangeal (interphalangeal) joint destruction. Artificial joint replacements have evolved considerably and will be refined over time, a boon to patients who have suffered from joint pain for a long time. As a joint surgeon, we are committed to promoting this technique and making it more widely known to patients, so that more patients with joint diseases can be relieved of their pain.