We know that the anatomical structure that allows our limbs to move and walk normally is the joint formed between the bones. The surface of the joint is covered with a thin, wear-resistant layer of cartilage. The joint is wrapped by a tough joint capsule, and its inner surface is covered by a synovial membrane, which secretes synovial fluid and acts as a lubricant and nutrient. The joint is surrounded by ligamentous tissue, which stabilizes the joint. Muscles provide the power for joint movement. When a joint becomes diseased, pain, restricted movement, deformity, and even loss of ability to work and care for oneself can occur. The incidence of joint disorders is also high. According to a World Health Organization statistic, there is an average of one case of arthritis or joint disease in every ten people. In the United States, 36 million people have joint disorders. It is estimated that there are about 100 million people with joint disease in China. With the improvement of people’s living standards and medical advances, the average life expectancy of human beings is increasing year by year, and arthritis occupies a high percentage of the elderly. In the early stage of the disease, we can use conservative treatment, such as taking anti-inflammatory drugs, hot compresses, local closure, etc.. However, when the joint lesion is so severe that conservative treatment is ineffective and joint movement is significantly limited and deformed, artificial joint replacement is the only treatment that can eliminate the symptoms, correct the deformity, improve joint function and enhance the quality of life. According to statistics, there are more than 1 million artificial joint replacements each year worldwide, with the knee alone accounting for 250,000 cases in the United States, making it one of the most common orthopedic surgeries today.
What is an artificial joint replacement?
When it comes to artificial joints, people think that the joint will be cut out and replaced with a fake joint, and that the limb will look like a robot after surgery, which is stiff and unnatural. In fact, in most cases, artificial joint replacement is simply the removal of the worn and damaged joint surface and the implantation of a smooth artificial joint surface, so it is also called artificial joint surface replacement. At present, it has been used to treat the shoulder joint, elbow joint, wrist joint, hand joint, and other joints. At present, it has been applied to the treatment of shoulder, elbow, wrist, hand, hip, knee and ankle joints, etc. Artificial hip and knee joint replacements are the most common.
What materials are used in artificial joints?
The design and selection of materials for artificial joints is the result of nearly half a century of continuous efforts and cooperation among biomechanics experts, material engineers and orthopedic surgeons. The metal materials used include titanium, cobalt-chromium-molybdenum and stainless steel, while non-metal materials include high-density, wear-resistant ultra-high-molecular polyethylene and special ceramics. Bone cement fixation is used to keep the joint and bone together and to prevent loosening in the future. There are also artificial joints that have many microscopic holes that allow bone tissue to grow into them and provide fixation.
What are the conditions that require artificial joint replacement?
Osteoarthritis (degenerative osteoarthritis) is by far the most common cause of prosthetic joint replacements. When the arthritis is severe, the joint cartilage will be severely worn and damaged, and there will even be bone exposure, joint deformity, pain, and limited function, so that conservative treatment is no longer effective, and artificial joint replacement is the shortest option. The disease mostly occurs in the hip and knee joints, but can also occur in other joints throughout the body.
Traumatic osteoarthritis, as the name implies, occurs when symptoms of osteoarthritis develop secondary to a history of past trauma to the joint and become more severe.
Rheumatoid arthritis and ankylosing spondylitis are allergic diseases that most often affect the knee, hip, ankle and small finger joints, causing severe deformity, dysfunction and joint pain.
Ischemic necrosis of the femoral head, in more severe cases, should be considered for artificial hip replacement.
Femoral neck fractures and displaced femoral neck fractures in the elderly are also indications for hip replacement in order to avoid complications such as ischemic necrosis of the femoral head and non-union of the fracture in the future.
Other conditions include tumors, fractures, joint tuberculosis, etc.
How long does an artificial joint last?
After an artificial joint replacement, most patients will experience a reduction in pain or even complete elimination of pain, and the function of the joint and its deformity will be significantly improved. However, patients often ask their physicians this question, but there is no uniform answer. Generally speaking, 95% of patients can use more than ten years. Younger, more active or heavier patients are more likely to have their artificial joints worn out, so for patients with osteoarthritis, physicians will try to wait until the patient is older before having a joint replacement. Maintaining an ideal body weight and avoiding strenuous exercise will also help to reduce the chance of wear and tear of the artificial joint.
How soon after surgery can I walk normally?
To prevent complications after lower extremity arthroplasty, we encourage patients to get out of bed as soon as possible, most often starting the day after surgery, to practice standing, walking and rehabilitation exercises with a walker or crutches. The patient can be discharged from the hospital about two to three weeks after surgery. Except for elderly patients or special cases, patients can fully resume daily activities three months after surgery. Work, travel and non-confrontational sports activities can be performed after six months.
What do I need to be aware of after my arthroplasty?
Upon admission, the patient will be given a packet of information on how to perform post-operative rehabilitation and how to avoid incorrect posture and movements. The physician and rehabilitation practitioner will also give the patient a thorough briefing on preoperative and postoperative precautions. In general, patients should maintain their ideal weight and return to the hospital for checkups if there is increased swelling and pain, or if there is an injury to the joint. In addition, prophylactic antibiotics should be used when there are dental problems or any inflammation on the skin to prevent bacteria from entering the joint and causing a serious infection.
What are the risks and complications of artificial joint replacement?
Like any other surgery, there are risks associated with joint replacement, but the surgeon will assess the patient’s physical condition thoroughly and consult with other physicians if necessary to minimize the risks of the surgery. The most devastating post-operative complication is infection, so antibiotics are given before and after surgery to reduce the rate of infection to less than 1% in the case of knee replacements. Other complications that may occur include loosening of the artificial joint, dislocation of the artificial joint, wear and tear of the artificial joint, and others such as vascular and nerve damage, fractures, venous embolism, and joint instability. Although there are many types, they are fortunately rare.
Artificial joint replacement has become a safe and common orthopaedic procedure. When your joint pain is no longer controlled by medication or other treatments, joint replacement by an experienced orthopedic surgeon will relieve most of the pain and allow you to resume a normal daily life.