What is joint replacement surgery?
Joint replacement is the surgical removal of a worn out, damaged joint and the implantation of a new one. This surgery is usually done by an orthopedic surgeon with specialized knowledge. Sometimes the surgeon may not remove the entire joint, but only replace or repair the damaged part of the joint.
Your doctor recommends that you have a joint replacement in order to improve your quality of life. Replacing a joint can relieve pain and improve your mobility. The hip and knee are the most common areas where joint replacement surgery is performed. Other joints such as the shoulder, elbow, wrist and ankle can also be replaced.
What can cause a joint to become diseased?
Arthritis, trauma, or other causes. Having arthritis or being elderly can cause excessive wear and tear on the joints and further cause pain, stiffness and swelling. Bones are alive and they need blood to provide nutrients, grow healthily and repair themselves. Disease and joint damage can restrict the flow of blood to nourish the joints, causing joint pathology.
What is a new joint?
A new joint that is surgically implanted, known as a prosthesis, can be made of plastic, metal, or a combination of both. It can be cemented into the body or fixed to your bone in a non-cemented form, and your bone can eventually grow into the joint prosthesis. The two methods can also be used in combination to put the new joint in a reasonable position.
Cemented joints are most often used in older patients with low mobility and in patients with “weak” bones. The joint prosthesis is cemented to the patient’s bone. Non-cemented joints are used in younger, more active patients and in patients with good bone quality. This type of joint takes longer to heal because it takes longer for the bone to grow into the joint prosthesis and for the two to bond together.
New joints typically last at least 15 to 25 years. Therefore, younger patients may require multiple joint replacements.
Are there more patients who need joint replacements?
Joint replacement surgery is becoming more common. For example, approximately 873,000 people in the United States need hip or knee replacement surgery each year, and this number is growing at a rate of 20-30% each year. Research shows that even if you are very old, joint replacement can help you regain your ability to walk and live a better life.
There are risks associated with any surgery. The risks of joint replacement surgery will depend on your health before surgery, how severe your arthritis is, and what type of surgery you are planning to have. Many large hospitals have long experience in joint replacement, and their specialists have a scientific study of joint replacement and have the knowledge and experience in how to best improve patient outcomes. At such hospitals, the joint replacement specialist will be responsible for your healing and functional recovery before, during, and after your surgery, and for the success of your surgery through specialized treatment. The author of this article has studied joint replacement surgery at some of the best hospitals in the United States. He has been trained in the latest surgical techniques.
Do I need joint replacement surgery?
Only your doctor can tell you if you need a joint replacement. Your doctor will examine your joint with an X-ray machine or other medical instrument. The doctor can look for damage directly through the arthroscope. A small sample of your joint tissue can also be tested at the immune and molecular level.
After examining you, if surgery is not needed at this time, your doctor may recommend appropriate exercises such as walking, walking with crutches, physical therapy, and medications. The medications used to treat arthritis are mainly to reduce inflammation. Depending on the type of arthritis, your doctor may prescribe medications such as steroids.
However, it is important to note: almost all medications may cause side effects such as bone loss.
If these treatments don’t work, your doctor may recommend osteotomy surgery. This means that the bones in and around the joint are removed and revised. This procedure is simpler than joint replacement surgery, but the recovery is longer. This procedure is no longer commonly performed in clinical practice.
If you have persistent joint pain and cannot move your joint well, such as walking, climbing stairs, or taking a shower, you may need a joint replacement. Then it is usually time for joint replacement surgery. What happens during surgery?
What happens during the surgery?
First, the surgical team will give you medicine to keep you from feeling pain and to put your whole body to sleep (anesthesia). This medication usually only blocks pain in one part of your body. The surgical team will then replace the damaged joint with an artificial joint prosthesis.
Each patient’s surgery is different. How long it takes depends on the extent of the damage to the joint and what type of surgery is performed. Unless there are complications, performing a knee or hip replacement usually takes about one hour. After surgery, you will be moved to a recovery room for 1 to 2 hours until you are fully awake or the numbness is gone.
What happens after surgery?
After a routine hip or knee replacement, you may be able to go home within 3 to 5 days after surgery. Your doctor will decide exactly how long you will stay in the hospital.
After a hip or knee replacement, you can usually stand or walk the day of your surgery. At first, you may need to use a walker or crutches. You may experience temporary joint pain after surgery because your muscles have not been fully used for a long time and are weak. Your doctor can suppress this pain with medication. In addition, this pain will usually resolve in the weeks or months following surgery as your body is in the process of healing and recovering.
Physical therapy can be started the first day after surgery to assist in strengthening the muscles around the joint and help you regain joint function. If you are having a shoulder replacement, you can usually start physical therapy the same day as your surgery! Your doctor will guide you through gentle, progressive functional exercises.
Will my surgery be successful?
The success of your surgery will depend greatly on what you do when you go home. When you go home, you should continue to follow your doctor’s instructions to eat properly, take the right medications, and talk to your doctor if you have any pain or mobility problems.
The success rate of joint replacement is usually over 90 percent. Even if complications do occur, most of them are curable. Possible complications include.
Infection C Infection may develop in the surgical wound or around the newly implanted joint. It can happen, and this infection may occur during your hospital stay or after you return home from the hospital. It can even occur several years after the surgery. If the infection is minor in the wound, it is usually treated with medication. A deep infection, on the other hand, may require a second surgery to treat the infection or to replace the joint.
Blood clots – If your blood flow is too slow, a blood clot can form. It is a symptom of swelling and pain that can form in one or both of your legs after hip or knee surgery. Your doctor may recommend medications to thin the blood, or special socks and functional exercises to help your blood flow more quickly. If you develop swelling, redness or pain in your leg after you leave the hospital, you will want to contact your doctor right away.
Looseness C The replaced joint can become loose and cause pain. If the loosening is severe, you may need another surgery.
Dislocation C After joint replacement surgery (mainly hip replacement), the joint prosthesis may become dislocated. In most cases, the surgeon can reset the hip joint manually without surgery. When this happens, your doctor will also give you a protective device (brace) to prevent it from dislocating again.
Wear and tear C All replacement joints will experience varying degrees of wear and tear. If there is too much wear, it can lead to loosening. Loosening of the prosthesis may require a new joint surgery. For this procedure, the surgeon sometimes just replaces the worn plastic lining rather than replacing the entire joint.
Nerve and blood vessel damage C During joint replacement surgery, nerves near the joint may be damaged, but this rarely happens. As the recovery time after surgery increases, these damages tend to get better or even disappear completely. Some blood vessels may also be damaged during surgery.
When you move the joint with proper functional training and get your muscles strong again, much of the pain will be reduced. Also the range of motion of the joint will increase and motor function will improve.
What are the current research developments in this area?
Scientists are conducting further research on joint prostheses in order to improve the patient’s ability to move and to increase the range of motion and flexibility of the joint. They are also looking at using new material materials and methods to improve surgery. Other researchers are working to find out what causes joint damage, how to prevent it, and how to treat it.
Some scientists are studying a condition called osteolysis, an inflammatory response around the bone where the implant loses condition. In 2008, scientists discovered that cells called fibroblasts trigger the inflammation that results in osteolysis. This discovery could help scientists develop new drugs to prevent osteolysis in joint replacements.