Joint Replacement

Orthopedics

​Joint Replacement Surgery

Joint cartilage is a tough, smooth tissue that covers the ends of bones where joints are located. It helps cushion the bones during movement, and because it is smooth and slippery, it allows for motion with minimal friction.

Osteoarthritis, the most common form of arthritis, is a wear and tear condition that destroys joint cartilage. Sometimes as the result of trauma, repetitive movement, or for no apparent reason, the cartilage wears down, exposing bone ends. This can occur quickly over months or may take years to occur. Cartilage destruction can result in painful bone-on-bone contact, along with swelling and loss of motion.

Osteoarthritis usually occurs later in life and may affect only one joint or many joints. When conservative treatment of osteoarthritis is not adequately addressing your needs, an orthopedic specialist may recommend total joint replacement surgery.

What is a joint replacement?

Total joint replacement is a surgery in which an arthritic or damaged joint surface is replaced with an orthopedic prosthesis. Joint replacement surgery can be performed on several major joints, with two of the most common being the knee or hip joints.

A total knee replacement is a bone and cartilage replacement with an artificial surface. The knee itself is not replaced, as is commonly thought, but rather an implant is inserted on the bone ends. This is done with a metal alloy on the femur and plastic spacer on the tibia and patella (kneecap). This creates a new, smooth cushion and a functioning joint that can reduce or eliminate pain.

A total hip replacement is an operation that removes the arthritic ball of the upper femur (thighbone) as well as damaged bone and cartilage from the hip socket. The ball is replaced with a metal ball that is fixed solidly inside the femur. The socket is replaced with a plastic or metal liner that is usually fixed inside a metal shell to create a smoothly functioning joint.

What are the results of total joint replacement?

Results will vary depending on the quality of the surrounding tissue, the severity of the arthritis at the time of surgery, your activity level, and your adherence to the doctor’s orders.

When is this type of surgery performed?

An orthopedic surgeon will decide if you are a candidate for the surgery. This will be based on medical history, exam, X-rays, and response to conservative treatment. The decision to have surgery will be yours.

How long will a joint replacement last and can a second replacement be done?

All implants have a limited life expectancy depending on your age, weight, activity level, and medical condition(s). A total joint implant’s longevity will vary in every patient. It is important to remember that an implant is a medical device subject to wear that may lead to mechanical failure. While it is important to follow all of the surgeon’s recommendations after surgery, there is no guarantee that a particular implant will last for any specific length of time.

Why is a revision sometimes required?

Just as an original joint wears out, a joint replacement will wear over time as well. The most common reason for revision is loosening of the artificial surface from the bone. Wearing of the plastic spacer may also result in the need for a new spacer. A surgeon will explain the possible complications associated with total knee replacement.

What are the possible complications associated with joint replacement?

While uncommon, complications can occur during and after surgery. Some complications include infection, blood clots, implant breakage, malalignment, and premature wear, any of which may necessitate implant removal/replacement surgery. While these devices are generally successful in attaining reduced pain and restored function, they cannot be expected to withstand the activity levels and loads of normal healthy bone and joint tissue. Although implant surgery is extremely successful in most cases, some patients still experience pain and stiffness. No implant will last forever, and factors such as a patient’s post-surgical activities and weight can affect longevity. You should be sure to discuss these and other risks with their surgeon.

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