The surgical procedure where parts of a damaged or arthritic joint are removed and replaced is called joint replacement. The replacement device used is called a prosthesis and can be made of metal, ceramic, or plastic, or a combination of all. It is also designed to replicate the movements (kinematics) of normal, healthy joints.
Unlike many years ago, joint replacements have now become very common. In 2011, almost a million joint replacements were carried out. And that’s in the United States alone. Knee and hip replacements are the most frequently performed procedures. However, replacement surgery can also be performed on other joints like the elbow, wrist, ankle, and shoulder.
The joint is where the ends of two (or more) bones meet. There are different types of joints found within the body. For instance, the knee is classified as a “hinge” joint because of its ability to straighten and bend just like a hinged door. The hip and shoulder joints, on the other hand, are referred to as “ball-and-socket” joint because the rounded end of one bone fits into the cup-shaped area of another, thus allowing circular movement.
Several conditions can result in disability and joint pain and can make people candidates for joint replacement surgery. In a lot of cases, joint pain can be attributed to damage to the articular cartilage (the cartilage that lines the ends of the bones)—either from fracture, arthritis, or other conditions. If conventional treatment interventions like physical therapy, medications, and lifestyle changes will not relieve the disability and pain, joint surgery might be recommended.
The Lowdown on Joint Replacement
While joint replacements have been performed for many years, many are still not familiar with the procedure. If you are a candidate, below are five things you need to know about joint replacement surgery:
1. To help ensure the success of the procedure, thorough preparation is necessary.
A joint replacement will not only effectively alleviate pain but it can also help patients live fuller and more active lives. Prior to the procedure, patients need to prepare both psychologically and physically. Planning ahead can help patients prepare for likely challenges the surgery might pose and help warrant a more successful outcome. Part of proper preparation should include talking to the doctor and asking about what to expect before, during, and after the surgery.
Key questions that need to be addressed should include:
- What type of prosthesis or implant will be used?
- How long will the hospital stay be?
- How long will the recovery take?
- How is pain managed after the procedure?
- What type of anaesthesia will be given?
2. The procedure can be performed in an outpatient surgery centre or in a hospital.
The surgery can take a few hours. During the surgery, the damaged bone and cartilage will be removed from the joint and will be replaced by prosthetic components. As mentioned earlier, the prosthetic components can be made of ceramic, plastic, or metal. The prosthesis is also designed to mimic the movement and the shape of the natural joint.
Case in point: in an arthritic hip, the upper end of the femur (damaged ball) will be replaced with a metal ball that is attached to a metal stem. It is fitted into the femur with or without bone cement. A plastic socket will also be implanted into the pelvis (with screws or cement) to replace the socket that has been damaged.
3. Most complications associated with the procedure can be treated successfully.
The complications and potential risks will be thoroughly explained by your doctor prior to the procedure. These complications include those that are related to the surgery and those that can occur after. Some of the common complications of joint replacement include deep vein thrombosis and joint replacement infection.
Joint Replacement Infection
Undoubtedly, no surgical procedure is risk-free. In the case of joint replacements, a small percentage (approximately 1 in 100) may develop an infection after the surgery. Infections can occur around the artificial implants or in the wound. An infection can also develop during the hospital stay or after the patient has gone home.
Deep Vein Thrombosis
When a blood clot forms in one of the body’s deep veins usually of the legs, the condition is known as deep vein thrombosis (DVT). While there are other risk factors for the development of DVT, two of the most prevalent are surgery in the knees or hips and injury to the lower body. Deep vein thrombosis can have serious consequences. If the blood clot breaks free, it can travel through the bloodstream and can block the blood’s flow to the lungs. While rare, this complication, called pulmonary embolism can be fatal.
4. Rehabilitation and recovery can vary from one patient to another.
Generally, patients will be encouraged to use their “new” joint shortly after the procedure. While no doubt challenging, following the doctor’s instructions can help speed up the recovery process. Many patients are likely to experience pain since the tissues are still healing, the body is still adjusting to the new joint, and the muscles have become weak due to inactivity. Exercise will play a key role in the recovery process. The doctor or physical therapist will provide specific exercises to help strengthen the joint and restore movement.
5. The procedure has a favourable long-term outcome.
Majority of patients who have undergone the procedure report to be able to perform daily activities more easily after.
Since the joint replacement can last for many years, patients can look forward to an improved quality of life—with enhanced strength and motion as well as less pain—scenarios that would have been impossible sans the procedure.