Total Joint Replacement

Total joint replacement is an advanced surgical procedure often performed to treat severe joint damage caused by arthritis, degeneration, recurring injuries or other conditions that cause chronic pain, swelling and stiffness in the hip, knee, shoulder, elbow or other joint. Joint damage occurs when cartilage, the smooth substance that coats the ends of the bones and allows for painless movement, becomes damaged or diseased and makes movement extremely painful.

The joint replacement procedure involves removing the damaged bone ends and replacing them with a prosthetic device. Prostheses are designed to move like a regular joint. They are made of durable ceramic, plastic and metal parts that fit together snugly but glide smoothly (as opposed to the painful friction associated with the worn cartilage of arthritic joints). The pieces are shaped like the structures they replace – for example, the damaged bones in a ball-and-socket joint of a hip or shoulder are replaced with a ball and socket.

Total Joint Replacement Procedure

During the joint replacement procedure, damaged areas of the affected joint are removed and replaced with metal, ceramic or plastic prostheses. Both cementless and cemented implants are available; the surgeon will determine which devices are appropriate.

Your surgeon may offer minimally invasive muscle sparing approaches such as an anterior approach for hip replacement or a sub-vastus exposure for knee replacement. Your individual condition will determine which techniques are best for you.

Recovery from Total Joint Replacement

After total joint replacement, patients will be encouraged to use their new joint as soon as they feel comfortable, usually the day after surgery. For hip or knee replacement, you will need to use a walker or cane before strength and stability have been restored. Patients may experience pain in the replaced joint as the tissues heal, but this does not usually last more than a few weeks.

A customized physical therapy program will help patients eventually move with ease after their surgery. As patients become accustomed to their new joint, symptoms will subside and a return to activities can begin. Your doctor will advise you as to when it is safe to resume physical activities. Most prostheses perform well for up to 20 years or longer.

Risks of Total Joint Replacement

As with any surgical procedure, there are certain risks associated with total joint replacement, some of which include:

Infection
Blood clots
Loosening of the prosthesis

Dislocation
Excessive wear
Nerve injury

Your surgeon will discuss these risks with you prior to surgery to ensure that you understand all aspects of your procedure. Medical clearance is part of the preoperative process. Antibiotics are administered before and after the operation. Most patients receive blood thinners for a few weeks following surgery. The vast majority of patients achieve successful results from joint replacement surgery and are able to regain full function with their prosthetic joint.

Revision Joint Replacement

Over time, the prosthetic device may wear down similar to the natural joint, causing pain and swelling. This is most common in younger patients, who place daily wear on the joint for many years after their initial procedure and outlast the life of their implant. Younger patients also tend to place a greater amount of stress on their joints that older patients. The replacement joint may also cause symptoms as a result of loosening, dislocation or infection.

In these cases, revision joint replacement may be needed to replace the old implant with a newer one to once again restore function and strength to the joint. In many cases only one part of original replacement needs to be revised. Sometimes the procedure is more complex and the surgeon requires bone grafts to reconstruct the supporting structure. Revision joint replacement procedures may take a little longer to perform but can still provide significant pain relief and restore movement to severely damaged joints. Hospital stay may be longer than for a primary joint replacement