Replacing Worn Joints

Joint replacement surgery involves replacing a damaged joint with a new one called a prosthesis. These new joints usually are made of special metals, such as stainless steel or titanium, and durable, wear-resistance plastic. Prostheses are designed to be accepted by the body and resist corrosion, degradation and wear so they can last at least 10 to 15 years. Hips and knees are the joints replaced most often, but shoulders, fingers, ankles and elbows can be replaced as well.

Joint replacement is usually considered after exercise, walking aids, physical therapy or medications cannot relieve pain and improve mobility. Surgery for hip replacement patients, for example, can help lessen problems walking up and down stairs or make it easier to stand from a seated position. Joint damage is caused by osteoarthritis, injuries, other diseases, joint wear caused by years of use, bone tumor or blood loss due to insufficient blood supply. Symptoms of joint problems include pain, stiffness and swelling.

Before surgery, the surgeon evaluates the patient’s range of motion and joint strength, takes a medical history and reviews medications currently being taken. Blood tests and X-rays also can be ordered. The doctor may put a small, lighted tube called an arthoscope into the joint to check for damage. In some cases, only the damaged parts would be replaced, not the entire joint. During a hip replacement surgery, diseased or damaged bone and tissue is removed and a metal stem and attached ball is then inserted into healthy bone and tissue that are left intact. Preparing for Joint Surgery >

New joints can be cemented into place to hold the new joint to the bone, or the prosthesis can be placed without cement so bone can grow and attach to it. A prosthesis is designed to duplicate the mechanical properties of the joint being replaced. A prosthetic knee, for example, will be flexible enough to bend without breaking and strong enough to bear weight.

Most hip and knee replacement patients are discharged from the hospital three to five days after surgery. Patients will be encouraged to stand and start walking soon after surgery with a walker or crutches. Pain from sore muscles or surgery can be helped with medication and usually disappears in a few weeks or months. Physical therapy exercises will help regain motion in the joint.

More than 90 percent of joint replacement surgeries are successful. However, if problems do arise, most can be treated. Possible complications from joint replacement surgery include infections, blood clots, loosening, dislocation or wear of the new joint, or nerve and blood vessel injury. Hip replacement patients also may experience a change in leg length or joint stiffening. Following hip replacement surgery, most patients eventually will be able to swim, play golf or bike ride comfortably, but high-impact sports such as basketball and running would not be possible.

Joint replacement surgery is becoming more common in the United States, with more than 773,000 Americans having a hip or knee replaced annually.

For more information about joint replacement, check with your doctor or call 561-882-9100 for a free referral to a specialist at the Institute for Advanced Orthopedics.