The goal of joint replacement surgery is to relieve the pain in the joint that is caused by arthritis or damage to the cartilage. Unfortunately, joint pain can become severe that a person avoids using the joint which weakens the muscles that surround the joint, causing further immobilization.
While replacement surgery is an effective option, it is always advised that other medical and surgical therapies are explored before considering joint replacement surgery. Successful non-surgical remedies include:
- Maintenance of a healthy diet and body weight: Any weight gain will create added force that may affect the joint and increase possible wear.
- Physical therapy: Strengthening the muscles around the affected joint will cause less stress to the joint itself.
- Steroid or artificial joint fluid injections: Injections relieve pain, swelling and inflammation.
- Anti-inflammatory drugs and pain relievers: Oral medications reduce pain, swelling and inflammation
If patients are not responding to these non-invasive treatment methods, surgery may be necessary. While hip and knee replacements are the most common, replacement surgery can be performed on other joints such as the ankle, shoulder and elbow.
There are two types of joint replacement surgery options where the cartilage and damaged ends of the bones are replaced with metal and plastic surfaces. This artificial joint is known as a prosthesis and is designed to fit the shape of the specific joint in order to movement and function. For the most part, an artificial joint is composed of two parts: a metal piece that replaces or covers the ‘ball’ of the joint, and a sturdy plastic piece that covers or replaces the ‘socket.’
- Partial joint replacement surgery: Some patients may be good candidates for partial knee replacement, if their arthritis is not too severe. In this case, surgeons only replace the affected compartment of the joint through smaller incisions.
- Full replacement surgery: With this procedure, patients have significant damage to the joint which requires the entire joint to be removed and replaced with an artificial joint.
Whether joint reconstruction of is a partial or total replacement, both joint replacement procedures are performed using minimally invasive techniques whenever possible.
After surgery, your pain will be controlled by intravenous as well as oral medications. You will have physical therapy the day after (sometimes even the day of) surgery. Your blood count will be monitored and you might need a transfusion. You will also be given blood thinners for approximately 30 days to prevent blood clot formation. Approximately three days after surgery you will be discharged home or to a rehabilitation facility. You will see your physician two weeks after surgery and then have regularly scheduled appointments to follow up with examinations and X-rays.
Most patients are back to their normal activities of daily living 4 to 6 weeks after surgery, and are walking normally and pain free after 4 to 6 months.
Any surgery does pose some risk, and knee replacement is no exception. The risks of this surgery include bleeding (often requiring transfusion), infection (possibly even requiring multiple surgeries to replace the metal), deep vein thrombosis (blood clots), incomplete relief of pain, need for further surgery, less motion (stiffness), intraoperative or post-operative fractures near the prosthesis, heart attack, medical problems and anesthetic risks. Preoperative sickness (such as diabetes, kidney disease or decreased blood flow) raises the chances of complications. Smoking is one of the biggest reasons for problems after surgery.