Total or partial joint replacement surgery, also known as arthroplasty, is a surgical procedure to remove and replace a joint that has been damaged by injury or arthritis. The artificial joint can be made of metal, ceramic or heavy duty plastic.
Many different joints of the body can be surgically replaced. Hips, knees and shoulders are the most common joints that are replaced, however, ankle, toe, finger, wrist and elbow joints can be replaced in some instances.
PCI Orthopedic surgeons use advanced robotic surgical technology to completely customize your surgery to your particular situation, and the goals you have for movement and mobility post-surgery. Because we use the most minimally-invasive procedures available, you will recover faster, have less pain and be happier with the results. In fact, patients who meet certain criteria can have their total joint replacements completed in an outpatient setting. Patients arrive in the morning and are home later in the day, with no overnight hospital stay.
Joint Replacement Procedures:
- Total Knee Replacement: During total knee replacement (which is also called total knee arthroplasty), the orthopedic surgeon removes the damaged surfaces of the knee joint and replaces them with metal and plastic components referred to as the prosthesis or implant. The implant is designed to replace the function of a healthy knee.
- Partial Knee Replacement: If arthritic damage is detected early, and has not progressed to all three compartments of the knee, some patients may be eligible for a partial knee replacement. During a partial knee replacement surgery, only the smaller damaged area is replaced, not the entire joint.
- Total Hip Replacement: Total hip replacement involves removing arthritic bone and damaged cartilage in the hip joint, and replacing them with an implant.
- Total Shoulder Replacement: Orthopedic surgeons perform total shoulder arthroplasty (TSA) to treat severe shoulder pain and lack of motion. During TSA surgery, the surgeon replaces diseased and injured joint components with medical-grade implants designed to appear similar to our normal, healthy shoulder joint.
Joint Replacement FAQs
Why get a joint replacement surgery?
Most people pursue joint replacement surgery to address the following factors:
- Pain relief: Joint replacement surgery can significantly alleviate chronic joint pain, allowing individuals to engage in activities that were previously limited or impossible.
- Improved function and mobility: Surgery can restore joint function and improve mobility, enabling individuals to perform daily activities with greater ease.
- Enhanced quality of life: Reduced pain and improved function can lead to a better overall quality of life, allowing individuals to participate in social, recreational, and occupational activities they enjoy.
- Long-term durability: Joint replacements can have a lifespan of 20-25 years or more, providing lasting relief and improved function for an extended period.
Who is a good candidate for joint replacement surgery?
Determining whether someone is a good candidate for joint replacement surgery is a decision that is typically made by an orthopedic surgeon, based on a comprehensive evaluation of the individual's medical history, symptoms, and diagnostic tests.
Here are some factors that are often considered when determining if someone is a good candidate for joint replacement surgery:
- Severe pain and functional limitations: Joint replacement surgery is usually recommended for individuals who experience persistent and severe joint pain that significantly affects their daily activities and quality of life. If pain medications, physical therapy, and other non-surgical treatments have been ineffective, surgery might be considered.
- Joint damage: X-rays, MRIs, or other imaging tests are used to assess the extent of joint damage. Joint replacement surgery is typically performed when there is substantial joint deterioration, such as advanced osteoarthritis or rheumatoid arthritis, where the joint cartilage is worn down, resulting in bone-on-bone contact.
- Failed conservative treatments: Candidates for joint replacement surgery often go through a series of conservative treatments before surgery is considered. These treatments may include pain medications, physical therapy, assistive devices, joint injections, or weight loss programs. If these options have not provided adequate relief, surgery may be recommended.
- Overall health and medical history: A person's overall health and medical history play a crucial role in determining candidacy for surgery. Factors such as age, presence of chronic diseases (e.g., diabetes, heart disease), obesity, and previous surgeries will be considered. The medical team will evaluate whether the individual can tolerate surgery and the subsequent rehabilitation process.
- Realistic expectations: Joint replacement surgery can improve quality of life and reduce pain, but it is essential for candidates to have realistic expectations about the outcomes. A thorough discussion with the healthcare provider can help establish appropriate expectations for the surgery's potential benefits and limitations.
What are the risks of joint replacement surgery?
- Surgical risks: As with any surgical procedure, joint replacement surgery carries risks such as infection, blood clots, adverse reactions to anesthesia, and complications related to wound healing.
- Implant-related risks: There is a small risk of complications related to the joint implant, including implant loosening, dislocation, or wear over time. Additional surgery may be needed to address these issues.
- Rehabilitation challenges: Recovery from joint replacement surgery involves a period of rehabilitation, which can be physically demanding and require dedication and effort from the patient.
- Individual factors: Age, overall health, and existing medical conditions can influence the risks associated with surgery and recovery.
It's important to note that the risks associated with joint replacement surgery are low, and most individuals experience successful outcomes. However, it is crucial to have a thorough discussion with your healthcare provider to understand the specific risks and potential benefits in your case.
Ultimately, the decision to undergo joint replacement surgery should involve a careful consideration of the potential rewards in terms of pain relief, improved function, and quality of life, balanced against the risks and potential complications associated with the procedure. Your healthcare team can provide personalized guidance based on your individual circumstances, helping you make an informed decision.
How long does a joint replacement last?
Advancements in technology have led to improvements in joint replacement implants, resulting in longer-lasting outcomes compared to previous years. While it is difficult to provide an exact lifespan for joint replacements, as it varies depending on several factors, it is generally accepted that modern joint replacements can last 20-25 years or more.
Several factors contribute to the improved durability of joint replacements:
- Implant materials: The materials used in joint replacement implants have evolved over time. Currently, implants often consist of highly durable materials such as metal alloys (e.g., titanium, cobalt-chromium) and high-density polyethylene or ceramic components. These materials have shown improved resistance to wear and corrosion, increasing the lifespan of the implants.
- Design improvements: The design of joint replacements has also seen significant advancements. Implants are now engineered to closely mimic the natural anatomy and function of the joint, resulting in improved stability and reduced stress on the implant components. These design enhancements contribute to better long-term performance.
- Surgical techniques: Advances in surgical techniques, such as minimally invasive approaches and robotic -assisted surgery, have led to more precise implant placement and reduced tissue trauma during surgery. This can enhance the long-term function and longevity of the joint replacement.
- Rehabilitation and postoperative care: Improved rehabilitation protocols and postoperative pain control play a crucial role in optimizing the outcomes of joint replacement surgery. Effective rehabilitation programs help patients regain strength, flexibility, and mobility, contributing to the long-term success of the joint replacement.
While modern joint replacements have shown improved durability, it's important to note that individual factors, such as a person's activity level, body weight, and overall health, can also influence the lifespan of the implant. It's always advisable to follow the recommendations of the healthcare provider regarding physical activity, weight management, and regular check-ups to monitor the condition of the joint replacement.
What is the patient process for joint replacement and how long does it take?
The process of joint replacement surgery involves several stages, from preoperative preparation to postoperative recovery. The timeline can vary depending on individual circumstances and the specific joint being replaced. Here is a general overview of the process:
Preoperative preparation:
- Consultation: You meet with the orthopedic surgeon to discuss the procedure, review medical history, and address any questions or concerns.
- Preoperative tests: Blood tests, imaging studies, and other diagnostic tests may be conducted to assess your overall health and the condition of the joint.
- Medical clearance: If you have any underlying health conditions, additional consultations with specialists may be necessary to ensure you are cleared for surgery.
Day of surgery:
- Anesthesia: You will receive anesthesia, typically either general anesthesia (puts you to sleep) or regional anesthesia (numbs the surgical area) some patients may also get a regional block for postoperative pain control
- Incision: The surgeon makes an incision over the joint to access the affected area.
- Joint preparation: The damaged portions of the joint are carefully removed, and the bone surfaces are prepared to receive the artificial implant.
- Implant placement: The artificial joint components, including the metal, plastic, or ceramic implants, are securely fixed in place.
- Incision closure: The incision is closed using sutures or staples, and a sterile dressing is applied.
Postoperative recovery:
- Hospital stay: The length of the hospital stay can vary from same day for selected patients to 1-2 days. During this time, pain management, physical therapy, and monitoring for potential complications will be provided.
- Immediate postoperative period: The initial focus is on pain management and early mobilization. You will start walking with the assistance of crutches, a walker, or a cane. Physical therapy begins soon after surgery to promote joint movement and strength.
- First few weeks: During this period, you will gradually increase your activity level and continue physical therapy. Your healthcare team will provide specific guidelines for weight-bearing, movement restrictions, and precautions to minimize the risk of complications. It's common to use assistive devices for walking during this phase.
- First few months: As the surgical site heals and the joint replacement settles, you will continue with physical therapy and gradually increase your strength, flexibility, and mobility. The focus will be on restoring normal joint function and improving endurance. You may start to reduce or eliminate the use of assistive devices and engage in more challenging activities under the guidance of your healthcare provider.
- Three to six months: By this stage, most individuals experience significant improvement in joint function and reduced pain. Many can return to performing daily activities with greater ease. However, it's important to note that activities with high impact or excessive stress on the joint may still need to be avoided or modified, as advised by your healthcare provider.
- Six months and beyond: Continuing with regular physical therapy exercises and following the guidance of your healthcare provider is crucial for ongoing recovery and optimal long-term outcomes. With time and diligent rehabilitation, many individuals can progressively increase their activity level and return to a wide range of activities, including sports and recreational pursuits.
It's important to note that the specific details of the surgical procedure and recovery plan will be discussed with your orthopedic surgeon, who will provide personalized guidance based on your case.
The duration of the entire process, from the initial consultation to complete recovery, can vary. Typically, it can take several weeks to months. The timeline depends on individual factors and the complexity of the joint replacement surgery.
During the consultation with your orthopedic surgeon, you can expect to receive more detailed information about the expected timeline specific to your situation.