Advancing age, illness and injury can all lead to joint damage or degeneration. When the condition is severe and mobility is affected and the pain is chronic, arthroplasty, or joint replacement surgery, is often the most effective solution. The procedure involves removing the affected joint and replacing it with an artificial one that mimics the movement of the natural joint and allows the patient to regain movement without pain. Hip, knee and shoulder replacement are the most common procedures.
Who Needs Joint Replacement?
A person with chronic joint pain, stiffness, limited mobility and inflammation of the joints that does not improve with rest, medication, physiotherapy, or the use of assistive devices like walking sticks, etc. is usually a candidate for joint replacement surgery. These symptoms can be caused by a range of conditions including:
- Osteoarthritis
- Rheumatoid arthritis
- Fractures
- Abnormalities of the joint
- A lack of blood supply to the bones that make up the joint (avascular necrosis)
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Which Joints Can Be Replaced?
The joints that can be replaced by arthroscopy are:
- Hips
- Knees
- Shoulders
- Elbows
- Ankles
- Wrists
- Toes
However, the most common joint replacements are of the hip and knee joints. It is common for the complete joint to be replaced, but in some cases, the surgeon may decide that since only part of the joint has degenerated, only that needs to be replaced, while the other part may remain intact. Joint damage is typically an ongoing degenerative process and the sooner a condition is diagnosed and a course of action decided on, the better it is for the patient.
The material of the artificial joint could be metal, ceramic or heavy-duty plastic. It will allow for natural movement of the joint. The lifespan of the prosthesis will depend on various factors including the overall health and lifestyle of the patient. That said, a prosthesis can be expected to last 10 to 15 years but may have a longer life. Once the artificial joint has worn out, a new joint can be put in place.
Preparing for Surgery
Once a decision for joint replacement is made, the patient will have to undergo several tests to evaluate his or her overall health and to decide on any additional precautions that will have to be taken during surgery or recovery. This will include cardiac health evaluation, various x-rays, scans, blood work, etc. The patient will also be prescribed a diet regimen, exercise programme and physical therapy that may be required as part of the preparation for the procedure. Some ongoing medication may have to be stopped or altered and additional medication taken as part of the preparation.
The Procedure
The specifics of the surgery will depend on the joint to be replaced. In some cases, minimally invasive techniques that have fewer and smaller incisions and support faster recovery may be used. However, this may not be viable for all surgeries. The decision on the type of procedure will be taken by the surgeon keeping the best interests of the patient in mind.
The procedure is done under general anesthesia to ensure that the patient feels no pain or discomfort during the surgery. The surgeon will make various incisions at the location of the damaged joint and using special tools, will remove the damaged parts. A new artificial joint of the correct size will then be put into place and held in place with special medical-grade screws. The incisions will be closed and the wound will be covered by a bandage. The patient will then be shifted to the recovery area.
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Recovery
After the surgery, the patient will need to stay in the hospital for a few days while the wound starts to heal and drain. Normally, the patient will be asked to gradually start moving the joint, under medical supervision, within a day or two. Once the surgeon is satisfied that the recovery is progressing normally, the patient will be allowed to go home.
At home, the patient will be given specific instructions on resting and exercise. Pain control medication may be prescribed in some cases. Regular follow-up visits to the hospital will be required to monitor the progress of the recovery, to modify any medication and to guide the patient on how to gradually increase the use of the new joint. Physiotherapy is typically a part of the recovery process.
Patients can normally begin working from home within a week and begin their return to normal activities in a phased manner. While the objective of the joint replacement is to enable the patient to return to the life and activities that he or she had before the joint problem, there may be some minor restrictions on movements and special care will have to be taken for the new joint. However, these will not impact the normal life of the now recovered patient.
Although joint replacement is a major surgical procedure, it is an increasingly common one and there is no need to fear undergoing it. If you have been diagnosed with a medical condition or injury that requires that a joint be replaced, or if you have chronic joint pain that has not responded to medication, it is essential that an orthopedic surgeon be consulted. The best place for such a consultation is a multispecialty hospital with a dedicated orthopedic department. This is because the best orthopedic specialists and surgeons, along with the most advanced diagnostic and treatment facilities will be available to diagnose, evaluate and provide the best treatment for the problem. Joint problems can have a huge negative impact on a patient’s quality of life and can affect personal and professional relationships in a manner that does not just affect the patient but also those around him or her. If there are any other medical problems relating to the joint issue that require treatment, a multispecialty hospital will have all that is required in one place.