Many people go to joint replacement surgeons since this type of surgery can improve joint mobility and relieve chronic joint pain when other non-surgical procedures are unsuccessful. If you are dealing with a limited range of motion and persistent pain where bones meet, joint replacement surgery may be worth considering to regain your overall quality of life and return to doing the things you enjoy pain-free.
"End-stage" or severe arthritis can be due to various problems, including osteoarthritis, rheumatoid arthritis, and other inflammatory joint issues, previous fractures and joint injuries, joint infections, and other rare conditions like osteonecrosis (also known as avascular necrosis). These problems damage the joints' different structures and eventually result in dysfunctional joints and significant irreversible damage.
A rheumatologist specializing in handling these disorders may best deal with certain arthritis types, such as rheumatoid arthritis and other inflammatory arthritis.
More common joint problems such as osteoarthritis are typically treated by a rheumatologist, orthopedic surgeon, or primary care doctor.
When medical treatment for arthritis recommended by the doctor gets less effective, joint replacement surgery might be another option. These joint replacement surgeons are better qualified to know if joint replacement therapy is a suitable treatment choice for you.
The meaning of "appropriate" for total joint replacement surgery shifts continuously. In general, there's no set upper age limit for joint replacement patients. Instead, the decision is best made depending on your fitness for surgery and general medical condition and how your arthritis influences your quality of life.
While few individuals are in perfect health, most undergoing joint replacement must be healthy enough or medically "tuned up" to safely conduct their surgery.
There are various joint surgeries available, and based on your symptoms and the affected joint, your doctor will determine the best surgery type for you. Your joint replacement surgeon could discuss all the options with you. The most common joint replacement surgeries are:
Total joint replacement (an arthroplasty) is a treatment involving removing a part or all of the damaged joint and having it replaced with artificial implants. Joint replacement surgery could improve mobility and offer significant pain relief. It may be needed due to an injury or for advanced arthritis. Knee, shoulder, and hip replacements are common types of joint replacement surgery. Joint replacement surgery could usually be done as a minimally invasive treatment, which utilizes smaller incisions, has shorter hospital stays, less pain for the replaced joint, and has a shorter recovery period than traditional joint replacement treatment.
Anterior Hip Replacement – An anterior hip replacement is another way to implant a hip replacement using minimally invasive techniques. This enables muscle-sparing rather than muscle splitting and enables faster recovery and fewer restrictions on activity after the treatment.
Partial Hip Replacement – A partial hip replacement (a hemiarthroplasty) involves replacing only the femoral head (the ball) and not the acetabulum (socket). This treatment is used more in older patients experiencing a hip fracture.
Partial Knee Replacement – The knee joint is distributed into three compartments (the medial, lateral, and patellofemoral compartments). If only one or two knee compartments are damaged, a knee joint replacement surgeon might recommend a partial knee replacement instead of total knee arthroplasty.
A partial knee replacement treatment, unlike a total knee replacement surgery, only involves removing damaged tissue, resurfacing existing regions, and implanting artificial parts into the affected knee slot(s).
Reverse Shoulder Replacement – The ball's position and socket in the joint are switched over and replaced using artificial parts. A prosthetic "ball" is surgically connected at the shoulder blade, and an artificial "socket" is then constructed at the top of your upper arm bone. Reversing the ball and socket's location lets the shoulder bypass the damaged tendons and muscles and use the muscles at the top of your shoulder and arm instead. This stabilizes your shoulder joint and restores pain-free function and motion.
Joint preservation helps restore normal and pain-free function to the hip, knee, and shoulder joint. It's achieved through different treatment methods, including activity modifications, physical therapy, medications, injections, and sometimes surgery. Joint preservation procedures are personalized for each patient, considering their age, activity level, expectations, and degree of joint dysfunction.
For most patients, arthritis or other joint problems often treated with joint replacement surgery could be diagnosed using simple x-rays. Other causes for knee or hip pain should be considered because referred back pain can be easily confused for pain attained with arthritis of the hip or knee, and pain from an arthritic hip could occasionally be referred to the knee.
Inflammation of the soft tissue structures surrounding the joint also can cause complications such as bursitis or tendonitis, which can be confused with the pain attained with arthritis. A careful examination by the orthopedic doctor and routine x-rays usually determine the actual cause of your pain. Depending on the patient, a second opinion may also be sought from joint replacement surgeons.
After a relatively short recovery time after surgery, patients getting joint replacement surgery often return to a high activity level and experience less pain. Speed of recovery after surgery depends on your level of activity before surgery, general health and overall physical fitness, duration and degree of physical impairment prior to surgery, the type of surgery you had, and your motivation and expectations. Physical therapy and occupational therapy after joint replacement are very important for overall health and long-term outcomes.
Following surgery, long-term physical limitations are nearly always due to other orthopedic or rheumatologic issues (chronic low back pain, significant arthritis in other joints) or major health issues (heart, breathing, other chronic illnesses) instead of any joint replacement limitations. Those undergoing knee and hip replacements can return to low-impact activities and specific exercises, like swimming, water exercise, biking, walking, low-impact aerobics, golf, and doubles tennis.
Though patients often obtain a functional range of motion after having their new joint, sometimes the motion of a total hip replacement limits could be exceeded, leading to dislocation out of its normal position. Patient education and an understanding of the limitations of total hip replacement, particularly regarding the potential for range and dislocation of motion restrictions, could help minimize the occurrence of this complication. Patients should be urged to discuss the best option, specific limitations, precautions, and activity restrictions following total joint replacement with their surgeons.