Joint replacement is a surgical procedure that replaces the joint with artificial prosthetic material. The damaged cartilage and bone are removed and replaced with metal and plastic prostheses. Total joint replacement surgery involves replacing the entire joint. Partial joint replacement surgery involves replacing only part of the joint with prosthetic material.
Joint replacement surgery is often performed for hip replacement and knee replacement for osteoarthritis of the hip and knee respectively. Besides the knee and the hip, many other joints can be replaced surgically, such as the ankle, shoulder, elbow, wrist, thumb, big toe and fingers.
Joint replacement surgery is one of the most successful and cost effective interventions in medicine. It offers relief of pain and disability for those who suffer from osteoarthritis. Over 300000 hip replacements are performed worldwide, and many more knee replacements.
Hip and knee arthritis are first treated with pain and anti-inflammatory medications and physiotherapy. Only in cases of severe pain, disability and deformity is joint replacement considered.
The indications for joint replacement are:
Pain
Severe pain that is distressing and not relieved by pain medications is an indication for joint replacement. Pain that prevents one from working is also an important consideration for those who are earning a living. Night pain that disturbs one’s sleep is another important indication for joint replacement.
Functional limitation
Osteoarthritis of the knee and hip may cause difficulties in walking and stair climbing. Joint deformity can also cause problems with driving and even simple, day-to-day activities such as wearing shoes and socks. Severe functional limitations are indications for joint replacement surgery.
Stiffness and deformity
Arthritis of the knee and hip can result in severe stiffness, leading to contractures. Stiffness reduces the range of motion and prevents one from performing daily activities such as walking, climbing stairs and driving. The wear and tear of the joint can also cause the joint to become deformed and the deformity may lead to bow legs or one leg appearing shorter than the other.
Age
Advanced age is not a contraindication to joint replacement surgery. Joint replacement can be considered if one is in relatively good health, without severe cardiac, lung or other organ dysfunction.
Joint replacement is successful in most patients who undergo surgery. However, a minority may suffer complications such as infections, loosening or dislocation of the artificial joint, deep vein thrombosis, and rarely, injury to nerves or blood vessels during surgery.
Following joint replacement surgery, one may need 3-5 days in hospital to recover. After that one will need one to a few months of physiotherapy to learn to walk with the new joint.
