Joint replacement surgeries have become, particularly in the instance of hip and knee, the accepted treatment for end-stage osteoarthritis. Other joint replacement surgeries are becoming more widely available and accepted. There are currently five types of prosthesis available for joint replacement surgeries.
These prosthesis options include:
This is the longest standing and most established joint replacement surgery. There are four types of prosthetic hips: metal ball with polyethylene liners, ceramic ball with polyethylene liner, metal ball with metal liner, and ceramic ball with ceramic liner. Each type of prosthetic hip has potential benefits and drawbacks that your orthopedic surgeon should be willing to discuss in detail prior to operating.
There are multiple brands and designs of prosthetic knees for joint replacement surgeries. Two general options are available: partial and total knee replacement. Much work has been done and continues to be done to have the prosthetic truly fit the patient, from unisex graduated sizing to ongoing research into woman-specific knee replacement devices due to the difference in joint angles and load bearing in women’s legs.
Two different sets of shoulder prosthetics exist for two distinct surgeries. The first is total shoulder replacement, which mimics all the components of the natural shoulder. This is the option generally recommended for shoulder replacements that are driven by pure joint degeneration, but where the rotator cuff and other soft tissues are in good condition.
For shoulder replacement required in part by torn or deteriorating rotator cuff injuries, a relatively new procedure has emerged in the last ten years, that of “reverse shoulder replacement.” The mechanical device is somewhat different from the natural shoulder configuration but gives a very similar range of motion and function to the natural shoulder.
Elbow joint replacement is becoming more common, particularly as a treatment for joints damaged by advanced rheumatoid arthritis (RA). While traumatic injury arthritis and joint disease other than RA can cause enough damage to warrant elbow replacement, it is much less frequent an occurrence than similar levels of damage from RA. These devices are generally two pieces of metal forming a hinge, with a single large pin completing the joint.
Four separate models of ankle prosthesis were recently approved by the FDA. Ankle replacement surgeries are currently a minority of the joint replacement surgeries, and the criteria for good candidacy is tighter than that of knee and hip replacement. Because the surgery is more complex than other joint replacements, many physicians have steered clear of the process for fear of complications. Medicare does cover this procedure, but the surgery and devices are still classified as “experimental” by most private insurers.
Devices and procedures continue to advance. While many patients experience considerable pain relief and an increase in function post surgery, there is a risk of complications with all joint replacement surgeries. Patients should consult carefully with their orthopedic surgeon when making decisions about joint replacement surgeries.