Arthroplasty literally means a surgical repair of a joint. It is an operative procedure done by an orthopedic surgeon who replaces or repairs a dysfunctional joint. In many cases these joints have been damaged through either injury or the long term degeneration of an arthritic condition. Arthritis is really a generic term that describes over 100 different medical conditions that affect the musculoskeletal system. In some severe cases, where the joints have been disabled and the individual is no longer able to be functional, arthroplasty surgery is recommended.
Currently there are forms of arthroplasty which include re-sectioning the joint structure, resurfacing the joint structure and replacing the joint structure. For the last 45 years the most common form has been a surgical replacement with a prosthetic. The most common form of arthroplasty is replacement of the hip, knee and hands. Other indications for arthroplasty include a vascular necrosis, congenital dyslocation, traumatized joints and rheumatoid arthritis. (1)
The purpose of any arthroplasty surgery is to relieve the pain and restore range of motion to the individual. Many times this means improved ability to walk, improve muscle strength or improved ability to use their hands.
While a total hip replacement or a total knee replacement has been practiced for decades it is only been in the last 10 years that researchers have made technological improvements in the joint replacements in order to both increase the lifespan of the prosthetic and decrease the risk to the individual following the surgery.
For instance, significant advances have occurred in a total knee replacement as to the type and quality of the materials used. Most recently manufacturers have begun using ceramics which leads to improve longevity of the joints. The primary indication for a total knee arthroplasty is to relieve pain and improve functionality. Correction of a significant deformity may be an indication that is rarely the primary indication for surgery. Prior to considering any arthroplasty surgery orthopedic surgeons must exhaust all conservative treatment measures.
More recently, resurfacing arthroplastic surgical procedures have been developed which are a temporary fix for an individual who has significant degenerative joint disease. This procedure has been used in order to increase the length of time an individual may be functional. For instance, the average lifespan of a total hip replacement is 20 years for the prosthetic joints. (2)
If an individual requires a total hip replacement prior to the age of 60 it is likely that they will outlive the usefulness of their prosthetic joints. Unfortunately when this prosthetic is implanted it often doesn’t leave enough bone and muscle of available for a second prosthetic to be implanted once the first has outlived its usefulness. Using a resurfacing technique first will require an individual to have a second surgical procedure to implant a prosthetic device but it will also increase the likelihood that an individual will remain functional for the remainder of their lives. (3)
An arthroplastic surgery is performed under general anesthesia and can last up to several hours. During this procedure the joints is fully exposed and all of the damage bone and cartilage are either removed or reshaped. Patients can expect several days in the hospital following the procedure as well as medications to use pain and extensive physical therapy. Physical and occupational therapy are used to bring the joint back to near normal function and avoid complications.
At this time arthroplasty is usually employed as a last resort. In order to extend the functionality and abilities of the individual past the point of the demise of the prosthetic, orthopedic surgeons must weigh the risks versus benefits of implanting a total joint replacements in an individual who is younger than expected.
According to the Arthritis Foundation there are over 500,000 joint replacements performed in the United States each year. The success will depend upon the selection of the individual who requires the replacement, their overall health and their ability to follow instruction after the surgery.
As with any surgical procedure there can be complications. In an arthroplasty surgery complications can be, but are not limited to, bleeding, infection, blood clots in the legs or lungs and loosening of the prosthetic heart once it is then implanted. During surgery it is possible to injure nerves are blood vessels which results in weakness or numbness. Other risks will depend upon your specific medical conditions as well as those general risks that accompany anesthesia.
(1) Joint Replacement Institute: Types of Hip Replacement and Methods of Fixation
(2) MayoClinic.com: Hip Resurfacing
(3) TriRivers Surgical Associates :Understanding Join