Arthritis is a generic term that encompasses over 100 different medical conditions, all of which affects the musculoskeletal system in one way or another. Osteoarthritis is the most common form of arthritic condition and affects over 60% of those who are diagnosed with arthritis each year. Osteoarthritis causes the degeneration of the joints to the point which the opposing bones begin to rub against each other. This causes incredible pain, discomfort, disability and swelling. One of the single greatest surgical contributions made to the treatment protocol of your arthritis has been joint replacement or arthroplasty. (1)
In a joint replacement surgery the physician will replace the destroyed joint with an artificial one. In the case of the knee or hip the artificial joint is made out of metal and plastic. In hand replacements the new joint is commonly made out of silicone or some of the patient\’s own tissue. Also known as arthroplasty, joint replacement surgery is very common. (2)
Knees, hips and hands are the most common joints to be considered for joint replacement surgery. Knees and hips often receive continuous stress from walking, running, injury and obesity. This affects the wearing of the cartilage and triggers arthritis. As the cartilage degenerates, the underlying bone is exposed limiting motion and frequently causes a popping sensation. Rheumatoid arthritis and psoriatic arthritis also can trigger the need for a joint replacement.
One of the more common joints to be replaced are hips. This surgery is very safe, effective and the prosthetic joint is fairly durable. Another option which is gaining popularity is called \”Surface Replacement Arthroplasty\”. (3) This is an interim alternative which can yield short-term benefits and is usually covered by insurance. Although patients are expected to out-live the treatment effectiveness it has the advantage of preserving enough healthy bone to allow for a future hip replacement. This is a significant advantage since most artificial hips typically do not last more than 20 years. If an individual requires hip replacement surgery prior to the age of 60 or 70 they may be faced with the loss of mobility in their latter senior years because their hip replacement has failed.
The new prosthetic may or may not be cemented in place. In some cases the physician will use both techniques to keep the new joint in its intended location. Cementing may be used more often in older individuals who do not move around as much. Cemented joints are not recommended for younger individuals who have good bone quality. The latter may take longer to heal because the bone must grow an attached to it.
About 773,000 Americans have a hip or knee replaced each year. Risks of these surgeries will depend upon the health of the individual prior to surgery, how severe the arthritis is, and the type of joint replacement being performed. For answers to questions about the particular long-term effects and success speak with your surgeon to get his statistics.
The wrist joint can also be replaced and will effect a better long-term outcome than the previous fusions which were used to decrease pain. The concept is very similar to a hip replacement and although it does eliminate pain it cannot completely restore normal function. A typical person suffers from severe osteoarthritis or rheumatoid arthritis but can also have some of the other less common causes. Following the surgery the patient must be willing to limit their activities in order to avoid destruction of the joint replacement. (4)
Only your physician can determine whether or not you need a joint replacement surgery for your arthritis. But only you can determine whether or not you\’re willing to undertake this procedure. Prior to discussing your alternatives your physician will have done specific diagnostic evaluation in order to determine the extent of your disease and the ability of your joint tissue to withstand the surgery.
Discuss your options with your primary care physician and your rheumatologist as well as your insurance company. Know all of your options and the consequences of any decisions you may make prior to making a decision which may significantly change the rest of your life. Undertaking a joint replacement because arthritis affected your joint will often significantly reduce, or eliminate, your pain and swelling. It can also increase your mobility and reduce your disability.
However, in order to gain the most advantages from the surgery it is also best to reduce the amount of stress on the joints which are suffering from degeneration or rheumatoid arthritis. This means reducing your weight in order to decrease the stress on knees and hips toward changing the way in which you are using your hands in order to reduce the stress on those joints.
(1) Arthritis Foundation: What is Osteoarthritis
(2) American Academy of Orthopedic Surgeons: Total Joint Replacement
(3) University of Wisconsin Sports Medicine: Rehabilitation Guidelines for Surface Replacement Arthroplasty
(4) American Academy of Orthopedic Surgeons: Wrist Joint Replacement