Joint Replacement

Joint Replacement surgery or Replacement arthroplasty in technical terms is an Orthopedic surgical procedure where a diseased or damaged joint surface is replaced by a prosthesis to provide a pain free mobile and functional joint.

Replacement surgeries of joints are becoming more common. Hips and knees are replaced more commonly than any other joint.

Historical facts

Earliest eveidence of joint replacement dates back to 1939, by Stephen S. Hudack on animals. Human trials were started in 1948. Since then joint replacement surgeries have taken leaps and bounds and presently have evolved to be one of the most successful surgeries.

Earlier forms of arthroplasties were:

interpositional arthroplasty
excisional arthroplasty
resection arthroplasty
resurfacing arthroplasty
mold arthroplasty
cup arthroplasty
Osteotomy to Rposition the weight bearing surface

To provide a painless mobile joint, current form of replacing the arthritic surface with a prosthesis is the most successful form of arthroplasty.

Joints which can be replaced now are:

Shoulder
Hip
Knee
Elbow
Ankle
Small joints in fingers

Procedure

Complete pre-operative investigation is done which include:

Detailed clinical assessment
Investigations
X-rays & other Imaging studies
Implant templating

Surgery is performed in regional or general anesthesia depending upon the requirement.

After surgery patient will require a few days of hopitalisation and about a month of physiotherapy.

Patient will take about a year of rehabilitation before he/she regains near normal strength.

Materials of Prosthesis:

Ceramic materials
Zirconia
Titanium nitride
Cobalt chrome
Stainless steel

Risks and complications;

Medical risks

Cardiac – Heart Attack
Brain – Stroke
Blood Vessels – Clot formation
Lungs – Pneumonia
Urinary Tract Infection

Surgical risks

Prosthesis failure
Fracture
Nerve injury
Injury to blood vessels
Infection
Persistent pain
Stiffness in joint
Weakness
Loosening of prosthesis
Wear and tear of prosthesis

Revision surgery

With the latest instruments, techniques and a well trained surgeon revision is usually not required for may be up to 20 years or more. But revision may become necessary in cases of:

Infection
Prosthetic failure
Fracture

Joint Replacement	Days stay in Hospital	EstimatedProcedure Cost in USD
Knee Replacement
TKR one knee	4	5000
TKR both knee	5	9500
Total Hip Replacement
THR (Cemented	5	4500
THR (Uncemented)	5	5500
Hemi-Replacement	4	3500
Ankle Replacement	4	6500
Elbow Replacement	4	6500
Shoulder Replacement
Total Shoulder replacement	4-6	8000
Reverse Shoulder replacement	4-6	9000
Hemi replacement	5	6000