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