Joint replacement
Joint replacement is one of the most common and successful operations in modern orthopedic surgery. It consists of replacing painful, arthritic, worn (or cancerous parts) of the joint with artificial surfaces shaped in such a way as to allow joint movement.
Prognosis is good to excellent in 95% of major joint replacements (hips and knees). Pain relief is especially reliable. Full recovery of range of motion is not always accomplished.
The abnormal bone and lining structures of the involved joint are removed surgically, and new parts are inserted in their places. These new parts may be made of special metal or plastic (certain forms of polyethylene) or specific kinds of carbon-coated implants. The new parts allow the joints to move again with little or no pain.
The following joints can be replaced-:
· Finger joints (the “first” joint, called the PIP joint)
· “Knuckle” joints (called MP joints, where the finger joins the hand)
· Wrist joints
Artificial joints should not be done if you have:
• An infection in the joint
• Muscles or tendons that normally would move the involved joint are damaged and cannot be repaired to allow a new joint to work properly
• Other joint replacements or hardware from other surgery that would block insertion or motion of a new implant
• Problems with skin or bone quality
Alternative procedures besides joint replacement
• Joint injections (steroid preparations are used most commonly)
• Oral medications (such as aspirin or anti-inflammatory medicines)
• Physical therapy exercises and protective splints
• Surgery to fuse bones together – called “arthrodesis” – which relieves pain by eliminating motion between damaged joint surfaces
• Surgery on tendons or ligaments to repair related joint injuries
Benefits of joint replacement surgery
Artificial joints may help:
• Reduce joint pain
• Restore or maintain joint motion
• Improve the look and alignment of the joint(s)
• Improve overall hand function
Risks of joint replacement surgery
Implant loosening, fracture or wear that occurs over time and which may require subsequent surgery to repair or replace the damaged parts
• Infection
• Joint stiffness or pain, if the procedure or implant fails
• Dislocation of the artificial joint
• Damage to vessels, nerves or other structures in the region of the surgery
