Arthroplasty

By Marty Polovich

(Hip Arthroplasty, Joint Arthroplasty, Knee Arthroplasty, Shoulder Arthroplasty, Finger Arthroplasty, Joint Replacement Surgery)

Procedure overview

What is arthroplasty?

Arthroplasty is a surgical procedure to restore the integrity and function of a joint. A joint can be restored by resurfacing the bones. An artificial joint (called a prosthesis) may also be used.

Various types of arthritis may affect the joints. Osteoarthritis, or degenerative joint disease, is a loss of the cartilage or cushion in a joint, and is the most common reason for arthroplasty.

Anatomy of the joint

Joints are formed where bones meet. Most joints are mobile, allowing the bones to move. Joints consist of the following:

  • Cartilage. A type of tissue that covers the surface of a bone at a joint. Cartilage helps reduce the friction of movement within a joint.

  • Synovial membrane. A tissue that lines the joint and seals it into a joint capsule. The synovial membrane secretes synovial fluid (a clear, sticky fluid) around the joint to lubricate it.

  • Ligament. A type of tough, elastic connective tissue that surrounds the joint to give support and limits the joint's movement.

  • Tendon. A type of tough connective tissue that connects muscles to bones and helps to control movement of the joint.

  • Bursa. A fluid-filled sac located between bones, ligaments, or other adjacent structures that helps cushion joints.

  • Meniscus. A curved part of cartilage in the knees and other joints that acts as a shock absorber.

Reasons for the procedure

Arthroplasty may be used when medical treatments no longer provide adequate relief from joint pain and/or disability . Some medical treatments for osteoarthritis that may be used prior to arthroplasty include, but are not limited to, the following:

  • Anti-inflammatory medications

  • Pain medications

  • Limiting painful activities

  • Assistive devices for walking (such as a cane)

  • Physical therapy

  • Cortisone injections into a knee joint

  • Viscosupplementation injections (to add lubrication into the joint to make joint movement less painful)

  • Weight loss (for obese people)

  • Glucosamine and chondroitin sulfate

  • Exercise and conditioning

People who have arthroplasty generally have substantial improvement in their joint pain, ability to perform activities, and quality of life, so these are important reasons for the procedure as well.

Most joint surgery involves the hip and knee, with surgery on the ankle, elbow, shoulder, and fingers being performed less often.

There may be other reasons for your doctor to recommend arthroplasty. Please see hip replacement and knee replacement surgical procedures for more specific information.

Risks of the procedure

As with any surgical procedure, complications can occur. Some possible complications may include, but are not limited to the following:

  • Bleeding

  • Infection

  • Blood clots in the legs or lungs

  • Loosening of prosthetic parts

Nerves or blood vessels in the area of surgery may be injured, resulting in weakness or numbness. The joint pain may not be relieved by the surgery.

There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your doctor prior to the procedure.

Before the procedure

  • Your doctor will explain the procedure to you and offer you the opportunity to ask any questions that you might have about the procedure.

  • You will be asked to sign a consent form that gives your permission to do the procedure. Read the form carefully and ask questions if something is not clear.

  • In addition to a complete medical history, your doctor may perform a complete physical examination to ensure you are in good health before undergoing the procedure. You may undergo blood tests or other diagnostic tests.

  • Notify your doctor if you are sensitive to or are allergic to any medications, latex, tape, and anesthetic agents (local and general).

  • Notify your doctor of all medications (prescribed and over-the-counter) and herbal supplements that you are taking.

  • Notify your doctor if you have a history of bleeding disorders or if you are taking any anticoagulant (blood-thinning) medications, aspirin, or other medications that affect blood clotting. It may be necessary for you to stop these medications prior to the procedure.

  • If you are pregnant or suspect that you are pregnant, you should notify your health care provider.

  • You will be asked to fast for eight hours before the procedure, generally after midnight.

  • You may receive a sedative prior to the procedure to help you relax.

  • You may meet with a physical therapist prior to your surgery to discuss rehabilitation.

  • The area around the surgical site may be shaved.

  • Arrange for someone to help around the house for a week or two after you are discharged from the hospital.

  • Based on your medical condition, your doctor may request other specific preparation.



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