Joint Replacement Surgery
Baby boomers
Joint replacement surgery involves the removal of damaged or diseased part of a joint and replacing them with new, man-made parts. Some 900,000 Americans have hip or knee joint replacement surgery every year. While these are the most often replaced joints, surgery can be performed on shoulders, fingers, ankles and elbows. Such procedures may become necessary after years of use, or because of disease or arthritis. A walking aid, such as a cane or walker, along with physical therapy and certain medications often relieve the pain in joints. But when the pain becomes excessive and makes daily activities difficult, surgery may become necessary. As baby boomers grow older and begin to reach retirement age, more and more turn to surgery as an option for relief from discomfort caused by active lifestyles. Advances in joint replacement surgery in recent years has led to fewer complications and faster recovery times for patients.
The knee
The knee is the largest joint in the human body. Knee replacement surgery involves replacing a damaged knee joint with a man-made prosthesis. The procedure requires removing cartilage and resurfacing the bone of the joint. The femur, or lower end of the thigh bone, is replaced along with the upper end of the shin bone, or tibia. These implants are usually made of metal. The patella, or backside of the kneecap, may be resurfaced and strong plastic cemented to it. A plastic insert is locked into place between the metal components. Previously, knee replacement was offered only to older patients, but now it can be performed on younger patients who wish to return to activities they can no longer enjoy due to knee pain. Patients typically spend one night in the hospital. Recovery speed depends on the patient. Many patients return to work two to three weeks after surgery and after stopping narcotics. Full recovery may take up to a year.
The hip
The human hip is made up of two major parts, one or both of which may need to be replaced during surgery. The hip socket, called the acetabulum, is usually replaced with a metal version while the upper end of the thighbone, or femoral head, will be replaced with metal or ceramic ball that is attached to a metal stem that goes into the thighbone. A plastic liner, which fits inside the socket, allows the replacement hip to move smoothly. Hip replacement surgery may be required for patients who have suffered from fractures in the thighbone or from arthritis. The patient will often stand or begin walking the day of surgery. At first, they will walk with a walker or crutches. The pain and stiffness that occurs after hip replacement surgery usually goes away shortly afterwards, with most patients enjoying a successful recovery period. Long-term data is limited, but a hip replacement may last anywhere from 15 to 20 years. For some it lasts longer.
The shoulder
Shoulder replacement surgery was initially performed in the United States in the 1950s to treat severe shoulder fractures. As the technology behind the procedure has improved, the surgery has come to be used for many other painful conditions of the shoulder, such as different forms of arthritis. Today, about 53,000 people in the U.S. have shoulder replacement surgery, according to the Agency for Healthcare Research and Quality. Dr. Lowry Barnes, chairman of the UAMS Department of Orthopaedic Surgery, urges people with shoulder pain that cannot be relieved with medications or lifestyle changes to consider replacement surgery. The typical total shoulder replacement involves replacing the arthritic joint surfaces with a highly polished metal ball attached to a stem and a plastic socket. Thousands have experienced an improved quality of life after shoulder replacement surgery, experiencing less pain and improved motion and strength.
In shape for surgery
Before undergoing joint replacement surgery, your orthopaedic surgeon will likely recommend safe and appropriate exercises that can help you get in shape and recover more quickly. Stretching, aerobic and strength training exercises can all be helpful. Among other things, doing exercises that strengthen your arms and upper body before surgery can make it easier to use a walker or crutches during recovery. Most surgeons require that patients have a Body Mass Index of less than 40 prior to having surgery since obesity increases risk of infection and makes the surgery more difficult. Most surgeons will not operate on patients that smoke or use tobacco products. These increase risk of infection and can cause trouble breathing while sedated. It is best if patients that are older and live alone find someone to stay with them in their homes for one to two weeks after surgery, as home is the healthiest place to recover.
Trusted by thousands of listeners every week, T. Glenn Pait, M.D., began offering expert advice as the host of UAMS’ “Here’s to Your Health” program in 1996. Dr. Pait began working at UAMS in 1994 and has been practicing medicine for over 20 years.