Joint replacement surgery

• Article
• 2021-01-30

Joint replacement surgery is the removal of a damaged joint and the insertion of a new joint. The doctor may suggest a joint replacement to improve your life. Joint replacement can relieve pain and help you move and feel better.

Hips and knees are most often replaced. Other joints that can be replaced include the shoulders, fingers, ankles, and elbows.

The new connection can be made of plastic, metal or ceramic parts. Sometimes the surgeon will not remove the entire joint, just replace or repair the damaged parts. Types of new joints include:

• Cemented joints: more commonly used in older people who move less and in people with "weak" bones. The cement will hold the new joint to the bone.
• Uncemented joints: Often recommended for younger, more active people and those with good bone quality. It may take longer to heal because bone takes longer to grow and attach to it.
• Hybrid Replacements: Use both methods to keep the new joint in place.

Complications

New technology and advancements in surgical techniques have significantly reduced the complications of joint replacements. If problems arise, most of them can be treated. Possible problems are:

• Infection. Areas in the wound or around the new joint can become infected. It can happen while you are still in the hospital or after you go home. It can happen even years later. Minor infections in the wound are usually treated with drugs. Deep infections may require a second surgery to treat the infection or replace the joint.
• Blood clots. If your blood moves too slowly, it can form lumps of blood called clots. If pain and swelling develop in your legs after hip or knee surgery, blood clots may be the cause. The doctor may recommend medications to thin your blood or special stockings, exercises, or boots to help your blood move more quickly. Contact your doctor right away if you notice swelling, redness, or pain in your leg after leaving hospital.
• Loosening. The new joint can come loose and cause pain. If the loosening is bad, you may need another surgery to reattach the joint to the bone.
• Dislocation. Sometimes, after a hip or other joint replacement, the ball of the prosthesis can come out of the socket. In most cases, the hip can be corrected without surgery. A brace can be worn for a while if dislocation occurs.
• Wear. Some wear and tear can be found with all joint replacements. Too much wear can help cause loosening. The doctor may need to operate again if the prosthesis comes loose. Sometimes the plastic can wear thin and the doctor can replace the plastic and not the entire joint.
• Nerve and blood vessel injury. Nerves near the replaced joint can be damaged during surgery, but this does not happen often. Over time, the damage often improves and can disappear. Blood vessels can also be injured.

Moving your new joint and getting your muscles strong again will reduce pain, increase flexibility and improve movement.

Life after surgery

With knee or hip surgery , you will likely need to stay in the hospital for a few days. If you are an older adult or have additional disabilities, you may need to spend several weeks in an intermediate care facility before you go home. You and your team of doctors determine how long you stay in the hospital.

After a hip or knee replacement, you will often be standing or walking on the day of surgery. Inat first you walk with a walker or crutches. You may experience temporary pain in the new joint because your muscles are weak from not using them. Your body is also healing. The pain can be managed with medication and should go away in a few weeks or months.

Physical therapy can begin the day after surgery to strengthen the muscles around the new joint and help you regain movement in the joint. If you have your shoulder joint replaced, you can usually start exercising the same day of your surgery! A physical therapist will help you with gentle range of motion exercises. Before you leave the hospital, your therapist will show you how to use a pulley machine to flex and extend your arm.

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