General Joint Surgery Information

• Direct-to-Consumer Marketing
• What Are Those Ads Talking About?
• Minimally Invasive Surgery — It's Not Just a Smaller Scar
• Canes: Why? How? When?
• About Joint Replacement
• The Number of Surgeries Performed by a Given Doctor Can Affect the Post-operative Complications
• "I Saw That on the Internet" — Research and New Procedures at TCJR
• The Patient and the Pain Pill
• Joint Replacement Patients Need Antibiotics Before Some Dental and Surgical Procedures
• What's a Physician Assistant (PA)?
• Nicotine Hinders Bone Grafts
• Post-Surgery X-Rays
• Managing Your Pain
• What Is the Difference between Cemented and Non-Cemented Fixation of Your Total Joint Prosthesis?
• Implants and Metal Detectors
• New Blood Options
• New Pain Medications

Thumbs Up for Joint Replacement

Roger Emerson, Jr., MD

Total joint replacement is one of the great orthopaedic surgical advances of this century. In this procedure, an orthopaedic surgeon replaces an arthritic or damaged joint with an artificial joint, called a prosthesis. In the United States alone, more than 150,000 total joint replacements are performed each year by orthopaedists.

The most frequent reason for performing a total joint replacement is to relieve the pain and disability caused by severe osteoarthritis. Osteoarthritis involves a wear-and-tear problem with bones and cartilage (the rubbery, cushion-like material that surrounds and protects the end of bones). The problem results from a gradual break down of cartilage, occurring most often in the hips, spine, knees, toes and fingers, the joints that you use most often.

Why does cartilage break down? There are several reasons. First, direct injury to the joint due to sports or physical labor can cause cartilage to break down. Hereditary conditions such as defective cartilage, dislocated hips or bowlegs also can cause cartilage to break down. Additionally, in some people, certain chemicals in the body attack the cells that make up cartilage.

When protective cartilage wears down, it softens and frays, leaving the joints unprotected. This may lead to a thickening of the bone ends, resulting in what are called spurs. Most people feel deep aching soreness, or stiffness that is particularly noticeable when they move. Sometimes these symptoms make it difficult to move the joints, especially after long periods of immobility.

Living with arthritis involves adjusting to and managing the pain. Although there is no cure for osteoarthritis, there is much one can do to alleviate the pain. Many people with osteoarthritis rely upon a combination of exercise, minor lifestyle changes, proper diet and medication. When these treatments fail the answer for many patients is total joint replacement. Total joint replacement is a surgical procedure where the damaged parts of the joint are replaced with artificial materials.

The materials used in a total joint replacement are designed to enable the joint to move in the same way as the normal joint. These artificial components are generally made of a metal piece that fits closely into a matching sturdy plastic partner piece.

If joint replacement is recommended, patients can expect significant relief from pain — often dramatically. Motion of the joint will also improve. The extent of improvement will depend on how stiff the joint was before the operation.

Many older persons can expect their total joint replacement to last a lifetime. The artificial joint will give years of pain-free living that would not have been possible otherwise. Materials and surgical techniques are improving rapidly because of the efforts of orthopaedists working with engineers and other scientists. The future is promising for those who choose to have a total joint replacement.