What is a Joint Replacement Surgery ?

In this procedure the damaged joint( hip or knee) is replaced with an artificial joint made of plastic, metal or polymers. The implants are fixed to the bone with help of bone cement (knee) or both with/without bone cement (hip). The major ligaments & tendons around knee joint are left intact that helps in active movements of knee joint and also provides stability. It can be partial or complete joint replacement depending upon the extent of damage to the joint.

Indications for Joint Replacement Surgery?

• Osteoarthritis (most common age related degeneration which leads to cartilage damage covering bone ends of a joint, uncommon below 40 years of age, females affected more than males, associated with obesity).
• Rheumatoid arthritis ( inflammatory condition leading to joint damage & deformity, usually involves multiple joints).
• Joint damage after an injury example bone fractures around joint ends.
• Avascular necrosis ( dead bone) especially hip joint in which the blood supply to the head of femur is damaged either due to trauma or other conditions.
• The damage to joints leads to pain, decreased movements, swelling, inability to walk & climb stairs. In severe cases it may lead to joint deformity.

The first line of treatment includes pain killers, weight reduction, oral supplements( Neutraceuticals- Glucosamine and Diacerin),local injections into joint (steroid or hyaluronic acid), exercises & physiotherapy.

When should I talk to my doctor for my Joint Replacement Surgery?

When Joint pain is so bad it actually interferes with the things you want or need to do, the time may be right. So, that is stage when all non surgical options have exhausted and quality of life is compromised with features like-

• Pain at rest
• Difficult in sleeping
• Walking with a limp
• Difficulty in bending joint or walking even with a stick
• Increasing joint stiffness and swelling
• Difficulty in doing daily routine activities due to severe painful joints.
• Markedly deformed limbs (in bowing or out bowing of legs)
• Limb length discrepancy (shortening or lengthening of affected leg)
• No relief even after taking multiple pain killers and doing exercises.
• Chronic painful joints affecting your emotional and mental well being

Goals of Joint Replacement Surgery

• To provide pain relief
• To correct limb length difference
• To restore normal limb alignment
• To restore functional range of motion of joint

Recovery following Joint Replacement Surgery

Patients usually resume their normal daily activities post surgery after a short recovery period without any limitations although high impact activities are to be avoided. Speed of recovery depends upon patient’s physical fitness, health, and level of physical activity prior to surgery, severity of joint damage & its duration and the type of surgery performed.

Key Takeways

• Arthritic joint pain for majority can be managed conservatively and if not, then surgery is the last option.
• Joint Replacement Surgery helps a patient to have a long term cure for painful joints and lead to a physically active and productive life.
• Delaying the surgery for joint damage may adversely affect the surgical outcome and recovery.