If your doctor recommends joint replacement surgery, it helps to know what to expect. Joint replacement surgery involves replacing a damaged joint with a new one called a prosthesis. These new joints usually are made of a metal, plastic or ceramic device. Hips and knees are the joints replaced most often, but shoulders, ankles and elbows can be replaced as well.                                                     

When to Consider Joint Replacement Surgery

Joint replacement is usually considered after exercise, walking aids, physical therapy or medications cannot relieve pain and improve mobility. Surgery for hip replacement patients, for example, can help lessen problems walking or make it easier to bend. Joint damage is caused by:

• Osteoarthritis
• Injuries
• Other diseases
• Joint wear caused by avascular necrosis (loss of bone caused by low blood supply)

Evaluation and Surgical Options

Before surgery, the surgeon evaluates the patient’s range of motion and joint strength, takes a medical history and takes x-rays to determine the extent of your damage. The doctor may put a small, lighted tube called an arthroscope into the joint to check for damage. In some cases, only the damaged parts would be replaced, not the entire joint. During a hip replacement surgery:

• Diseased or damaged bone and tissue is removed
• A metal stem and attached ball is inserted into the bone
• A cup is inserted into the socket of the hip joint

New joints can be cemented into place to hold the new joint to the bone. Another way is by the prosthesis being placed without cement so bone can grow and attach to it. A prosthesis is designed to duplicate the mechanical properties of the joint being replaced. A prosthetic knee, for example, will be flexible enough to bend without breaking, and strong enough to bear weight.

After Surgery

Most hip and knee replacement patients are discharged from the hospital one to three days after surgery. Patients are encouraged to perform specific exercises recommended by their doctors to help the recovery process. Pain after surgery is normal as it comes from lack of activity and healing tissues.

A majority of patients who undergo joint replacement surgery find it easier to perform daily activities and experience less pain throughout their lives. However, if problems do arise, most can be treated.

Possible complications from joint replacement surgery include infections, blood clots, loosening, dislocation or wear of the new joint, or nerve injury.

Hip replacement patients also may experience a change in leg length or joint stiffening. Following hip replacement surgery, most patients eventually will be able to swim, play golf or bike ride comfortably, but high-impact sports such as skiing and running are not recommended.

Joint replacement surgery is becoming more common in the United States, with more than 1 million Americans having a hip or knee replaced annually. Talk to your doctor for more information about joint replacement options.