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What is Total Joint Replacement?
Total joint replacement is a surgical procedure in which the arthritic
or damaged joint is removed and replaced with an artificial joint
called a prosthesis, designed to move just like a healthy human
joint. Performed since the 1960s, total joint replacements now result
in pain-free living for over 90% of patients, enabling them to return
to normal functioning and enjoy favorite activities once again.
The prosthesis comprises several parts that are made of a metal
alloy or ceramic (to replace diseased bone) and of high-density
plastic (to replace diseased cartilage). In a knee replacement,
for example, one part is attached to the end of the femur where
diseased bone has been removed, and another is anchored to the shinbone.
The replacement may also include another small component—a
circular piece of plastic that is designed to replace cartilage
or diseased bone. Cement may or may not be used to hold the prosthesis
in place.
Common Causes of Joint Pain
The most common cause of long-term joint pain and loss of function
is arthritis.
The most common types of arthritis are:
Osteoarthritis
(OA)—sometimes called degenerative arthritis because
it is a “wearing out” condition involving the breakdown
of the cartilage that cushions the knee. When the cartilage wears
away, the bones rub against each other, causing pain and stiffness.
OA usually occurs in people aged 50 years and older with a family
history of arthritis.
Rheumatoid
Arthritis (RA)—a disease that causes the synovium
to become thickened and inflamed. In turn, too much synovial fluid
is produced within the joint space, which causes a chronic inflammation
that damages the cartilage. This eventually results in cartilage
loss, pain, and stiffness.
Post-traumatic
Arthritis—can develop after a serious joint injury.
A joint fracture or severe ligament tear may lead to degeneration
of the articular cartilage, causing excess wear and pain, and reduced
function in the joint over time.
Joint pain can also be caused by deformity or direct injury. In
some cases, the pain is made worse by the fact that a person will
favor the painful joint, weakening the muscles and making the joint
even more difficult to move.
Based on an orthopaedic evaluation of your condition—including
a thorough medical history, physical exam, x-rays, and other tests—Jeffrey
R. Ginther, MD will diagnose the cause of your pain, determine the extent of damage
or deformity, and recommend a course of treatment.
Is Joint Replacement Right for You?
Total joint replacement is usually reserved for patients who have
severe arthritic conditions. Most patients who have artificial joints
are over 55 years of age, but the operation is being performed in
greater numbers on younger patients thanks to new advances in artificial
joint technology.
Circumstances vary, but generally patients are candidates for joint
replacement surgery if: Pain is severe
enough to restrict not only work and recreation, but also the ordinary
activities of daily living Pain is not relieved
by more conservative methods of treatment Stiffness in
the joint is significant X-rays indicate
advanced arthritis or other problems
For patients with conditions such as these, total joint replacement
can provide a new lease on life. More than 90% of individuals who
have a total joint replacement experience a dramatic reduction in
pain and a significant improvement in their ability to participate
in the activities of daily living. In a follow-up study, about 90%
of patients reported that they were not experiencing any pain in
the replacement joint 6 years after surgery.
An Elective Approach to Surgery
Jeffrey
R. Ginther, MD emphasizes that a key part of their responsibility as joint specialists
is to empower each patient to make an informed decision whether
to have surgery. Because each patient’s condition is unique, Jeffrey
R. Ginther, MD helps the patient fully understand his or her diagnosis, recommended
treatment options, and potential outcomes. Given the “big
picture,” patients can make an educated choice to have surgery
or continue with more conservative methods of pain management.
Joint replacement is a decision you should also discuss with your
family. It is important to understand the treatment options and
the likely long-term results. We invite you to ask questions throughout
the decision-making process so that you will feel comfortable and
confident in your chosen course of treatment.
Jeffrey R. Ginther, MD, FACS | Servicing Central Indiana | 317-770-4100
