About Joint Replacements

Total joint replacement is usually reserved for patients who have severe arthritic conditions. Most patients who have artificial hip or knee 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 considered for total joint replacement if:

• Functional limitations restrict not only work and recreation, but also the ordinary activities of daily living
• Pain is not relieved by more conservative methods of treatment, such as those described above, by the use of a cane, and by restricting activities
• Stiffness in the joint is significant
• X-rays show advanced arthritis or other problems

What is Total Joint Replacement?

Total joint replacement is a surgical procedure in which certain parts of an arthritic or damaged joint, such as a hip, knee or shoulder joints, are removed and replaced with a plastic or metal device called a prosthesis. The prosthesis is designed to enable the artificial joint to move just like a normal, healthy joint.

Hip replacement involves replacing the femur (head of the thighbone) and the acetabulum (hip socket). Typically, the artificial ball with its stem is made of a strong metal, and the artificial socket is made of polyethylene (a durable, medical grade plastic). In total knee replacement, the artificial joint is composed of metal and polyethylene and it is used to replace the diseased joint. The prosthesis is anchored into place with bone cement or is covered with an advanced material that allows bone tissue to grow into it.

In shoulder replacement surgery, the artificial shoulder joint can have either two or three parts, depending on the type of surgery required.

• The humeral component (metal) is implanted in the humerus.
• The humeral head component (metal) replaces the humeral head at the top of the humerus.
• The glenoid compontent (plastic) replaces the surface of the glenoid socket.

Total joint replacements of the hip, knee, and shoulder have been performed since the 1960s. Today, these procedures have been found to result in significant restoration of function and reduction of pain in 90% to 95% of patients. While the expected life of conventional joint replacements is difficult to estimate, it is not unlimited. Today’s patients can look forward to potentially benefiting from new advances that may increase the lifetime of the prostheses.

After Surgery — Limitations

For approximately 12 weeks after surgery certain limitations are placed on your activities. When fully recovered, most patients can return to work. However, some types of work may not be advisable for individuals with a joint replacement. These types of work include:

• Construction work
• Certain types of carpentry
• Occupations that involve repeated high climbing

Athletic activities that place excessive stress on the joint replacement will need to be avoided. Examples of these activities include:

• Skiing (snow or water)
• Basketball
• Baseball
• Contact sports
• Running
• Frequent jumping

Realistic Expectations

Physical Activities
After joint replacement, acceptable physical activities should:

• Not cause pain — including pain felt later
• Not jar the joint — running and jumping should be avoided
• Not place the joint in the extremes of its range of motion
• Be pleasurable

Longevity of Joint Replacement
It is impossible to predict in individual cases how long a joint replacement will last. Many factors determine the outcome including:

• Age
• Weight
• Activity level

When will I be able to go back to a normal daily routine?

This is a decision only you and your surgeon can make. Every patient’s experience is different.

However, there are some general guidelines your doctor may give you:

• You'll practice stair — climbing in the hospital and should be able to do this by the time you leave
• You should have no restrictions on leaving your home as long as your safety and comfort are assured. Just don't tire yourself out; a good balance of exercise, rest, and relaxation is best for helping your body heal and gain strength
• When to resume driving a car, going to work, and/or participating in sports activities are all highly individualized decisions. Be sure to follow your doctor's or orthopaedic surgeon's advice and recommendations