What Is Joint Replacement Surgery?
Joint replacement surgery or joint arthroplasty is the surgery to replace the damaged joints. Joints are the intersection where two or more bones come together, as in the knee, hip, and shoulder.
Joint replacement surgery involves removing a damaged joint and inserting a new one. Sometimes, the orthopaedic surgeon will not remove the entire joint but will only replace or fix the damaged parts.
A new joint (prosthesis) made of plastic, metal or combination of both, maybe cemented into one place or not cemented. The new bone grows into it.
A cemented joint is used more for older people who are less active and patients with “weak” bones. The cement holds the new joint to the bone. A non-cemented joint is used more for younger, more active people and patients with good bone quality. But this may take longer to heal.
Risk Factors:
All surgeries have risk factors. Joint surgery risk depends on the patient’s health before surgery, how severe are arthritis and the type of surgery. Many hospitals and doctors have decades of experience replacing joints and this reduces risks. The doctor will inform the patient of the risks involved. The orthopaedic doctor will be involved before, during and after the surgery to ensure a quick recovery.
Do I Need to Have My Joint Replaced?
The doctor will advise if a joint needs to be replaced, after studying the results of the X-ray or other tests. The doctor might use the arthroscope (a small, lighted tube) to look into the joint for damage. A tissue test could also be done.
A less-frequently used option called osteotomy could also be advised where the surgeon “aligns” the joint. The bone or bones around the joint are cut to improve alignment. This can be simpler than joint replacement but takes longer to heal.
Joint replacement is often the solution for people with constant joint pain, and having trouble doing routine actions such as walking, climbing stairs, and taking a bath.
What Happens During the Surgery:
- The patient is given anaesthesia (to avoid feeling pain). It could be regional or general anaesthesia, the pain blocked only in one part of the body (regional) or the whole body is put to sleep (general anaesthesia).
- The surgery team then replaces the damaged joint with a prosthesis.
- Length of the surgery depends on the degree of joint damage and the surgery process. A knee or a hip replacement generally takes about two hours or less.
- After the surgery, the patient is moved to a recovery room for one or two hours, until the patient recovers consciousness or the numbness goes away.
What Happens After the Surgery:
- Knee or hip surgery needs a hospital stay for a few days. The elderly or those with additional disabilities may then need to spend several weeks in an intermediate-care facility before going home. The team of doctors observe the patient’s speed of recovery and determine the length of the stay in the hospital.
- After hip or knee replacement, the patient can stand or begin walking the same day of the surgery. A walker or crutches may be needed initially. Some temporary pain in the new joint can be there due to weakened state of the muscles and the body’s healing process. Medicine can reduce the pain, and the pain ends in a few weeks or months.
- Physical therapy begins the day after the surgery, to help strengthen muscles around the new joint and to help the patient regain motion involving the joint. A shoulder joint replacement allows the patient to exercise the shoulder on the same day as the surgery!
Dr. Seshadri Sen, Consultant Orthopaedics, Narayana Multispeciality Hospital, Barasat.
