This article is more than 5 years old. Information may no longer be current.
What is a total joint replacement?
Click Here to Manage Email Alerts
A total joint replacement is a surgical procedure in which an orthopedic surgeon removes a joint damaged by injury or disease and replaces it with a prosthesis comprised of components made of metal, plastic, ceramic or a combination of these materials. Total joint replacement can occur in a variety of anatomic sites, including the foot, ankle, shoulder, wrist, elbow and fingers. The most common procedures are hip and knee replacements. The goals of a total joint replacement are to decrease pain and improve function.
An orthopedic surgeon will conduct a physical examination, arthroscopy, or order imaging studies or laboratory testing to assess joint damage prior to a total joint replacement. During the procedure, the prosthesis can be implanted with or without cement. In cemented procedures, surgeons use bone cement to secure the prosthesis. In cementless cases, a press-fit implant is used, which features materials that allow bone to grow into the prosthesis. In addition, total joint replacements can be performed with minimally invasive surgical (MIS) techniques, in which orthopedic surgeons use smaller incisions and specific instruments. Some orthopedic surgeons hold that MIS techniques lead to faster recovery, less blood loss and reduce damage to the soft tissues and muscles surrounding the joint. However, others note a high surgeon learning curve, longer operative time and a greater risk of complications using these methods.
Overall, the complications of total joint replacement can include infection, neurovascular injury, severe postoperative pain, osteolysis, breakage of the prosthesis, loosening, dislocation and wear, and thromboembolic events, such as deep venous thrombosis and pulmonary embolism. A strategy of anticoagulants, compression stockings or boots may be used in an effort to prevent thromboembolic events, and prophylaxis protocol varies by institution, patient factors and type of surgery.
Physical therapy and the ability of patients to weight bear, exercise, resume activities of daily living and ambulate without assistance also varies by the type of procedure. Durability of the prosthesis depends on implant type and patient age, weight, activity level and medical conditions.
Additional information can be found by searching the following websites: