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What is arthroplasty?
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Arthroplasty is a surgical procedure performed by an orthopedic surgeon that alters or completely replaces a joint in the body, usually to restore normal motion and relieve pain in a malformed or diseased joint, such as the hip, knee, shoulder, elbow or ankle. Arthroplasty may also be required due to cartilage that wears out, limb/joint malalignment, joint space narrowing, a stiff joint, disease, or other degenerative or traumatic conditions.
Depending on the severity of the problem with the joint and other factors, resection arthroplasty, interpositional arthroplasty or total joint arthroplasty may be performed.
In resection arthroplasty, the orthopedic surgeon removes a minimal amount of tissue surrounding the joint in an attempt to restore joint function. This may be successful as a first surgical treatment or interpositional arthroplasty can be done. During interpositional arthroplasty the joint is surgically reshaped and, to provide better contact between the sides of the joint, a material (such as metal, plastic, ceramic or the patient’s own soft tissue) is positioned at the site where the joint articulates.
Total joint arthroplasty is a surgical procedure that replaces or treats both sides of the joint articulation or the total joint. Hemiarthroplasty is performed to treat a problem with just one side of a joint. Total joint arthroplasty is typically indicated after a conservative, nonoperative course of therapy has failed.
During total joint arthroplasty, the orthopedic surgeon uses special instruments to remove damaged portions of the joint and replaces them with artificial components. Stems or pegs on the artificial joint components are fitted into the healthy, remaining part of the bone and kept in place with either bone cement or a special coating on the implant that fosters new bone growth in the area. The fixation method used is based on the patient’s age, bone quality and activity level.
Resurfacing arthroplasty replaces or “resurfaces” only the damaged, extreme end of a joint. The goal of resurfacing is to maintain the remainder of the joint and preserve more of the patients own anatomy.
Orthopedic surgeons have several types of arthroplasty implants or prostheses to choose from to replace or resurface the joint. Different implants and materials have distinct success rates in clinical use.
Following arthroplasty surgery, patients should expect to undergo a rest and rehabilitation period. Then, under their doctor’s direction, they will gradually begin to regain strength and flexibility in the area surrounding the replaced joint, and re-learn how to use the joint.
Orthopedic surgeons follow up with their patients at regular intervals after surgery with a physical examination and X-rays or other types of imaging. This process helps ensure the arthroplasty procedure and devices are performing as expected.
Occasionally, patients develop complications following total joint arthroplasty, such as an infection or a loose implant, and the prosthesis or device needs to be removed along with the surrounding damaged or infected tissues. The procedure to implant a new arthroplasty device in place of the original or primary component is called a revision arthroplasty.
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