Welcome to United Bone & Joint Replacement
What is Joint Replacement?
Joints are formed by the ends of two or more bones connected by tissue called cartilage. Healthy cartilage serves as a protective cushion, allowing smooth, low-friction movement of the joint. If the cartilage becomes damaged by disease or injury, the tissues around the joint become inflamed, causing pain. With time, the cartilage wears away, allowing the rough edges of bone to rub against each other, causing more pain.
When only some of the joint is damaged, a surgeon may be able to repair or replace just the damaged parts. When the entire joint is damaged, a total joint replacement is done. To replace a total hip or knee joint, anorthopedic surgeon at United Bone & Joint removes the diseased or damaged parts and inserts artificial parts, called prostheses or implants. These prostheses are considered medical devices, which are regulated by theFood and Drug Administration.
The American Academy of Orthopedic Surgeons calls total hip replacement an orthopedic success story, enabling hundreds of thousands of people to live fuller, more active lives. In 2009, it was reported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases that 773,000 Americans have a total knee or hip replacement per year. Total knee replacement is highly successful in relieving pain and restoring joint function, says the AAOS. And a hip or knee replacement lasts at least 20 years in about 80 percent of those who get them.
But despite their success, hip and knee joint replacements still have drawbacks. There may be complications. They don’t always last a lifetime and when they fail, surgery may be needed.
As artificial joints and surgical techniques to implant them continue to evolve, the medical community and patients hold out hope for joint replacements that cause fewer problems, last longer, and move more like a healthy natural joint.
Why Joint Replacement?
The most common reason for having a hip or knee replaced is osteoarthritis, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). This degenerative joint disease, marked by the breakdown of the joint’s cartilage, is not limited to older people. Although it most commonly affects people over age 45, younger men and women also can get this disease.
Some people are born with a deformed joint or defective cartilage, which leads to osteoarthritis. Excess weight,joint fracture, ligament tears, or other injury can damage cartilage and cause osteoarthritis.
Rheumatoid arthritis is another condition that may be alleviated by hip or knee joint replacement. This chronic inflammation of the joint lining causes pain, stiffness, and swelling. The inflamed lining can invade and damage bone and cartilage. Rheumatoid arthritis generally starts in middle age, but can also affect children and young adults.
Loss of bone caused by poor blood supply (avascular necrosis), which led to Van Halen’s hip replacement, andbone tumors may be other reasons for joint replacement.
The Risks of Replacement
Like any surgery, hip and knee joint replacement carries certain life-threatening risks, such as infection, blood clots and complications from anesthesia. Other complications include nerve damage, dislocation or breakage after surgery, and wearing out or loosening of the joint over time. After hip replacement surgery, one leg may be shorter than the other.
Infection is an ongoing risk for people with joint replacements. Not only can it occur in the hospital, but it can happen years later if bacteria travel through the bloodstream to the replacement area.
In the rare case that an infection spreads to the new joint and does not clear up with antibiotic treatment, the joint must be replaced. This usually requires two surgeries–one to remove the infected joint and another surgery later to insert the new joint. Between surgeries, the infection is treated with antibiotics.
In 2001, the FDA approved a temporary artificial hip for people with hip joint infection. The temporary hip, called Prostalac, can be inserted and left in place for about three months after the infected hip is removed. It consists of a metal stem and ball that fits into the thighbone, a plastic cup that attaches to the hipbone, and a bone cement that contains antibiotics. The antibiotics in the cement, along with oral antibiotics taken by the patient, help to treat the infection. The temporary hip allows a person some movement while healing.
How Do You Know It’s Time for Surgery?
The specialists at United Bone & Joint have a checklist of items — if you are experiencing any of these signs, you should speak to your orthopedic surgeon about the possibility of joint replacement:
- you are unable to sleep at night because of the pain
- you’ve tried a series of different medications that don’t help alleviate the pain, or the medication you have been on no longer works
- you feel that the pain from your arthritis is keeping you from regular outings, such as visiting friends, going shopping or taking a vacation
- your activity is restricted to the point where you have trouble getting out of a chair, going up stairs, getting off the toilet, or getting up from the floor.