Total Joint ReplacementWhile the symptoms of joint pain may be tolerated with medications and lifestyle adjustments, there may come a time when surgical treatment is necessary. Total joint replacement surgery, also called arthroplasty, removes the damaged portion of the joint and replaces it with artificial implants. For nearly 50 years, joint replacement procedures have decreased pain and restored function to those suffering from pain. New designs, materials, technologies, and techniques in joint replacement continue to evolve.
Our Board Certified joint replacement specialists are trained to evaluate, diagnosis and perform non-surgical as well as surgical treatment of all joint replacement procedures using the latest techniques to help ensure optimal outcomes for joint replacement patients. Our physicians will gladly answer all of your questions about these and other joint replacement procedures:
- Minimally Invasive Surgery
- Partial Joint Replacement
- Ceramic-on-Ceramic Hip Replacement
- Metal-on-Metal Hip Replacement
- Hip Resurfacing
- Advanced Hip Replacement
- Female Knee Replacement
To learn more, please visit our Patient Education page or contact one of our offices.
WHAT IS TOTAL JOINT REPLACEMENT?An arthritic or damaged joint is removed and replaced with an artificial joint, called a prosthesis.
The goal is to relieve the pain in the joint caused by the damage done to the cartilage. The pain may be so severe, a person will avoid using the joint, weakening the muscles around the joint and making it even more difficult to move the joint. A physical examination, and possibly some laboratory tests and X-rays, will show the extent of damage to the joint. Total joint replacement will be considered if other treatment options will not relieve the pain and disability.
WHY IS TOTAL JOINT REPLACEMENT NECESSARY?
You will be given an anesthetic and the surgeon will replace the damaged parts of the joint. For example, in an arthritic knee the damaged ends of the bones and cartilage are replaced with metal and plastic surfaces that are shaped to restore knee movement and function.
HOW IS A TOTAL JOINT REPLACEMENT PERFORMED?
In an arthritic hip, the damaged ball (the upper end of the femur) is replaced by a metal ball attached to a metal stem fitted into the femur and a plastic socket is implanted into the pelvis, replacing the damaged socket.
Although hip and knee replacements are the most common joint replaced, this surgery can be performed on other joints, including the ankle, foot, shoulder, elbow, and fingers.
The materials used in a total joint replacement are designed to enable the joint to move just like a normal joint.
The prosthesis is generally composed of two parts: a metal piece that fits closely into a matching sturdy plastic piece. Several metals are used, including stainless steel, alloys of cobalt and chrome, and titanium. The plastic material is durable and wear resistant (polyethylene). A plastic bone cement may be used to anchor the prosthesis into the bone.
Joint replacements also can be implanted without cement when the prosthesis and the bone are designed to fit and lock together directly.
In general, your orthopaedic surgeon will encourage you to use your "new" joint shortly after your operation. After total hip or knee replacement, you will often stand and begin walking the day after surgery. Initially, you will walk with a walker, crutches, or a cane.
WHAT IS THE RECOVERY PROCESS?
Most patients have some temporary pain in the replaced joint because the surrounding muscles are weak from inactivity and the tissues are healing. This will end in a few weeks or months.
Exercise is an important part of the recovery process. Your orthopaedic surgeon or the staff will discuss an exercise program for you after surgery. This varies for different joint replacements and for differing needs of each patient.
After your surgery, you may be permitted to play golf, walk, and dance. More strenuous sports, such as tennis or running, may be discouraged.
The motion of your joint will generally improve after surgery. The extent of improvement will depend on how stiff your joint was before the surgery.
Before surgery, your orthopaedic surgeon will make some recommendations, such as suggesting that you:
HOW DO YOU PREPARE FOR TOTAL JOINT REPLACEMENT?
- Donate some of your own blood so that, if needed, you may receive it during or after surgery
- Stop taking some drugs before surgery
- Begin exercises to speed your recovery after surgery
- Evaluate your need for discharge planning, home therapy and rehabilitation after surgery
Most older persons can expect their total joint replacement to last a decade or more. It will give years of pain-free living that would not have been possible otherwise.
IS TOTAL JOINT REPLACEMENT PERMANENT?
Younger joint replacement patients may need a second total joint replacement. Materials and surgical techniques are improving through the efforts of orthopaedic surgeons working with engineers and other scientists.
The future is bright for those who choose to have a total joint replacement to achieve an improved quality of life through greater independence and healthier pain-free activity.
Your orthopaedic surgeon is a medical doctor with extensive training in the diagnosis and nonsurgical and surgical treatment of the musculoskeletal system, including bones, joints, ligaments, tendons, muscles, and nerves.
Tell your orthopaedic surgeon about any medical conditions that might affect the surgery. Joint replacement surgery is successful in more than 9 out of 10 people. When complications occur, most are successfully treatable.
WHAT ARE THE POSSIBLE COMPLICATIONS?
Possible complications include the following....
Infection may occur in the wound or deep around the prosthesis. It may happen while in the hospital or after you go home. It may even occur years later. Minor infections in the wound area are generally treated with antibiotics. Major or deep infections may require more surgery and removal of the prosthesis. Any infection in your body can spread to your joint replacement.
Blood Clots result from several factors, including your decreased mobility causing sluggish movement of the blood through your leg veins. Blood clots may be suspected if pain and swelling develop in your calf or thigh. If this occurs, your orthopaedic surgeon may consider tests to evaluate the veins of your leg. Several measures may be used to reduce the possibility of blood clots, including:
1. blood thinning medications (anticoagulants)
2. elastic stockings
3. exercises to increase blood flow in the leg muscles
4. plastic boots that inflate with air to compress the muscles in your legs
Despite the use of these preventive measures, blood clots may still occur. If you develop swelling, redness or pain in your leg following discharge from the hospital, you should contact your orthopaedic surgeon.
Loosening of the prosthesis within the bone may occur after a total joint replacement. This may cause pain. If the loosening is significant, a revision of the joint replacement may be needed. New methods of fixing the prosthesis to bone should minimize this problem.
Dislocation occasionally occurs after total hip replacement the ball can be dislodged from the socket. In most cases, the hip can be relocated without surgery. A brace may be worn for a period of time if a dislocation occurs. Most commonly, dislocations are more frequent after complex revision surgery.
Wear can be found in all joint replacements. Excessive wear may contribute to loosening and may require revision surgery.
Prosthetic Breakage of the metal or plastic joint replacement is rare, but can occur. A revision surgery is necessary if this occurs.
Nerves in the vicinity of the total joint replacement may be damaged during the total replacement surgery, although this type of injury is infrequent. This is more likely to occur when the surgery involves correction of major joint deformity or lengthening of a shortened limb due to an arthritic deformity. Over time, these nerve injuries often improve and may completely recover.
Direct Anterior Muscle Sparing Total Hip Replacement
Hip Replacement - The Direct Anterior Muscle Sparing Total Hip Replacement Technique
WHAT IS THE DIRECT ANTERIOR MUSCLE SPARING TOTAL HIP REPLACEMENT?Direct Anterior Muscle Sparing Total Hip Replacement allows the surgeon to reach the hip joint from the front of the hip as opposed to the lateral (side) or the posterior (back) approach. This way, the hip can be replaced without detaching the muscle from the pelvis or femur during surgery. The most important muscles for hip function, the gluteal muscles that attached to the pelvis and femur, are left undisturbed and, therefore, do not require a healing process.
WHAT RESTRICTIONS DOES CONVENTIONAL HIP REPLACEMENTS SURGERY IMPOSE?
Conventional posterior hip replacement surgery typically requires strict precautions for the patient. Most patients must limit hip motion for 6 to 8 weeks after surgery. Patients must limit flexing of the hip to no more than 60 or 90 degrees which complicates normal activities like sitting in a chair, on a toilet seat, putting on shoes or getting into a car. Simply climbing stairs may also be more difficult during recovery.
Direct Anterior Muscle Sparing Total Hip Replacement allows patients to immediately bend their hip freely and bear full weight when comforable, resulting in a more rapic return to normal function. After surgery; patients are instructed to use their hip normally without cumberson restrictions. In supervised therapy, patients go up and down strairs before they are released from the hosptial.
HOW IS PATIENT RECOVERY IMPROVED WITH DIRECT ANTERIOR MUSCLE SPARING TOTAL HIP REPLACEMENT?
SPECIAL SURGICAL TABLE TO AID SURGEONS AT VALLEY VIEW HOSPTIAL
A technologically advanced surgical table is often used for Direct Anterior Muscle Sparing Total Hip Replacement. It works with the surgeon to minimize trauma under the skin by precise patient positioning that is not as easily preformed with conventional tables. For example, the patient’s leg is extended downward to allow frontal access to the hip while minimizing tissue damage. It also allows for easier x-ray imaging during surgery to more accurately control implant placement and leg length.
MAKO® Partial Knee & Total HipMAKO® is powered by highly advanced robotic arm technology that assists your orthopedic surgeon in achieving consistently reproducible precision for patients undergoing partial knee resurfacing and total hip replacement.
MAKO® is a surgeon-controlled robotic arm-assisted procedure that combines computer imaging and specialized instrumentation that enables surgeons to precisely place the implant that has been selected for that individual.
HOW IS MAKO® DONE?
RIO® ROBOTIC ARM INTERACTIVE SYSTEM
MAKO® PARTIAL KNEE RESURFACINGMAKO® Partial Knee Resurfacing is an innovative treatment option for adults living with early to mid-stage osteoarthritis that has not progressed to all three compartments of the knee. During the procedure, the diseased portion of the knee is resurfaced, sparing the patient's healthy bone and surrounding tissue. An implant is then secured in the joint to allow the knee to move smoothly again.
WHO IS A CANDIDATE FOR MAKO® PARTIAL KNEE RESURFACING?Typically MAKO® patients share the following characteristics:
- Knee pain with activity, usually on the inner knee and/or under the knee cap.
- Start up knee pain or stiffness when activities are initiallyed from a sitting position.
- Failure to respond to non-surgical treatments or nonsteroidal anti-inflammatory medication.
MAKO® Partial Knee Resurfacing Can...
- Facilitate ideal implant positioning to result in a more natual feeling knee following surgery.
- Result in a more rapid recovery and shorter hosptial stay then traditional knee replacement surgery.
- Be preformed on an outpatient basis.
- Promote a repid relied from pain and return to daily activities.
How may MAKO® benefit me?The MAKO® Partial Knee Resurfacing procedure is designed to relieve the pain caused by joint degeneration and potentially offers the following benefits:
1. Improved surgical outcomes.
2. Less implant wear and loosening.
3. Joint resurfacing.
4. Bone and tissue sparing.
5. Smaller incision.
6. Reduced blood loss.
7. Minimal hospitalization.
8. Rapid recovery.
MAKO® can be performed as either an in-patient procedure or on an out-patient basis depending on what your orthopaedic surgeon determines is right for you. Hospital stays average anywhere from one to three days, ambulatory patients return home the same day. In many cases, patients are permitted to walk soon after surgery, drive a car in the fist few weeks, and return to normal daily activity shortly thereafter.
If I undergo MAKO®, what can I expect?
MAKO® Total Hip Replacement is an innovative total hip replacement procedure performed using a highly advanced, surgeon-controlled robotic arm system that allows the surgeon to treat the patient’s specific hip condition with accuracy and precision.
MAKO® TOTAL HIP ARTHROPLASTY
What are the potential benefits of MAKO® Total Hip Replacement when compared with traditional hip replacement?
- Accurate placement of your hip implant using the surgeon-controlled robotic arm system
- More consistency in leg length
- Reduced risk of impingement and dislocation
Who is a candidate for MAKOplasty® Total Hip Replacement?If you have one or more of the following symptoms, you may be a candidate for MAKO® Total Hip Replacement:
- Pain while putting weight on the affected joints
- Limping to lessen the weight-bearing pressure on the hip
- Hip pain or stiffness during walking or other impact activities
- Failure to respond to non-surgical treatments or pain medication
Benefits of MAKO® Total Hip Arthroplasty1. Accurate placement of your hip implant using the surgeon-controlled robotic arm system, which can reduce the likelihood of hip dislocation
2. More consistency in leg length, potentially decreasing the need for a shoe lift
3. Decreased risk of the implant and bone abnormally rubbing together – this may improve the life of the implant
If your surgeon determines that you are a good candidate for the MAKO® procedure, he or she will schedule a computed tomography (CT) scan of your hip one or two weeks prior to your surgery date. A patient-specific 3-D model of your pelvis and femur and a unique surgical plan is created to plan for optimal implant placement.
During surgery, the robotic arm enables controlled cup preparation and placement. Tactile, visual, auditory, and real-time data feedback assists the surgeon in achieving accurate cup positioning and leg length restoration, which can be difficult to achieve using conventional manual techniques.
MAKO® Partial Knee Resurfacing & Total Hip Replacement is an arthroplasty procedure and is typically covered by Medicare and private health insurance. Please check with your private health insurer to confirm your coverage.
IS MAKO® COVERED BY INSURANCE?
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MAKOPLASTY® GENERAL BROCHURE
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