Avascular necrosis describes the death of bone tissue that occurs when the blood supply to an area of bone is cut off. It causes severe damage to the bone and is also known as ischemic bone necrosis, aseptic necrosis, bone infarction and osteonecrosis.…
What is joint replacement?
A joint is where two or more bones connect. Joint replacement (arthroplasty) is when a damaged joint is surgically removed and replaced with an artificial (prosthetic) joint by an orthopedic surgeon. Prosthetic joints can be made of metal, plastic, or a mix of both. In other cases, rather than replace the whole joint, only the damaged parts are replaced or fixed.
The most common types of joint replacement surgery are for the hips and knees, but other joints such as the shoulders, fingers, elbows and ankles can also require surgery.
Reasons for procedure
The main reason for joint replacement surgery is joint pain, often due to arthritis, which affects an individual's quality of life and/or ability to perform daily activities. Joint replacement surgery is considered if the joint pain does not respond to other simpler treatment options.
There are many different types of joint replacement, including:
- Hip joint replacement;
- Knee joint replacement;
- Shoulder joint replacement, and;
- Hand joint replacement.
What happens during surgery
Before your surgeon performs your procedure, you will be given an anesthetic to either block pain to the site of your surgery (regional anesthesia) or to render you unconscious (general anesthesia). Each procedure is different and depends on the site, technique, and how badly the joint is damaged. To replace a knee or joint it typically takes about two hours or less.
What happens after surgery
Depending on the type of surgery, such as knee or hip surgery, you may need to stay in hospital for a few days. Pain medications are often needed for the first few days after surgery. Physical therapy is often needed to help strengthen the muscles around the new joint and regain motion in the joint. Usually you will be provided with a group of exercises to help with rehabilitation.
Specific complications depend on the type of joint replacement surgery you are undertaking or have had, but in general they include:
- Stiffness and swelling;
- Blood clots - these result from inactivity during and after surgery and the slow flow of blood through the blood vessels;
- Infection - all surgeries carry a small risk of infection and antibiotics may be taken after surgery to help reduce your risk of infection;
- Nerve injury - although rare, there are many nerves around the joints and they can sometimes be damaged during surgery;
- Fracture - although rare, during total joint replacement there is drilling into bone, which may cause the bone to fracture;
- Implants failing or coming loose, and;
- Joint dislocation - this is when joints pop out of place.
The outlook depends on the type of joint replacement surgery you have had. Doing physical exercises as prescribed by your surgical team will help improve outcomes, such as greater range of movement and stability of the joint. Depending on your age and circumstances, you may require more surgery in the future, with the majority of hip and knee replacements lasting about 20 years.