A person may opt for a joint replacement if arthritis or a traumatic injury damages a joint beyond repair. Orthopedic surgeons can replace many joints, including knees and hips.
A joint replacement may be partial or total. Although a replacement joint may never feel quite like the original one, it can improve a person’s comfort, mobility, and overall quality of life.
This article looks at the types of joint replacement and what the procedure involves.
Joint replacement surgery may be suitable if a joint is no longer functioning properly due to osteoarthritis, rheumatoid arthritis, gout, or a traumatic injury.
A surgeon will remove the damaged joint and replace it with a prosthesis or artificial joint. The replacement may be total, replacing the whole natural joint, or partial, replacing only the damaged part.
Materials manufacturers use to make artificial joints
- polyethylene, a type of plastic
- titanium, a strong but light metal
- cobalt-chrome, another type of metal
- ceramic
- silicon rubber for fingers
Designers of artificial joints aim to ensure that people can move them like natural joints with little or no pain.
Surgeons can replace many joints,
Learn more about the different types of knee replacement.
A person may benefit from a joint replacement if:
- pain and loss of mobility affect their quality of life and ability to do everyday tasks
- pain relief, debridement (cleaning), and physical adjustments have not helped or no longer work
- their fitness and overall health make a full recovery likely and mean there is a low risk of complications
- not replacing the joint could worsen the outcome, for instance, following a traumatic injury
Before surgery, a doctor will explain the procedure to the individual. They may also discuss the alternatives, such as pain management and debridement or “cleaning” of the joint.
The individual may decide with the doctor on a less invasive approach if appropriate.
Points to consider
A person will also need to consider:
- insurance coverage and other financial and legal arrangements
- the need for preoperative procedures, such as scans and blood tests
- their overall medical history, including any allergies, previous procedures, and current medications
- emergency contacts and who will support them during recovery
Physical preparation
Certain steps a person may take before surgery that may improve the chance of a positive outcome include:
- eating a nutritious diet
- avoiding or quitting smoking, which can affect circulation during recovery
- losing weight, if necessary, to reduce stress on the new joint
- scheduling any necessary dental work well before the surgery, as dental treatment is not advisable for some weeks after
- taking measures to avoid rashes, injuries, and any skin problems around the joint, as these could increase the risk of infection
- doing any preparatory exercises the doctor recommends
- following the doctor’s advice on stopping any regular medications beforehand
- avoiding alcohol for at least 48 hours before surgery
- avoiding eating and drinking from midnight the night before or as the healthcare team advises
Other questions
Other questions to ask include:
- how long the hospital stay will be
- what to bring
- what type of anesthesia the surgeon will use
- how much pain to expect, and how the surgeon plans to manage it
- how long recovery is likely to be
The procedure will likely involve the following steps:
- The anesthetist will administer general and sometimes local anesthesia. This is to ensure that the person is comfortable.
- The surgeon will open the joint and remove the damaged bone and cartilage.
- They will replace the removed parts with artificial parts and close the wound.
- Members of the healthcare team will observe the individual until they wake up.
- The healthcare team will continue to observe the individual and provide drugs to manage the pain.
The length of the procedure will depend partly on the joint the surgeon is replacing and the extent of the replacement. A total joint replacement can take several hours.
Find out more about minimally invasive (laparoscopic) knee surgery.
From as early as the following day, a physical therapist will start training the individual to use the new joint.
This may be painful and uncomfortable, but exercising according to the doctor’s instructions can improve the chance of a good outcome.
Exercising the joint can also strengthen the muscles around it. This will help improve strength and mobility and reduce pain.
How long it takes for a person to get back to their usual activities will depend on various factors, such as:
- the joint in question
- whether the replacement was total or partial
- the person’s health and fitness levels before surgery
- how closely they follow the exercise recommendations
The doctor will advise on how soon a person can drive, return to work, and so on.
Learn more about recovering from knee replacement surgery.
Joint replacement surgery is now a routine procedure, and many people make a smooth recovery.
However, complications can sometimes arise,
- infection or blood clots after surgery
- dislocation or instability of the joint
- pain and stiffness
- nerve or blood vessel damage
- bone degeneration (osteolysis), resulting in the joint coming loose
In some cases, a surgeon may need to repeat the procedure.
Following the instructions of medical staff before and after surgery and engaging in any recommended rehabilitation can help ensure a good outcome.
Find more about the risks of knee replacement surgery.
The long-term outlook for joint replacement surgery will depend on the type of surgery, the joint, the person’s activity and health levels, and other factors.
According to the American Academy of Orthopedic Surgeons, 90% of people who have a total knee replacement find the joint still works well after 15 years.
Meanwhile, the Arthritis Foundation notes that finger replacements do not work as well as natural fingers and that 30% of silicone implants stop working within 10 years as the silicone, while flexible, can break and slip.
A surgeon can advise on how long a new joint is likely to last.
How painful is joint replacement?
There may be severe pain in the days following the procedure, but it will gradually lessen. This may take a few weeks. Pain relief medication and other strategies can help manage the pain until it disappears.
What does a joint replacement do?
In joint replacement surgery, a surgeon replaces a damaged joint with an artificial one. A person can use the replacement joint as they would a natural one. The procedure aims to improve mobility and reduce pain.
Is a joint replacement a high risk surgery?
Before surgery, a doctor assesses the individual’s risk of complications and advises them on how to prepare. Taking precautions can dramatically reduce the risk, although complications can sometimes still arise.
Find out more about the risks of knee surgery.
Joint replacement surgery aims to replace a part or all of a joint, such as a knee or hip, that is no longer working as it should due to arthritis or an injury. A surgeon can also replace elbows, joints in the fingers, and other joints.
For the best outcome, a person needs to follow the surgeon’s recommendations throughout the preparation stage and rehabilitation.