Robert Wood Johnson University Hospital
 

Arthroplasty

Arthroplasty

(Hip Arthroplasty, Joint Arthroplasty, Knee Arthroplasty, Shoulder Arthroplasty, Finger Arthroplasty, Joint Replacement Surgery)

Procedure overview

What is arthroplasty?

Arthroplasty is a surgical procedure to restore the integrity and function of a joint. A joint can be restored by resurfacing the bones. An artificial joint (called a prosthesis) may also be used.

Various types of arthritis may affect the joints. Osteoarthritis, or degenerative joint disease, is a loss of the cartilage or cushion in a joint, and is the most common reason for arthroplasty.

Anatomy of the joint

Anatomy of the knee joint
Click Image to Enlarge

Joints are formed where bones meet. Most joints are mobile, allowing the bones to move. Joints consist of the following:

Reasons for the procedure

Arthroplasty may be used when medical treatments no longer provide adequate relief from joint pain and/or disability . Some medical treatments for osteoarthritis that may be used prior to arthroplasty include, but are not limited to, the following:

People who have arthroplasty generally have substantial improvement in their joint pain, ability to perform activities, and quality of life, so these are important reasons for the procedure as well.

Most joint surgery involves the hip and knee, with surgery on the ankle, elbow, shoulder, and fingers being performed less often.

There may be other reasons for your doctor to recommend arthroplasty. Please see hip replacement and knee replacement surgical procedures for more specific information.

Risks of the procedure

As with any surgical procedure, complications can occur. Some possible complications may include, but are not limited to the following:

Nerves or blood vessels in the area of surgery may be injured, resulting in weakness or numbness. The joint pain may not be relieved by the surgery.

There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your doctor prior to the procedure.

Before the procedure

During the procedure

Arthroplasty requires a stay in a hospital. Procedures may vary depending on your condition and your doctor’s practices.

Arthroplasty may be performed while you are asleep under general anesthesia, or while you are awake under localized anesthesia. Your anesthesiologist will discuss this with you in advance.

Generally, arthroplasty follows this process:

  1. You will be asked to remove clothing and will be given a gown to wear.
  2. An intravenous (IV) line may be started in your arm or hand.
  3. You will be positioned on the operating table in a manner that provides the best access to the joint being operated on.
  4. A urinary catheter may be inserted.
  5. If there is excessive hair at the surgical site, it may be clipped off.
  6. The anesthesiologist will continuously monitor your heart rate, blood pressure, breathing, and blood oxygen level during the surgery.
  7. The skin over the surgical site will be cleansed with an antiseptic solution.
  8. The doctor will make an incision in the area of the joint.
  9. The doctor will remove the damaged surfaces of the knee joint and resurface the knee joint with the prosthesis. The knee prosthesis is made up of metal and plastic. The two most common types of artificial knee prostheses used are cemented prostheses and uncemented prostheses. A cemented prosthesis attaches to the bone with surgical cement. An uncemented prosthesis attaches to the bone with a porous surface onto which the bone grows to attach to the prosthesis. Sometimes, a combination of the two types is used to replace a knee.
  10. The incision will be closed with stitches or surgical staples.
  11. A sterile bandage or dressing will be applied.

After the procedure

In the hospital

After the surgery you will be taken to the recovery room for observation. Once your blood pressure, pulse, and breathing are stable and you are alert, you will be taken to your hospital room. Arthroplasty usually requires an in-hospital stay of several days.

It is important to begin moving the new joint after surgery. A physical therapist will meet with you soon after your surgery and plan an exercise program for you. Your pain will be controlled with medication so that you can participate in the exercise. You will be given an exercise plan to follow both in the hospital and after discharge.

You will be discharged home or to a rehabilitation center. In either case, your doctor will arrange for continuation of physical therapy until you regain muscle strength and good range of motion.

At home

Once you are home, it will be important to keep the surgical area clean and dry. Your doctor will give you specific bathing instructions. The stitches or surgical staples will be removed during a follow-up office visit.

Take a pain reliever for soreness as recommended by your doctor. Aspirin or certain other pain medications may increase the chance of bleeding. Be sure to take only recommended medications.

Notify your doctor to report any of the following:

You may resume your normal diet unless your doctor advises you differently.

You should not drive until your doctor tells you to. Other activity restrictions may apply.

Making certain modifications to your home may help you during your recovery. These modifications include, but are not limited to, the following:

Your doctor may give you additional or alternate instructions after the procedure, depending on your particular situation.

Online resources

The content provided here is for informational purposes only, and was not designed to diagnose or treat a health problem or disease, or replace the professional medical advice you receive from your doctor. Please consult your health care provider with any questions or concerns you may have regarding your condition.

This page contains links to other websites with information about this procedure and related health conditions. We hope you find these sites helpful, but please remember we do not control or endorse the information presented on these websites, nor do these sites endorse the information contained here.

American Academy of Orthopaedic Surgeons

American College of Rheumatology

Arthritis Foundation

National Institute of Child Health and Human Development

National Institutes of Health (NIH)

National Library of Medicine

 

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