Replacement arthroplasty, or joint replacement surgery, is a procedure of orthopedic surgery in which an arthritic or dysfunctional joint surface is replaced with an orthopedic prosthesis. Replacing a joint can reduce pain and help you move and feel better. Hips and knees are replaced most often. Other joints that can be replaced include the shoulders, ankles, and elbows.
Total Shoulder Replacement
Total shoulder replacement, also known as total shoulder arthroplasty (TSA), is a tremendously successful procedure for treating the severe pain and stiffness that often result at the end stage of various forms of arthritis or degenerative joint disease of the shoulder joint. The primary goal of shoulder replacement surgery is pain relief, with a secondary benefit of restoring motion, strength, function, and assisting with returning patients to an activity level as near to normal as possible. Many patients return to the sports they love like tennis, golf, and swimming, while also pursuing personal health initiatives such as individual training, yoga and pilates.
Hip replacement surgery, or hip arthroplasty, provides pain relief and restores movement to people who have hip pain or stiffness. Most hip replacements are performed to remedy hip arthritis. This is where cartilage between the bones of the hip joint wears down. The bones then scrape together, causing more damage, as well as pain and stiffness. Arthritis of the hip can make it painful for a person to walk or even to get in or out of a chair. This surgery can also be used to fix injuries such as bone breaks, hips that grow incorrectly, and other conditions.
Knee replacement surgery, or knee arthroplasty, offers pain relief and improved movement to those suffering from advanced arthritis of the knee or a weakened knee joint. In most cases, the cartilage is worn away and the surface of the knee becomes pitted, eroded, and uneven. This causes pain, stiffness, instability, and a change in body alignment.
Total Knee Replacement (TKR) is most common and involves removing the damaged bone and cartilage and replacing the knee joint with implants to restore the natural motion and function of the knee.
Severe arthritis of the ankle joint, as with other joints, is the result of progressive wearing down of the layer of articular cartilage that cushions the joint’s moving surfaces, ultimately resulting in bone-on-bone grinding with joint motion. This “end stage” arthritis results in pain, combined with loss of function and mobility – severely limiting normal activity. When this end stage is reached and non-operative options (such as medication, injections, and bracing) have been exhausted, total ankle replacement (TAR) may provide relief.
The design and success of total ankle replacement have evolved over many years. As an alternative to ankle fusion, which locks the joint in a fixed position and does not permit ankle motion, ankle replacement replaces the arthritic surfaces with metal and plastic low-friction implants. The primary benefit is pain relief with retained ankle motion.
Elbow replacement is less common than hip or knee replacement. Elbow arthritis is usually treated nonsurgically with physical therapy, anti-inflammatory medications, or both.
If these treatments fail, an elbow replacement may be necessary. However, this surgery has a far lower success rate than hip or knee replacement. The elbow is a complicated hinge joint, and the bones into which artificial joint components must be inserted are smaller than those of the hip or knee.
Effectiveness and practice variation of rehabilitation after joint replacement
Early mobilization is the gold standard for achieving functional mobility after arthroplasty. The value of additional interventions to improve range of motion during the immediate inpatient period is not proven. Home is the preferred discharge destination and yields similar outcomes compared with inpatient rehabilitation. It is possible to improve outcomes related to physical activity by implementing exercise programs carried out at home or at a credited Physical Therapy Facility.