Joint replacement surgery is a type of Orthopaedic procedure performed on the musculoskeletal system (muscles, bones and connecting tissues, ligaments and tendons) of human body in which parts of damaged joints are removed and replaced by a new joint called Prosthesis which is made up of metal, plastic or ceramic, biocompatible with the body. It is mostly recommended in case of injuries and conditions such as Arthritis, disease or infection inside the joint and excessive wear and tear due to aging that can cause persistent pain, swelling, stiffness, limited range of motion and even disability. Joint replacement surgery usually takes a few hours and is mostly performed in hospital or outpatient surgery centre.
Knee replacement surgery
Constant pain in knees, difficulty in walking, climbing stairs or performing everyday routine activities can be an indication of damaged or inflamed knees. If medication, physical therapy and walking aids don’t provide relief then knee replacement surgery should be considered. Knee replacement surgery is the most common joint replacement surgery which relieves the pain, improves mobility with increased independence and thus improves the overall quality of life.
During surgery the damaged or worn out part of the joint is removed and is replaced with an artificial knee joint which is especially designed according to patient’s weight, height and activity level. The knee implant or artificial joint is attached to all three components of knee joint that is the thigh bone (femur), shin (tibia) and the kneecap (knee cap) with the help of a biocompatible acrylic cement to restore painless smooth gliding movement and normal function.
Types of knee replacement surgery:
- Total knee replacement: It is most commonly performed and has the highest success rate, in which whole knee is replaced with an artificial joint.
- Partial knee replacement: It is indicated in case of partial damage to the knee.
- Kneecap replacement: It only replaces the under surface of the kneecap. But it is seldom performed because of its low success rate.
- Revision knee replacement: It is indicated in severe arthritis or in cases of repeated knee surgeries.
Arthroscopic knee surgeries: With the advancement in the field of medicine and technology, surgical techniques have also progressed with a greater success rate and less trauma to the patient. Arthroscopic knee surgeries are an example of surgical technique that can diagnose and treat problems in knee simultaneously. During the procedure a small incision (cut) is made and a tiny camera or an arthroscope is inserted inside the knee. Arthroscope provides the complete view of inside of the joint and also allows the orthopaedic specialist to correct the problem at the same time such as torn meniscus and ligaments, repositioning of patella (knee cap), treating fractures and removal of cyst as well.
Shoulder replacement surgery or Shoulder Arthroplasty (SA): Shoulder joint is formed by the upper end of the hind arm known as Humerous, which is shaped like a ball and fits into a cup shaped cavity of the shoulder blade known as Scapula. Muscles and ligaments help to hold these bones together.
The primary indications of SA is painful shoulder joint due to Shoulder Arthritis ,injury or any other degenerative joint disease. The main goal of SA is pain relief with restoration of motion and function as near to normal level possible.
Before surgery, X-ray shoulder, MRI and CT scan are done to evaluate the extent of damage and for treatment planning accordingly. Usually the upper head of the Humerous is removed and is replaced with a long metal piece (which is structurally similar to bone). In case if the socket part of the shoulder (Glenoid) is also damaged, then it is replaced with a smooth lining for the humerous head to move against it without friction. These two bones are held together with the help of special cement. An implant can also be indicated to replace the whole joint with the advantage of native bone growing around it and ensures better results.
Rehabilitation: After evaluation if there is no post-operative complication ,physical therapy is usually started after a day or two postoperatively to ensure proper blood circulation in the operated site and may be continued for few weeks to few months depending on the range of motion.