Arthroplasty, also known as joint surgery, is a surgical procedure to correct and restore joint function. During this procedure, the surgeon can remove a section of the damaged or injured joint and replace it using metal, plastic, or a ceramic device.
Also, the surgeon can use various replacement prostheses as well as surgical techniques. This depends on your joint shape and size, age, activity level, weight, and general health.
Arthroplasty hip and knee replacement are usually the most prevalent forms that surgeons often perform. However, they can also conduct the procedure on other joints such as the elbow, ankle, wrist, and shoulder.
Types of Arthroplasty
The two types of arthroplasty procedures include;
Hemiarthroplasty (partial arthroplasty): This is the removal and replacement of one section of the joint.
Total arthroplasty: This refers to the removal and replacement of the whole joint.
Who Needs an Arthroplasty?
When other medical treatment options fail to relieve joint pain and impairment, arthroplasty is usually an effective solution. Arthroplasty is thus conducted to replace the injured or damaged joint with a healthier one. This enables the patient to live a complete, active, and happy life with sufficient mobility.
The doctor can suggest an arthroplasty to address serious joint deterioration and damage that occurs due to the following;
- Joint infections (septic arthritis)
- Joint injuries such as fractures, torn cartilage, and torn ligaments that can result in permanent joint damage.
- Osteoarthritis, also known as degenerative joint disease, a condition in which the cartilage and bones in the joint break down, causing pain, swelling, and stiffness. This is usually the most prevalent reason for undergoing arthroplasty.
- Osteonecrosis, or bone death. It is, however, an uncommon disorder.
- Rheumatoid arthritis, an autoimmune illness that causes inflammation in the joints.
Joint discomfort, capacity to do activities, and quality of life all improve significantly for people who undergo arthroplasty. The healthcare provider may also suggest arthroplasty of the shoulder, hip, and ankle, among others, for additional reasons.
How to Prepare for Arthroplasty?
The steps you take while preparing for surgery can help you feel more comfortable and have a better outcome. Therefore, you can get ready for arthroplasty of hip, knee, or cervical arthroplasty by doing the following;
- Inform your doctor of everything concerning your medical history and medications, including your prescriptions, over-the-counter medications, herbal medicines, and vitamins. You can consider carrying a list of all the health conditions you have, allergies, and drugs.
- Undergo preoperative testing as instructed. The type of testing you receive depends on your age, overall health, and procedure. A chest x-ray, electrocardiogram (EKG), blood tests, and other procedures may be performed prior to surgery.
- Take a balanced diet and activity regimen to cut some weight before surgery. The surgeon may sometimes decide to postpone surgery until you've lost excessive weight.
- Do not eat or drink anything before surgery as directed by your doctor. This is because you might choke on the stomach contents during anesthesia. So if you eat or drink too soon to the commencement of operation, the doctor may have to cancel the procedure.
- Quit smoking as soon as you can. Even if it only meant you quit for a few days, it can aid with the healing process.
- Take or discontinue using drugs according to the instructions. In most cases, the doctor may ask you to stop taking aspirin, ibuprofen (Advil, Motrin), or blood thinners. You'll get instructions from your doctor on how to take other meds and vitamins when necessary.
How is Arthroplasty Performed?
Arthroplasty is usually done within the hospital setting. The procedure can vary based on the joint condition and the surgeon’s expertise.
The surgeon will also perform the procedure under general anesthesia while you are fully asleep or under local anesthesia when you are awake. Your surgeon will discuss this with you in detail beforehand.
Arthroplasty procedure typically involves creating an incision or cut in the joint to take out the injured or damaged bone and cartilage. After that, the surgeon will replace these parts with an implant known as a prosthesis or an artificial material.
Depending on your health state and extent of damage, you might be subjected to any of these surgical approaches;
- Open surgery
This involves creating a big cut in the joint. This enables the surgeon to view and access the joint through the open incision. Compared to minimally invasive surgery, open surgery has a longer recovery time and causes more discomfort.
Also, open surgery necessitates a wider incision and entails more cutting and displacement of muscle and other tissues. Regardless of this, open surgery could be a safe or even more effective option for other people.
- Minimally invasive surgical procedure
This entails making small incisions in the joint and inserting surgical equipment called an arthroscope. The arthroscope is tiny, illuminated equipment with a small camera that transmits images to a video screen. When performing the procedure, the surgeon uses a video screen to view the inside part of the joint.
In comparison to open surgery, minimally invasive surgery usually involves a speedier recovery and less pain. This is because it leads to less damage to the tissues and body organs. Instead of the bigger incisions like in open surgery, your physician utilizes small ones. Also, rather than cutting through to displace elements like muscle or tendons as in open surgery, surgical equipment is threaded around them.
The surgeon can sometimes combine both open surgery and minimally invasive procedure when performing arthroplasty. However, he or she will advise you about the best suitable procedure for you and the duration you will remain in the hospital. In most cases, this depends on your age, diagnosis, medical history, overall health, and even your preference.
What Happens After Arthroplasty?
After surgery, you will remain in the recovery room until you are completely awake, breathing normally, and the vital signs are stable. If a tube was inserted into your windpipe during surgery, you might experience a sore throat. This is normally temporary; however, inform the medical team if you feel uncomfortable.
If you have narcotic pain medicine, general anesthesia, or sedatives, you may feel drowsy for up to 24 hours following surgery. You might also feel a little nauseous. However, inform your doctor in case you are nauseated so that you can receive treatment.
Following discharge from the hospital, some patients often choose to remain in a rehabilitation facility. Rehabilitation aids in the recovery and restoration of mobility and joint function so that you can safely go back home.
Recovery generally involves a gradual process. The amount of time it takes to recover depends on the joint being treated, the operation, age, overall health, and other factors. It can take weeks or months to recover fully.
As you recover, watch out for infection signs such as;
- Swelling or redness around the joint area
- Chills and fever
- Bleeding or drainage around the surgical area
- Tingling and numbness of the repaired joint
- Too much pain on the surgical site
Risks of Arthroplasty
Arthroplasty is associated with several risks, just as with other major procedures. The most common include infection and the formation of blood clots. People with cardiac issues, uncontrolled diabetes, and weakened immune systems are at risk of these complications. In order to avoid complications, a surgeon may administer antibiotics and blood thinners.
Although rare, nerve injury can sometimes occur when the nerves around the replaced joint are injured during the procedure. Another likely side effect of arthroplasty is that the replacement joint can fail to function properly and might feel stiff or weak. This normally happens when a person fails to engage in active rehabilitation or adhere to other factors of their treatment regimen.
Implants can also get loose or displaced over time. As a result, the replacement joints might require changing in the future because of wear and tear.
Based on the overall health of the patient and the medical issues, there may be additional risks associated with the treatment. Therefore, ensure that you talk to your surgeon about any concerns you have before the procedure.
How to Avoid or Minimize Arthroplasty Complications?
You can avoid or lower your complication risks by sticking to your treatment plan and doing the following;
- You should adhere to the exercise, nutritional, and lifestyle restrictions and guidelines before operation and during healing. Examples are physical therapy, occupational therapy, and all other rehabilitation therapies.
- If you're breastfeeding or think you might be pregnant, be sure to tell your doctor.
- Disclose any problems, including fever, bleeding, increased discomfort, or reddening of the wound, swelling, or drainage, to your doctor right away
- Take your meds as prescribed.
- If you have any allergies, be sure to inform your healthcare team.
Arthroplasty can help improve your general quality of life and allow you to participate in activities you enjoyed before. It can be walking, running, biking, swimming, and many other activities. Surgeons conduct countless surgery treatments each year, and only a small percentage of patients sustain complications.
In spite of this, it's always a good idea to discuss all of the possible risks and benefits of arthroplasty with your doctor. This will help you understand how they apply to your specific circumstance. You should also think about how much time you'll need to heal and for rehabilitation.