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Joint Replacement Surgery Table of Contents Everything You Want to Know About Joint Replacement Surgery Table of Contents Understanding Your Joints: PG.3 How, when and why joint pain occurs Diagnosing Joint Pain: PG.4 The most common conditions and injuries Exploring the Options: PG.5 A look at partial and total joint replacement Seeing What’s New: PG.6 Medical advances in joint replacement surgery Answering Your Questions: PG.7 A discussion with Dr. Donald Hohman, Joint Replacement Program Medical Director Learning More: PG.9 Connecting with Texas Health Center for Diagnostics and Surgery Getting Ready: PG.10 My questions about joint replacement surgery Texas Health Center for Diagnostics & Surgery is a joint venture owned by Texas Health Resources and physicians dedicated to the community and meets the definition under federal law of physician-owned hospital. Physicians on the medical staff practice independently and are not employees or agents of the hospital. PAGE 2 Understanding Your Joints: How, when and why joint pain occurs Healthy joints aren’t just necessary for performing the physical activities we enjoy. They are the mechanical instruments that make virtually every movement possible. When our joints begin to succumb to years of natural wear and tear or degenerative conditions like arthritis, even the most common movements — like walking or climbing stairs — can become painful. Left untreated, joint pain can be potentially debilitating, severely diminishing one’s quality of life. New hope for joint pain Here’s the good news: it is possible to significantly reduce joint pain. Medical advancements in joint surgery have come a long way, particularly partial and total joint replacement. What used to require a lengthy hospital stay and an arduous rehabilitation period has now been refined so that pain levels are dramatically lower and long-term outcomes are better. In other words, relieving joint pain is no longer a pain in and of itself. Yet for many people suffering from chronic pain, joint replacement surgery remains somewhat of a mystery. Perhaps like Hip many people, you’ve never considered joint replacement. Or perhaps you’ve given thought to it but have put off exploring it for fear of the Knee impact on your mobility and the amount of time you believed it might take. In either case, this E-book is for you. Ankle Learning how our joints work and understanding what causes them to hurt are the first steps on the journey to long-term relief. Obviously, joints are all over the body, but this E-book focuses on the major joints of the lower body—the knee, hip and ankle—as they tend to bear the brunt of most of our more rigorous physical activities and A lifetime of movement thus are the most common joints that experience pain. puts a natural strain on our joints Anatomy of the Joint Hip Ankle Knee The bones within joints are The joint is surrounded by A tissue called the synovial membrane covered with a layer of cartilage ligaments and tendons. Ligaments lines the joint and seals it into a joint which helps reduce the friction give support and limit movement capsule. This membrane also excretes within a joint. while connecting bones together. a clear, sticky fluid, which helps to Tendons match muscles to bones reduce friction. and enable movement. Joints deteriorate over time as the lubrication begins to diminish. When this deterioration begins, pain becomes increasingly apparent. The greater the deterioration, the more pain you feel. PAGE 3 Diagnosing Joint Pain: The most common conditions and injuries Degenerative Conditions Injuries and Wear and Tear Osteoarthritis Ligament Injuries Osteoarthritis is a degenerative disease of the joints, usually Ligament injuries are mainly caused by a sudden twisting accompanied by pain and stiffness. It causes a great deal of motion. Because they stabilize the knee, if a ligament is pain and discomfort to a large number of people and affects injured, the knee will be unstable when planting the foot, both males and females alike. The cause of the disease is causing the knee to buckle and give way. not known but it is described as a degenerative disorder developing with age. Bursitis Bursitis is an inflammation of the fluid-filled pads that act Rheumatoid Arthritis as cushions at the joints. Bursitis is caused by overusing In rheumatoid arthritis, the body’s immune system attacks the joint, but it can also be caused by an injury. its own tissue, including joints. This condition affects joint linings, causing painful swelling. Over long periods of time, Cartilage Injuries the inflammation associated with rheumatoid arthritis can Meniscal cartilage can be injured if the knee is twisted cause bone erosion and joint deformity. while bearing weight. This could result from a sports injury or even something simple, like twisting when getting out of a chair. A partial or total tear may occur. The seriousness of the injury depends on the location and the size of the tear. Sprains and Strains A sprain is a stretching or tearing of ligaments. The most common location for a sprain is in the ankle. A strain is a stretching or tearing of muscle or tendon. Common Treatments Although most cases of mild joint pain or injury can be successfully managed at home, it’s important to make an appointment with your primary care physician if your pain is accompanied by swelling, redness and/or tenderness and warmth around the joint. If you have been treating your joint pain at home and the pain has increased significantly or is accompanied by joint deformity, inability to use the joint, or sudden swelling, it’s time to see an orthopedic specialist. It is important to remember that some joint issues are repairable with surgery, but others may not require it at all. An orthopedic specialist can provide an accurate diagnosis and recommend the proper course of treatment. Non-Surgical Options Surgical Options • Medicines to reduce pain, swelling and inflammation • Arthroscopic surgery • Physical therapy and/or exercise to improve • Partial joint replacement movement and strength • Total joint replacement • Weight loss • Electrical stimulation to strengthen muscles PAGE 4 Exploring the Options: A look at partial and total joint replacement Joint replacement surgery, or arthroplasty, removes a damaged joint and places a new, artificial joint in its place. There are two types of arthroplasty: total joint replacement and partial joint replacement. Both are performed in a hospital under anesthesia. Partial Joint Replacement Partial joint replacement is a minimally invasive procedure during which only the diseased or damaged joint surfaces are removed and replaced with artificial surfaces and the healthy parts of the joint are left intact. Partial joint replacement is a viable option for certain patients when all possible conservative means of treatment, such as rest, anti-inflammatory medications or physical therapy have proven to be ineffective in relieving symptoms. In partial knee replacement, only a part of the knee is replaced, metal preserving as much of the original healthy bone and tissue as component possible. During the procedure, a surgeon removes the arthritic portion of the knee — bone and cartilage — and replaces that plastic spacer compartment with a prosthesis. original hip socket metal In partial hip replacement, only the ball of the femur is replaced component with a metal stem and ball. The new hip joint is then rejoined to the new hip joint original hip socket. original femer bone Total Joint Replacement Total joint replacement is a surgical procedure performed to replace the entire damaged joint with artificial implants. Total joint replacement is usually performed when the joint is severely damaged, and when all other remedies, including partial joint replacement, are unlikely to yield a positive outcome. In total knee replacement, the damaged cartilage surfaces at the ends of the femur (thigh bone) and tibia (shin bone) are removed along with a small metal amount of underlying bone. The removed cartilage and bone are replaced component with metal components that recreate the surface of the joint. These metal parts may be cemented or “press fit” into the bone. The undersurface of the patella (kneecap) is cut and resurfaced with a plastic component. Some plastic spacer surgeons do not resurface the patella, depending on the case. Lastly, a medical-grade plastic spacer is inserted between the metal components to create a smooth gliding surface. In total hip replacement, damaged cartilage is removed from the hip socket artificial hip socket and the ball portion of the femur is removed. The removed bone is replaced new hip joint with either a metal or plastic hip joint which is attached to the femur with cement or a similar material. The removed cartilage is replaced with an femoral stem artificial hip socket, and the new hip joint is inserted into the socket. implant In total ankle replacement, damaged bone and cartilage are removed from metal the lower end of the tibia and top of the talus (foot bone). The cut bone component surface is replaced with metal components to recreate the joint surface. This replacement can happen with bone cement or a similar material. A medical-grade plastic spacer is then inserted between the two metal components and screws may plastic spacer be placed to stabilize your ankle. PAGE 5 Seeing What’s New: Medical advances in joint replacement surgery Thanks to a number of medical advancements, patients no longer view joint replacement surgery as a “last resort” option, but rather, as a near-term opportunity to get more fulfillment out their favorite activities, like keeping up with the grandkids, taking a hike or hitting the links. Today most patients are able to return to moderate activities in a matter of weeks. Here are some of the notable changes that have made this possible.
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