Total Hip Replacements
Hip replacement surgery removes a diseased hip joint and inserts a new hip joint. The most common causes of total hip replacements are damage from osteoarthritis, rheumatoid arthritis, and traumatic arthritis. When other treatment options are not successful at treating the pain and restricted motion associated with joint disease a total hip replacement can be used to improve a patient's ability to perform daily activities and move about. Different materials are used to make artificial hip joints, though all consist of two main components a ball made of metal or ceramic, and a titanium stem. A non-cemented prosthesis is also available that is coated with textured metal or a bone-like substance that enables young, strong bone to grow into the prosthesis.
Ceramic-on-ceramic Hip Replacement or Oxinium
Ceramic hip replacements are typically used in active patients (for example someone suffering from severe juvenile arthritis). Ceramic implants are very smooth, which decreases the amount of friction between the moving components, and thereby reduces wear on the joint. Traditional implants can loosen over time, though most can last for up to 25 years. The ceramic-on-ceramic replacement pieces are made from aluminum oxide ceramic.
Minimally Invasive Total Hip Replacement or Oxinium
Minimally invasive surgical techniques have been developed recently that allow a surgeon to insert the replacement components of a total hip replacement through only a few small incisions. It is believed that this less invasive approach can reduce hospital time, speed recovery, and decrease blood loss. It is important that implants be positioned properly therefore this procedure is not recommended for people with severe deformities or who carry excess weight as these factors may already lead to malpositioning of an implant.
Total Knee Replacements
When the knee joint is damaged and cannot be repaired, as is typical of some forms of arthritis, a total knee replacement may provide relief from pain and restricted movement. Approximately 581,000 knee replacements are performed each year in the United States. Most patients who undergo a total knee replacement are 60-80 years old, but surgeons evaluate patients individually based on pain and level of disability, not age. Many different types of materials are currently used in total knee replacement surgery. Most replacements consist of three components: a femoral piece made of metal, a tibial piece made of durable plastic held in a metal tray, and a patellar piece also made of durable plastic. Total knee replacements can restore a patient to their previous level of function, but recovery requires a significant amount of exercise and therapy post-surgery.
Minimally Invasive Total Knee Replacement
Minimally invasive surgical techniques are a recent advancement for total knee replacement technology. A minimally invasive approach is more complex than a standard knee replacement because the incisions are approximately half the size of those used in a typical open surgical approach. The smaller incisions are used with advanced imaging techniques to provide surgeons an in-depth view of the knee. A minimally invasive approach may reduce hospital stay and the need for extended inpatient rehabilitation.
Computer Navigation Total Knee Replacement
The success of total knee replacement surgeries is dependent on accurate alignment and implantation of the parts. While surgeons are experts at performing these surgeries, they now have the assistance of computer navigation to make the process of aligning the implant easier. Minimally invasive wireless probes transmit data pertaining to the movement of the knee to a computer. This data is then used to create real-time images that provide the surgeon and in-depth view of the way their patient's knee functions. These probes remain active throughout the surgery to provide intra-operative feedback regarding the accuracy of placement and alignment to maximize the consistence and accuracy of the replacement joint. This method has also demonstrated a decreased amount of blood loss because the probe does not need to cross the intramedullary canal of the femur.
Partial Knee Replacements
Although not as common as total knee replacement, a partial (unicompartmental) knee replacement is an alternative in some cases. The designs of the partial knee replacement devices have improved over the years but are still composed of a combination of metal and plastic pieces. The partial knee replacement also utilizes smaller, minimally invasive incisions to perform the procedure. The partial knee replacement is used to replace a single part of the three parts of the knee, the medial (inner) part. If the damage is limited to the medial of the knee, that part can be treated with a partial replacement.
Total Shoulder Replacements
The shoulder joint enables you to raise, twist, and bend your arm forward, to the side, and behind you. Damage to this joint can be very painful and inhibit motion. Approximately 23,000 people a year undergo surgery to replace their damaged shoulder joint. There are different types of shoulder replacements, but the most common is a total shoulder replacement. Total shoulder replacement uses highly polished metal parts (a ball attached to a stem) and a plastic socket to substitute for the natural joint. The humeral (arm) component of the joint can be implanted with or without bone-cement depending on the health of the bone surrounding the joint. Most often an all-plastic socket component is implanted with bone cement. Each surgery is individualized to meet the exact needs of each patient.
Resurfacing procedures can be performed for the hip. This procedure places a metal "cap" over the damaged parts of a joint that rub together causing pain and stiffness. These smooth metal surfaces function like healthy cartilage by creating a good surface for the parts of the joint to glide over, facilitating movement. These procedures require more surgery but actually less recovery time than total joint replacements, however resurfacing is a good option for very young patients.
Arthritis is inflammation of the joints that causes pain and restricts movement. Arthritis is caused by the breakdown of cartilage that normally protects the joint facilitating smooth movement. Without cartilage bones rub together which creates inflammation, pain, and stiffness. There are a variety of different types of arthritis but some common causes are autoimmune disease, broken bones, age related wear and tear, and infection.
- Joint swelling
- Reduced ability to move the joint
- Redness of the skin
- Low-impact aerobic activity
- Range of motion exercises for flexibility
- Strength training for muscle tone
- Avoid placing extra stress on your affected joints
- Modify your home to make activities easier
Osteoarthritis is the most common joint-related disorder, like other forms of arthritis the cartilage between the bones wears away in the joints. There is no cure for osteoarthritis and its cause is often unknown. It is believed to be related to aging but can also occur if the disease runs in the family, if a patient is overweight, or due to long-term uses of a joint. Bony spurs or growths typically form around the joint and the ligaments and muscles can loosen and become weak.
- Deep aching joint pain that gets worse after exercise and is relieved by rest
- Pain that is worse when you start activities after a period of no activity
- Over time, pain is present even when you are at rest
- Grating of the joint with motion
- Increase in pain during humid or moist weather
- Joint swelling
- Limited movement
- Muscle weakness around arthritic joints
- Physical Therapy
Osteoarthritis of the Knee
Osteoarthritis of the knee is the result of wearing down the cartilage and synovial membranes inside of the knee joint. In some cases, bone spurs in the knee can form inside the joint causing pain. Osteoarthritis can be caused by overuse, heredity, and injuries to the knee joint, or excess weight.
- Aching pain deep in joint
- Inflammation of joint
- Stiffness in the joint
- Crunching or grinding sound
- Rest and ice
- Anti-inflammatory medication when necessary
- Arthroscopic surgery to remove damaged cartilage
- Knee replacement surgery
Rheumatoid arthritis is a degenerative disease that causes inflammation of the joints and surrounding tissue. When the lining of the joint becomes inflamed, it gives off fluid and the joint becomes swollen. Joint pain is often felt on both sides of the body, and may affect the fingers, wrists, elbows, shoulders, hips, knees, ankles, toes, and neck. Rheumatoid arthritis is considered an autoimmune disease, whose cause is unknown. Women are more affected by this disorder than men.
- Loss of appetite
- Morning stiffness (lasting more than 1 hour)
- Widespread muscle aches
- Anemia if bone marrow fails to produce enough new red blood cells
- Hand and feet deformities
- Limited range of motion
- Nodules under the skin
- Numbness or tingling
- Skin redness or inflammation
- Physical Therapy
Glenohumeral arthritis affects four basic aspects of the shoulder joint: amount of movement, stability, strength of the surrounding muscles, and smoothness in the joint. Over time the durability of these aspects wears down and gives way to glenohumeral arthritis, which is an age-related disorder.
- Pain with movement
- Pain at night interfering with sleep
- Weakening of shoulder muscles
- Tenderness and swelling of the joint
- Rest and Ice
- Anti-inflammatory medication when necessary
- Steroid injection when necessary
Traumatic arthritis is a form of arthritis that is caused from blunt, penetrating, or repeated trauma to a joint. Damage to the articular cartilage can occur when too much pressure is exerted on a joint, causing the cartilage to rip or break into small pieces that become lodged in the joint. Holes in the cartilage develop scar tissue that can reduce the ability of the joint to move feely. The joint can be made weak, and inflamed which causes the pain associated with arthritis.
- Joint instability
- Internal bleeding
- Surgery to remove bits of torn cartilage
- Physical Therapy