Total joint replacement is a surgical procedure performed to replace the damaged joint with the artificial implants. Total joint replacement is usually performed when the joint is severely damaged by osteoarthritis, rheumatoid arthritis, post-traumatic arthritis or avascular necrosis.
In a normal joint, the joint surface is covered by a smooth articular surface that allows for smooth movement within the joint, whereas in arthritic joint the cartilage is gradually worn out causing the articular ends of the bones to rub against one another leading to pain and restricted range of motion.
Total joint replacement may be considered in patients with severe pain which is not relieved through medications, injections, physical therapy, or other treatments. The goal of the surgery is to relieve pain and restore the normal functioning of the joint. Total joint replacement can be performed through an open or minimally invasive approach.
In the open approach, an incision is made over the affected joint to expose the joint. The arthritic part of the joint is removed and prepared to receive the artificial components. The artificial components are fixed in place. The muscles and tendons are then repaired and the skin is closed.
A minimally invasive approach has been developed in recent years where surgery is performed through one or two smaller incisions rather than the single long incision as in the traditional approach. Advantages of the newer approach are lesser muscle dissection, minimal pain, quicker recovery, and faster rehabilitation.
Possible risks and complications of joint replacement surgery include:
- Infection around an implanted joint
- Dislocation or instability of an implanted joint
- Damage to nerves or blood vessels
- Blood clots (deep vein thrombosis)
- Wound irritation
- Limb length discrepancies
- Wearing of the joints
- Scar formation