Total Joint Replacement

Orthopaedic surgery residency in San Antonio gave me a vast exposure to the various conditions and treatment methods in orthopaedics. I studied and was taught by the leaders in orthopaedics, literally by the surgeons who write the textbooks that the majority of orthopaedic surgeons in the world use as standards of care.

Total joint replacement is a surgical procedure in which parts of an arthritic or damaged joint are removed and replaced with a metal, plastic or ceramic device called a prosthesis. The prosthesis is designed to replicate the movement of a normal, healthy joint.

In 2011, almost 1 million total joint replacements were performed in the United States. Hip and knee replacements are the most commonly performed joint replacements, but replacement surgery can be performed on other joints, as well, including the ankle, wrist, shoulder, and elbow.

A joint is where the ends of two or more bones meet. There are different types of joints within the body. For example, the knee is considered a “hinge” joint, because of its ability to bend and straighten like a hinged door. The hip and shoulder are “ball-and-socket” joints, in which the rounded end of one bone fits into a cup-shaped area of another bone.

Several conditions can cause joint pain and disability and lead patients to consider joint replacement surgery. In many cases, joint pain is caused by damage to the cartilage that lines the ends of the bones (articular cartilage)—either from arthritis, a fracture, or another condition.

If nonsurgical treatments like medications, physical therapy, and changes to your everyday activities do not relieve your pain and disability, your doctor may recommend total joint replacement.

In the weeks before your surgery, your surgical team and primary care doctor will spend time preparing you for your upcoming procedure. For example, your primary care doctor may check your general health, and your surgeon may require several tests — such as blood tests and a cardiogram — to help plan your surgery.

There are also many things you can do to prepare. Talk to your doctor and ask questions. Prepare yourself physically by eating right and exercising. Take steps to manage your first weeks at home by arranging for help and obtaining assistive items, such as a shower bench, handrails, or a long-handled reacher. By planning ahead, you can help ensure a smooth surgery and speedy recovery.

For a step-by-step guide to planning your joint replacement surgery:

Total joint replacement surgery takes a few hours. The procedure is performed in a hospital or outpatient surgery center.

During the surgery, the damaged cartilage and bone is removed from your joint and replaced with prosthetic components made of metal, plastic, or ceramic. The prosthesis mimics the shape and movement of a natural joint. For example, in an arthritic hip, the damaged ball (the upper end of the femur) is replaced with a metal ball attached to a metal stem that is fitted into the femur, and a plastic socket is implanted into the pelvis, replacing the damaged socket.

-aaos.org