Hip and knee joint replacements have been performed since the 1960s. They have since increased in popularity and success resulting in more than 160,000 hip and knee replacements being performed in England and Wales last year. Further joint replacements such as elbows, shoulders and ankles have since been introduced over the years.
What is a joint?
A joint is formed where the ends of two bones meet. The two bones are held together by thick bands called “ligaments”. Each bone end is covered in a tough, smooth layer of material called cartilage, which helps it to glide with little friction. This is helped further by a fluid, which effectively “oils” the joint.
Your joints are involved in every activity. Simple activities such as walking, bending, twisting and turning require the use of many joints simultaneously. Normally, all of these joints work together and the joint moves easily and without pain. But when the joint becomes diseased or injured, the resulting pain and stiffness can severely limit the ability to move and function. Consequently, the surrounding muscles become weak and less effective as they are unable to work in their normal way.
What is a joint replacement?
A total joint replacement is a surgical procedure in which certain parts of a diseased or damaged joint are removed and replaced with a plastic or metal device called a prosthesis, which is designed to move just like a normal, healthy joint.
When is a joint replacement needed?
One of the most common causes of joint pain, is arthritis. The most common type being Osteoarthritis, a condition where the cartilage is worn away over time,leaving the two bony surfaces to rub together. The main joints affected are those that bear the bodies weight e.g. the hip and knee joints. This is why weight gain can exacerbate the problem, as the damaged joints have to bear that extra weight. This is also why as we get older osteoarthritis can become more common, just because our bodies have had to work harder for longer.
Rheumatoid arthritis however is an inflammatory condition where the body attacks its own joints, leading to joint damage, pain and swelling. Although less common, the more widespread effects of the disease may mean that more than one joint needs replacing.
Accidents or injuries involving the joints may cause irreparable damage, leading to a total joint replacement being considered. Younger individuals who undergo joint replacements tend to be those that have suffered injury from accidents such as motorbike or sporting incidents.
A joint replacement may be considered when all other forms of conservative treatment are no longer effective. Pain and resulting limitations may by then have become a significant problem.
How can you prepare for surgery?
You can prepare for surgery by doing a few simple things that will make your life easier afterwards.
- Begin exercises to speed your recovery.
- Strengthen muscles which support the affected joint, and get those joints moving that have become stiff.
- If you are overweight, try to loose some of those extra pounds so that you will reduce the pressure on your new joint.
- Look after yourself to make sure that you are in tip top condition for your operation.
- Have a think about what you will need after surgery. Your Occupational or Physiotherapist can help you with this.
What is the recovery process?
In general, you will be encouraged to use your “new” joint shortly after your operation. After total hip or knee replacement, you will often stand and begin walking the day after surgery.
Recent advances in surgical techniques have meant that the incisions can be smaller, reducing healing time and the time spent in hospital.
Most patients have some temporary pain in the replaced joint because the surrounding muscles are weak from inactivity and the tissues are healing. This will end in a few weeks or months.
The motion of your joint will generally improve after surgery. The extent of improvement will depend on how stiff your joint was before your operation and how hard you work at your exercises afterwards!.
Exercise is an important part of the recovery process. Speak to your physiotherapist who will guide you through exercises for before and after surgery. This will vary for different people and for different joint replacements.
Getting a new joint should mean that your life becomes more comfortable giving you the ability to return to most activities. Appropriate exercise and advice will help you achieve this. A bit of hard work both before and after surgery will help you to maximise the benefits of your new joint.