Arthroplasty

What is arthroplasty?

Arthroplasty is the surgical replacement or repair of a diseased joint. Arthroplasty involves removing arthritic or damaged surfaces of bone and replacing them with artificial material or an implant called a prosthesis. Joints are the areas where two bones meet and also contain ligaments, tendons, cartilage, and lubricating fluid. Arthroplasty, sometimes called joint replacement surgery, can help restore pain-free motion and full function in a diseased joint.

Arthroplasty is a common but major surgery with significant risks and potential complications. You may have less invasive treatment options and should consider getting a second opinion about all of your treatment choices before having an arthroplasty.

Types of arthroplasty

The types of arthroplasty procedures include:

• Hemiarthroplasty (partial arthroplasty) is the removal and replacement of one side or part of the joint.
• Total arthroplasty is the removal and replacement of an entire joint.

Why is arthroplasty performed?

Arthroplasty is a major surgical procedure that your doctor may recommend to treat certain diseases and conditions of the joints. Your doctor may only consider arthroplasty if other treatment options that involve less risk of complications have been ineffective. Talk with your doctor about all of your treatment options and consider getting a second opinion.

An arthroplasty is a surgery that your doctor may recommend for severe joint damage caused by:

• Joint infections, also called septic arthritis
• Joint injuries, including fractures, torn ligaments, and torn cartilage, which may lead to irreversible joint damage
• Osteoarthritis, or degenerative joint disease, a breakdown of cartilage and bones within the joint, resulting in pain, stiffness and swelling. It is the most common reason for arthroplasty.
• Osteonecrosis, or death of bone. Osteonecrosis is a rare condition.
• Rheumatoid arthritis, an autoimmune disease characterized by joint inflammation

How is arthroplasty performed?                 

Arthroplasty is performed in a hospital by a surgical team led by an orthopedic surgeon. An orthopedic surgeon is a physician who specializes in conditions of the bones and connective tissues. Your orthopedic surgeon will perform the procedure by making an incision in the joint to remove damaged cartilage and bone. He or she will then replace the damaged areas with artificial material or an implant called a prosthesis.

Surgical approaches to arthroplasty

Your doctor will perform an arthroplasty using one of the following approaches:

• Minimally invasive surgery is a procedure performed by inserting special instruments and an arthroscope through small incisions in the joint. The arthroscope is a thin, lighted instrument with a small camera that transmits pictures of the inside of your body to a video screen. Your doctor sees the inside of your joint on the video screen as he or she performs the surgery. Minimally invasive surgery generally involves a faster recovery and less pain and risk of complications than open surgery. This is because it causes less trauma to tissues and organs. Your doctor will make a small incision instead of a larger one used in open surgery. He or she can then thread surgical tools around structures, such as muscle or tendons, instead of cutting through or displacing them as in open surgery.
• Open surgery is performed by making a large incision in the joint. An open incision allows your doctor to directly view and access the surgical area. Open surgery generally involves a longer recovery and more pain than minimally invasive surgery. This is because it causes more trauma to tissues. Open surgery requires a larger incision and more cutting and displacement of muscle and other tissues than minimally invasive surgery. Despite this, open surgery may be a safer or more effective method for certain patients.

In some cases, your doctor may combine a minimally invasive procedure with an open surgery. In addition, your doctor may decide after beginning a minimally invasive procedure that you require an open surgery to safely and most effectively complete your surgery. Your doctor will determine which type and method of surgery is best for you and how long you need to stay in the hospital based on certain factors. These include your diagnosis, age, medical history, general health, and possibly your personal preference. Learn about the different arthroplasty procedures and ask why your doctor will use a particular type of procedure for you.