What is arthroplasty?

Arthroplasty, sometimes called joint replacement surgery, is the replacement or repair of a diseased joint. Joints are the areas where two bones meet. Common types of arthroplasty include hip, knee, and shoulder repair or replacement.

Joints contain ligaments, tendons, cartilage, and lubricating fluid. Arthroplasty involves removing arthritic or damaged surfaces of bone and replacing them with artificial material or an implant called a prosthesis. Arthroplasty can 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. 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? 

Your doctor may recommend an arthroplasty to treat 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

Your surgeon may only consider arthroplasty for you if other treatments that involve less risk of complications have been ineffective. Ask your surgeon about all of your treatment options and consider getting a second opinion before deciding on arthroplasty. 

Who performs arthroplasty?

An orthopedic surgeon or podiatric surgeon performs arthroplasty. Orthopedic surgeons specialize in conditions of the bones and connective tissues. Podiatric surgeons are podiatrists who specialize in foot and ankle surgery. 

How is arthroplasty performed?

Your arthroplasty will be performed in a hospital. The surgery involves making an incision in the joint to remove damaged cartilage and bone. Your surgeon then replaces the damaged areas with artificial material or an implant called a prosthesis.

Surgical approaches to arthroplasty

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

  • Minimally invasive surgery involves inserting special instruments and an arthroscope through small incisions in the joint. The arthroscope is a thin, lighted instrument with a small camera that sends pictures to a video screen. Your surgeon sees the inside of your joint on the video screen while performing the surgery. Minimally invasive surgery generally involves a faster recovery and less pain than open surgery. This is because it causes less trauma to tissues and organs. Your surgeon uses small incisions instead of a larger one used in open surgery. Surgical tools are threaded around structures, such as muscle or tendons, instead of cutting through or displacing them as in open surgery.
  • Open surgery involves making a large incision in the joint. An open incision allows your surgeon to directly see and access the joint. Open surgery generally involves a longer recovery and more pain than minimally invasive surgery. 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 some patients.

Your surgeon may combine a minimally invasive procedure with an open surgery. Your surgeon will advise you on which procedure is best for you and how long you need to stay in the hospital based on your diagnosis, age, medical history, general health, and possibly your personal preference. Learn about the different types of arthroplasty and ask why your surgeon will use a particular type for you.