What Is Total Joint Replacement?

Total joint replacement is one of the surgical treatment methods used to relieve joint pain caused by cartilage destruction. Orthopedics and Traumatology specialists at Yeditepe University Hospitals have answered frequently asked questions about total joint replacement.

What Is Total Joint Replacement?

The arthritic or damaged joint is removed and replaced with an artificial joint called a "prosthesis." This procedure is referred to as total joint replacement.
The goal is to eliminate joint pain that develops due to cartilage destruction. When the pain becomes unbearable, the person avoids using the joint, which leads to weakening of the muscles around the joint and makes movement even more difficult.
Physical examination, laboratory tests, and X-rays reveal the extent of damage to the joint. Total joint replacement is performed when other treatment methods fail to relieve pain and restricted movement.

What Is the Preparation Process Before Total Joint Replacement Surgery?

Before surgery, the orthopedic specialist may make the following recommendations:

• You may be asked to donate your own blood in advance, as it may be needed during surgery.
• Your doctor will determine which medications to stop and which to continue.
• You can do exercises that will speed up recovery.
• Hospital discharge, home care, and rehabilitation needs should be planned together with the doctor.

How Is Total Joint Replacement Surgery Performed?

After anesthesia is administered, the orthopedic specialist removes the damaged parts of the joint and places artificial components in their place. For example:

• In the knee: The damaged ends of bone and cartilage are replaced with metal and polyethylene surfaces that restore knee movement and function.
• In the hip: The damaged femoral head is replaced with a metal ball and a metal stem placed into the femur. The deteriorated joint socket is replaced with a new socket made of durable polyethylene with a metal outer coating.

Although hip and knee replacements are the most commonly performed procedures, prostheses can also be applied to the wrist, ankle, shoulder, elbow, foot, and finger joints.
Prostheses are designed to mimic natural joint movement. They are typically made of metals such as steel, cobalt-chromium alloys, and titanium, as well as wear-resistant polyethylene. The prosthesis can be fixed with bone cement specific to the joint. In some prostheses, a cementless method is used, which allows direct fusion between the bone and the prosthesis.

What Is the Recovery Process After Total Joint Replacement Surgery?

In most patients, the orthopedic specialist encourages the use of the new joint shortly after surgery. After total hip or knee replacement, patients usually begin standing and walking on the first day. A walker, crutches, or a cane may be used initially. Temporary pain may occur during the healing of muscles and tissues that have weakened due to inactivity; this usually resolves within a few weeks or months. Exercise is an important part of recovery. The surgeon plans a personalized exercise program.
After surgery, activities such as swimming, walking, and dancing can be performed; however, high-impact sports such as running and tennis should be avoided.

What Are the Complications of Total Joint Replacement?

If you have any medical condition that may affect the surgical procedure, be sure to inform your orthopedic specialist. Joint replacement surgery is successful in 9 out of 10 patients. If complications develop, they can often be successfully treated. Possible complications include:

• Infection
• Blood clots
• Loosening
• Dislocation
• Wear
• Prosthesis fracture
• Nerve injury

Is Total Joint Replacement Permanent?

Elderly patients can use their prostheses for more than 10 years and thus maintain a pain-free life. In younger patients, a second surgery may be needed over time.
Surgical techniques and materials are continuously being improved. This is expected to allow joint replacement applications to offer greater freedom of movement and a healthier life in the future.