Joint replacement surgery is only performed when more conservative options like joint injections, physical therapy, and rest are not sufficient to provide long-term relief of pain and restoration of function in the joint. Many joints can be replaced including the knee, hip, shoulder, wrist, and elbow. More than 400,000 hip and knee replacements are performed each year in the U.S. Joint replacement surgery is far more common among older patients and among athletes whose joints have been subjected to considerable strain.
Joints are complex structures, forming where one bone meets another. In total joint replacement surgery, the entire joint structure is replaced with an artificial joint composed of multiple components designed to replicate the natural joint. Total joint replacements usually replace the head of one or both bones that form the joint. In a total shoulder replacement, the socket portion of the joint usually is relined to cover and strengthen damaged surfaces. In partial joint replacement, only select parts of the joint are replaced, leaving undamaged portions in place.
Joint replacement surgery can be performed using minimally-invasive techniques with several small incisions or using more traditional techniques requiring larger incisions. Prior to joint replacement surgery, the joint will be very carefully assessed using diagnostic imaging to determine the best approach. Often, diagnostic arthroscopic surgery is used to see inside the joint to obtain additional information. During the procedure, the damaged portions of the joint are removed and the remaining surfaces are prepared to accept the implant. Damaged ends of bones are carefully removed and replaced with metal components designed to mimic the structure of the natural bone. Socket portions are carefully abraded and prepared to receive a new lining. Some artificial components are attached using very strong medical cements while other joints are designed to remain firmly in place without the use of cement. Following surgery, patients will undergo several weeks of physical therapy to restore normal function and range of motion in the joint.
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