A Guide to Orthopaedic Joint Replacements: Part ll
We discussed different types of joint replacement surgeries in a previous blog. There are many popular options, so we added a second post to avoid turning this topic into an epic novel. Here are some more common joint replacement surgeries.
Unicompartmental Knee Replacement
There are two types of knee replacement procedures: partial and total knee replacements. Whichever is used will depend on the patient’s situation. When compared, patients who receive partial knee replacements will benefit from a quicker recovery, less post-operation pain, and less blood loss, though the blood loss is usually not significant. On the other hand, patients who undergo a partial knee replacement will also experience less predictable pain relief and the potential need for additional surgery.
Candidates for partial knee replacement are those who experience inflammatory arthritis, significant ligament damage and significant knee stiffness. The problematic pain must be a result of one specific area of the knee. A total knee replacement will be conducted if the entire knee is problematic.
During the operation, the surgeon will remove the damaged cartilage and bones, insert prosthetic and cement them into the joint, and insert a spacer to create a smooth service to bend and hinge the joint.
Patients can expect to go home within 1 to 3 days after the operation. Afterward, a patient will go through a physical therapy regime to restore strength.
Total Elbow Replacement
These replacements occur significantly less than knee or hip replacement, but they are an option for relieving joint pain in the elbow. A candidate for total elbow replacement surgery may experience post-traumatic arthritis, severe fractures, instability, and rheumatoid or osteoarthritis.
During the operation, the surgeon will replace the damaged areas of the humerus and ulna, more specifically, the damaged portions of these bones that join at the elbow. The artificial component is made of metal, plastic, and two metal stems that promote the typical hinging motion of the elbow.
Due to the range-of-motion limitations, physical therapy will focus on strengthening the muscles around the area and how to manage motion with the artificial hinge.
Shoulder Joint Replacement
Roughly 50,000 people undergo shoulder replacement surgery each year. Although it is not as common as total hip or knee replacement, it’s just as successful at relieving joint pain. Candidates for this joint replacement surgery are people whose conservative treatments—medication, activity changes, braces—are no longer helpful at relieving shoulder pain and are significantly limited by the joint’s dysfunction. Common causes of this severe of shoulder pain are severe fractures, osteonecrosis, significant rotator cuff tear, and post-traumatic, rheumatoid and osteoarthritis. Those with bone-to-bone osteoarthritis and intact rotator cuff tendons are quality candidates for this operation.
Similar to the hip joint, the shoulder is a ball and socket joint, and the replacement parts will mimic this function. Specifically, the shoulder joint consists of three bones: the clavicle (collarbone), the scapula (shoulder blade), and humerus (upper arm) which fit into a shallow socket in the scapula.
The areas that will be replaced largely depend on the patient’s specific case. Hemiarthroplasty (simply replacing the ball) and resurfacing hemiarthroplasty (replacing the humeral head) can be supplemented to avoid a total shoulder replacement.
During a total shoulder joint replacement, the surgeon will remove the degraded cartilage and bone of the three bones that form the shoulder joint. The replacement components consist of a metal ball, which mimics the ball-and-socket joint, attached to a metal stem that is cemented into the humerus.
Reverse Total Shoulder Replacement is another option for shoulder replacement surgery. This option is used for patients whose pain will not be reduced from a typical shoulder replacement surgery. This option significantly limits the shoulder rotator cuff’s mechanics and makes this an ideal option for patients with rotator cuff limitations.
During this surgery, the metal socket ball is flipped. The metal socket is implanted into the shoulder blade, instead of the metal component, allowing the patient to use their deltoid muscles, rather than the rotator cuff, to mobilize the shoulder joint.
Patients will go through a physical therapy regime no matter the shoulder surgery. Once fully recovered, most patients who undergo any form of shoulder replacement experience an immediate pain relief following the procedure.