Total Joint Replacement
Hip and knee joint replacements are helping people of all ages live pain-free, active lives. Advances in less invasive procedures, special navigation tools and robotic surgery systems are improving outcomes.
When Joint Replacement is Recommended
Joint replacement is considered when the joint tissue (cartilage), which provides a cushion between the bones coming together at the joint, breaks down. Over time the once healthy cartilage that allowed smooth, fluid movement of the bones becomes damaged by disease or injury. The degenerating tissue results in friction as the bones move over one another with less protective cushion, causing pain and inflammation.
When only part of the joint is damaged, a surgeon may be able to repair or replace just the damaged parts. This type of procedure on the knee is called a partial knee replacement (PKR). When the entire joint is damaged, a total knee replacement (TKR) is performed.
A total hip replacement and total knee replacement entails the removal of the diseased or damaged joint tissue and replacement with a prosthetic implant. Today there are a number of different types of prosthetic implants,which your surgeon will explain before your procedure. Learn more about the parts and materials used in knee and hip joint replacement systems.
There are a number of minimally invasive joint replacement procedures available today, reducing recovery time and improving outcomes.
Total Hip Replacement
Total Knee Replacement
Prevention of Blood Clots and Pulmonary Embolisms following Joint Replacement Surgery
Perhaps no other aspect of joint replacement surgery is as controversial as prevention of deep venous thrombosis (DVT) or pulmonary embolism (PE). It has been recognized for several decades that patients with hip and knee replacement can develop blood clots in their legs. A blood clot can break off and travel to the patient’s lungs causing a pulmonary embolism, which is potentially life-threatening. Fortunately, the incidence of fatal PE is considered to be approximately one in 2,000-10,000.
To reduce risks, many doctors recommend blood thinning (anticoagulation) medications after joint replacement surgery. Unfortunately, the agents that are most effective at thinning the blood can also cause bleeding at the surgical site. Surgeons who perform many joint replacement surgeries have recognized that bleeding into the surgical site has a complication rate far in excess of fatal PE. Importantly, infection may result from poor wound healing due to bleeding caused by blood thinners. Other risks of blood thinners include bleeding of the gastrointestinal tract and prolonged anemia(low blood count) after surgery.
Many orthopedic surgeons prefer measures other than strong blood thinners to minimize the impact of blood clots. For example, the use of calf or foot compression devices is now generally accepted for most patients. Early ambulation, efficient surgery and regional anesthesia (spinal anesthesia), as well as the use of mild blood thinners such as aspiring have become widespread. The American Academy of Orthopaedic Surgeons (AAOS) has a position paper on this topic, which can be found on their website (www.aaos.org). The Joint Commission, which is the accrediting body at many hospitals , addresses this on their website (www.jointcommission.org).