Joint Replacement Arthroplasty - Procedure, Benefits, Recovery

Joint replacement surgery is also known as arthroplasty. Arthroplasty is a surgical method used to bring back a joint in function by replacing the bone joint with a prosthetic (artificial) joint. The prosthetic joint used as an implant may be of different material depending upon the joint to be treated. Arthroplasty is among the safest and one of the most reliable treatments for treating joint abnormalities. 

Any joint replacement surgeries like hip or knee replacement surgeries done today are very safe and durable. The treatment can be expected to last about 20 years and more. In most cases, the joint replacement treatment results in a lifelong solution for joint problems of the hip and knee joints. 

1. Joint replacement surgery is recommended when certain conditions cause joint pain and even disability to a person.
2. Joint replacement surgery is also performed in case of joint stiffness, inflammation and limited mobility.
3. In some cases, joint pain is caused due to the damage to the cartilage that forms the lining of the bones.
4. It can be caused by any conditions like arthritis, fracture, avascular necrosis or any other joint conditions.

First of all, the non-surgical treatments are tried. The doctor recommends total joint replacement surgery or arthroplasty if the conditions cannot be treated through medicines only.

If the surgery for joint replacement is delayed or not done on time, the following types of complications can occur. 

1. Vasculitis (inflammation of blood vessels)
2. Pleuritis (the thin layer of tissue that separates the lungs from the chest wall got inflamed)
3. Scleritis (inflammation in scleral and episcleral tissues)
4. Chronic obstructive pulmonary disease (COPD)

1. First of all, an anesthesiologist will inject you with a precise dose of appropriate anaesthesia.
2. A tube is inserted in the throat to ease breathing during the surgery.
3. If any excess hair is present on the surgery site, it is cleaned and shaved before surgery. 
4. An antiseptic solution is applied to the incision site to prevent any kind of infection.
5. Then the surgeon makes incisions on the site of the surgery. 
6. The affected cartilages and bones are removed, cleaned, and then the artificial implant is placed in the position and fixed there.
7. The bone is cleaned, and a metal spacer is placed between the two surfaces of the metal implants. It is done to prevent the rubbing of the two surfaces of metal. 
8. After completing and fixing the implants, the site is then closed either using sutures or staples.
9. Then the site is covered using a sterile bandage and sterile cotton tape.

1. The joint replacement surgery may take around 1 to 3 hours. The cost of unilateral knee replacement surgery is around Rs 2 to 3 lakhs, while bilateral knee replacement costs around Rs 3 to 5 lakhs. Hip replacement surgery costs around Rs 2 to 3 lakhs.
2. After reaching out to an orthopaedic surgeon, the surgeon will first perform a physical examination. 
3. He may order imaging tests like X-ray and CT scans.
4. The surgeon will also ask you about the symptoms that you are feeling. He/she may ask you about the condition and how much it bothers you? And how is it affecting your daily life?
5. The surgeon may also ask about the previous diagnosis and medicines that you might be taking before coming.
6. After diagnosing the condition, the doctor will tell you about the treatment choice. 
7. Overnight fasting before the surgery is generally advisable for all patients.
8. You will be explained the type of prosthetic joint they will implant.

1. Before leaving home, follow all the instructions ordered by the doctor.
2. Leave all the valuables at home.
3. Try to reach the hospital before the time of the surgery.
4. After reaching the hospital, you will be asked to fill out a consent form before the surgery.
5. Reach the hospital in loose-fitting clothes that are comfortable for you.
6. You will be asked to change into a surgical gown and cap.
7. All the vital signs are checked before shifting to the operation theatre.
8. IV is inserted in the arm, and the patient is wheeled to the surgery room.

1. The complete procedure of the joint replacement surgery is done under the effect of general anaesthesia. So, the patient does not feel any sensations during the surgery.
2. The implants used may be of metal, plastic or ceramic. It depends upon the place of the joint that is to be treated.
3. A metal ball is used in arthritic hip, and a plastic socket is used in pelvis damage. 
4. All the vital signs like heart rate, blood pressure and oxygen level are monitored continuously during the surgery.
5. The patient is positioned on the operation table to provide the best and easy access to the surgery site. 
6. A urinary catheter may also be inserted.

1. After the completion of the surgery, the patient is taken to the recovery room. 
2. In the recovery room, all the vital signs like heart rate, breathing, and blood pressure are checked regularly until the patient gains full consciousness. 
3. It is an in-patient surgery and needs a stay of several days in the hospital.
4. After the completion of the surgery, a physiotherapist will also meet you to set up a program of exercise sessions. 
5. After a few days of stay at the hospital, if the doctor does not notice any complications, then you can be discharged and may be shifted either to a rehabilitation centre or home. 
6. You need to follow the exercise instructions at home also. 
7. The complete recovery from the surgery takes around six months.
8. There would be an improvement in movement with reduced pain within 3 weeks after the surgery.
9. The patients may experience increased strength and range of motion within 4 to 6 weeks after the surgery.

1. The follow-up appointments after the surgery are made to check some of these issues. In early appointments, the surgeon will mainly focus on the occurrence of infection and a blood clot in and around the surgical site.
2. The different surgeons may have different follow-ups for their patients. However, for short follow-ups, the time may be after two weeks, after six weeks, after three months, and after the completion of 1 year.
3. In long-term follow-ups, the first-year appointments are similar, but the appointments after the completion of a year of surgery are often known as surveillance visits. During these surveillance visits, the surgeon may order an X-ray to check the functionality of the implant. 

Consulting a doctor becomes necessary when you experience any of the following symptoms. 

1. Chest pain
2. Fever
3. Swelling and redness around the incision site
4. Numbness and tingling sensation
5. Breathlessness
6. Pulmonary embolism (formation of a clot in the lungs)
7. Deep vein thrombosis (thrombosis in legs vein)
8. Infection around the joint replaced
9. Prosthetic joint not functioning as per program
10. Nerve injury around the surgical site (rare)