What Is Joint Replacement Surgery?

Joint replacement surgery is a procedure in which a surgeon removes a damaged joint and replaces it with a new, artificial part. A joint is where two or more bones come together, like the knee, hip, and shoulder. The surgery is usually done by a doctor called an orthopaedic (or-tho-PEE-dik) surgeon. Sometimes, the surgeon will not remove the whole joint, but will only replace or fix the damaged parts.

The doctor may suggest a joint replacement to improve how you live. Replacing a joint can relieve pain and help you move and feel better. Hips and knees are replaced most often. Other joints that can be replaced include the shoulders, fingers, ankles, and elbows.

What Can Happen to Joints?

Joints can be damaged by arthritis and other diseases, injuries, or other causes. Arthritis or simply years of use may cause the joint to wear away. This can cause pain, stiffness, and swelling. Diseases and damage inside a joint can limit blood flow, causing problems in the bones, which need blood to be healthy, grow, and repair themselves.

What Is a New Joint Like?

A new joint, called a prosthesis (praas-THEE-sis), can be made of metal, plastic, or ceramic parts. It may be cemented into place or not cemented, so that your bone will grow into it. Both methods may be combined to keep the new joint in place. Your doctor will discuss these options with you.

When Should Joint Replacement Be Considered?

Your doctor may recommend joint replacement surgery when other treatments are not effective in relieving pain and helping you move. These include walking aids such as braces or canes, physical therapy, medicines, exercise, and weight loss.

Your doctor may also consider a different surgery that does not involve replacing the whole joint.

Joint replacement is often the answer if you have constant pain and can’t move the joint well—for example, if you have trouble with daily activities such as walking, climbing stairs, and taking a bath.

What Happens During Surgery?

First, the surgical team will give you medicine so you won’t feel pain (anesthesia). The medicine may block the pain only in one part of the body (regional), or it may put your whole body to sleep (general). The surgical team will then replace the damaged joint with a new artificial joint.

Each surgery is different. How long it takes depends on how badly the joint is damaged and how the surgery is done. Your doctor or someone on your doctor’s team will inform you how to prepare for surgery, how long it will take, and what to expect in the hours after surgery.

What Happens After Surgery?

Several things affect how soon you will be able to return home after joint replacement. These include the type of surgery that you have, your medical history and your support network at home. You may have some temporary pain in the new joint because your muscles are weak from not being used. Also, your body is healing. The pain can be helped with medicines and should end in a few weeks or months.

Physical therapy may help strengthen the muscles around the new joint and help you regain motion in the joint.

As you move your new joint and let your muscles grow strong again, pain will lessen, flexibility will increase, and movement will improve.

Are There Risks Associated With Joint Replacement?

Any surgery has risks. The risks of joint surgery will depend on your overall health and the health of your joints before surgery, and the type of surgery done.

After surgery, it is important to follow your doctor’s advice about what to eat, how to take your medicines, and how to exercise. Talk with your doctor about any pain or trouble moving.

Joint replacement is usually a success in most people who have it. When problems do occur, most are treatable. Possible problems include: infection, blood clots, loosening of the new joint, and nerve and blood vessel injuries.

Research Supported by NIH/NIAMS

Scientists supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), part of the National Institutes of Health (NIH), are studying replacement joints to find out which are best to improve movement and flexibility. They are also looking at new joint materials and other ways to improve surgery. For example, researchers are looking for ways to reduce the body’s inflammatory response to the artificial joint components, and are trying to learn why some types of prostheses are more successful than others.

Other scientists are also trying to find out why some people who need surgery don’t choose it. They want to know what things make a difference in choosing treatment, in recovery, and in well-being. Studies of the various forms of arthritis, the most common reason for joint replacement surgery, are helping doctors better understand these diseases and develop treatments to stop or slow their progression and damage to joints.

More information on research is available from the following websites:

• NIH Clinical Research Trials and You helps people learn more about clinical trials, why they matter, and how to participate. Visitors to the website will find information about the basics of participating in a clinical trial, first-hand stories from clinical trial volunteers, explanations from researchers, and links on how to search for a trial or enroll in a research-matching program.
• ClinicalTrials.gov offers up-to-date information for locating federally and privately supported clinical trials for a wide range of diseases and conditions.
• NIH RePORTER is an electronic tool that allows users to search a repository of both intramural and extramural NIH-funded research projects from the past 25 years and access publications (since 1985) and patents resulting from NIH funding.
• PubMed is a free service of the U.S. National Library of Medicine that lets you search millions of journal citations and abstracts in the fields of medicine, nursing, dentistry, veterinary medicine, the health care system, and preclinical sciences.

Where Can I Find More Information About Joint Replacement Surgery?

National Institute of Arthritis and Musculoskeletal
and Skin Diseases (NIAMS) Information Clearinghouse

National Institutes of Health
1 AMS Circle
Bethesda, MD 20892–3675
Phone: 301–495–4484
Toll free: 877–22–NIAMS (226–4267)
For telecommunications support, dial 711
Fax: 301–718–6366
Email: NIAMSinfo@mail.nih.gov
Website: niams.nih.gov

If you need more information about available resources in your language or another language, please visit our website or contact the NIAMS Information Clearinghouse.

Other Resources

For updates and for any questions about any medications you are taking, please contact the U.S. Food and Drug Administration toll free at 888–INFO–FDA (888–463–6332) or visit its website. For additional information on specific medications, visit Drugs@FDA. Drugs@FDA is a searchable catalog of FDA-approved drug products.

For updates and questions about statistics, please contact the Centers for Disease Control and Prevention’s National Center for Health Statistics toll free at 800–232–4636 or visit its website.

American Academy of Orthopaedic Surgeons
American College of Rheumatology
Arthritis Foundation