JOINT REPLACEMENT

Joint replacement surgery has evolved in the last thirty years to where it makes a significant improvement in the quality of life for those suffering with joint pain and dysfunction. It is major surgery and therefore involves some form of anesthesia. Your doctor will explain the preoperative procedures and what your responsibility is during the days before surgery. The most important item is to be free from any possible source of infection regardless of whether it comes from your gums, skin, or urinary tract. The joint replacement process and procedures are constantly being improved with new techniques and technologies. It is interesting to note that the surgical part of the process is short and generally lasts several hours. The recovery is usually about 3 to 5 days in the hospital, but then the rehabilitation part can last several months.

Physical therapy plays a pivotal role in getting the new joint into functional shape. Patients have commented "on how greatly improved their conditions were even while recovering from surgery." As you read the information below, keep in mind that technology and surgical procedures are constantly evolving. The following is some general information on most of the typical types of joint replacements:

wrist replacement pictureJoint replacement surgery on the wrist is less common but can be an option if you have painful arthritis that does not respond to other treatments. Wrist joint replacement can be done as an outpatient procedure, unlike a hip or knee replacement. Wrist replacement surgery is often combined with other procedures to correct deformities or disorders in the tendons, nerves, and small joints of the fingers, and thumb. On average, a wrist replacement can be expected to last 10 to 15 years with careful use. As with all implants, long-term follow up is advised. Follow up every year or every two years will identify any developing conditions or problems.

shoulder replacement pictureShoulder replacement surgery started in the 1950s. It became clear that many painful conditions like arthritis could be corrected with this type of surgery. This procedure involves removal of the damaged parts and their replacement by metal components. There are two options: 1. replacement of just the head of the humerus bone, or 2. replacement of both the ball and the socket.
Physical therapy for total shoulder replacement is divided generally into three phases. First phase deals with pain mangement and gentle range of motion. Second phase works on shoulder joint active range of motion. The third stage involves strengthening exercises and functional movements. On the average these stages last approximately four to eight months.

shoulder replacement picture Hip joint replacement is commonly done in people age 60 and older who have had a hip fracture or severe hip joint arthritis. A normal hospital stay is 3 to 5 days. During that time the patient will recover from anesthesia, and from the surgery itself. The patient will be asked to start moving and walking usually the first day after the surgery. Following the surgical stay in the hospital the patient should take advantage of the inpatient rehabilitation center after their discharge from the hospital. Inpatient physical therapy services are given up to six times per week as opposed to 2 to 3 times per week in a homecare situation. Once released from either homecare or the inpatient physical therapy you should now continue your treatment at the outpatient physical therapy clinics

shoulder replacement picture During knee joint replacement surgery damaged cartilage and bone are removed from the knee joint, and prostheses are placed in the knee. The hospital stay is about 3 to 5 days. Normally the patient will start moving and walking as soon as the first day after surgery. The hospital program will follow with inpatient rehabilitation which normally includes physical therapy services up to six times per week. Outpatient clinics offer only to 2 to 3 sessions per week. It is important to understand the need for intense physical therapy in achieving maximum range of movement which should not be less than 90 degrees of knee bend, and not greater than 5 degrees away of full extension.

shoulder replacement picture Surgery to replace the ankle joint with an artificial joint (called ankle arthroplasty) is becoming more common. This surgery is not done as often as the replacement of the knee or hip joints. Still, when necessary, this operation can reduce the pain from arthritis of the ankle. Recent advances in the design of the artificial ankle and changes in the way the operation is performed have made artificial ankle replacement a growing alternative to ankle fusion for the treatment of ankle arthritis. After surgery your ankle will probably be placed in a cast or splint. Your therapist will help you find ways to do your tasks that don't put too much stress on your ankle joint. Before your therapy sessions end, your therapist will teach you a number of ways to avoid future problems.