What is Arthroplasty?

Marjorie McAtee

Arthroplasty is a medical procedure designed to replace or partially replace a joint. Arthroplasty is mostly used to reconstruct the hip, knee, and shoulder joints, as well as the joints in the hands and feet. This type of surgery is generally used to treat rheumatoid arthritis, osteoarthritis, or quiescent tuberculous arthritis. The procedure can also be used to correct joint deformity and fractures in the neck of the femur, or thigh bone. There are three types of arthroplasty: half-joint replacement, total joint replacement, and excision arthroplasty.

An X-ray of the pelvic area, showing a metal replacement hip.
An X-ray of the pelvic area, showing a metal replacement hip.

The half-joint replacement procedure involves replacing only one of the articulating parts of the joint. This surgery may be used to replace the head of the femur or to replace a damaged metatarsal or phalangeal bone. Half-joint replacement can be useful in cases where only one half of the joint is injured, because the uninjured half can be left in place. Unlike total joint replacement, half-joint replacement typically leaves as much as 75 percent of bone, ligaments, and muscle intact. The damaged half of the joint is usually replaced with a prosthetic made of metal or silicone rubber.

Crutches may be required after arthroplasty.
Crutches may be required after arthroplasty.

Total joint replacement is generally needed in cases of osteoarthritis, rheumatoid arthritis, or quiescent tuberculous arthritis, when both articulating halves of the joint are damaged. In total joint arthroplasty, the entire joint is removed and replaced with an artificial one. The artificial joint may be made of metal, ceramic, or polyethylene. Total joint replacement surgery is generally used to replace hips and knees. Replacement joints can last for years.

Excision arthroplasty usually requires the excision, or removal, of both articulating ends of the joint, to leave a gap between the bones. This gap may naturally fill with fibrous scar tissue, or the surgeon may attach a pad of muscle or other tissue between the excised bones. This procedure usually allows for an acceptable range of motion in the affected joint, though that joint may be unstable. Because excision arthroplasty contributes to joint instability, it isn't generally used in the ankles or knees. Excision arthroplasty is typically used in the feet and hands, but may be used as a stopgap measure if total hip replacement surgery has failed.

Most patients experience some pain and discomfort while recovering from joint replacement surgery. Most surgeons encourage patients to begin walking with crutches and other assistance immediately after surgery. During the recovery process, gentle exercises like walking are typically encouraged. More strenuous activities, like running, are usually discouraged until the joint has completely healed, six to eight weeks after surgery.

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