Joint replacement surgery can help patients with traumatic injuries or joint conditions such as osteoarthritis. In a joint replacement, a surgeon removes damaged portions of the joint, replacing bone with durable prosthetic materials that can significantly reduce pain and restore function.
Joint replacement surgery—also called joint arthroplasty—is the surgical repair of a damaged joint that's causing pain, stiffness, and other symptoms. It's typically used to treat severe arthritis, though traumatic injuries or other diseases that damage the joints may benefit from joint arthroplasty.
The details of each joint replacement procedure are slightly different. However, in any joint replacement, a surgeon removes the damaged parts of your joint and substitutes them with a prosthetic device made of metal, ceramic, or plastic.
In some partial joint replacement procedures, such as hip resurfacing, the damaged components are covered with metal or ceramic rather than being completely removed.
The joint replacement surgery provided at the Brigham and Women's Hospital Department of Orthopaedic Surgery is delivered with the expertise and innovation you would expect from a world-class hospital. U.S. News & World Report has consistently ranked our orthopaedic surgery program as one of the nation's best. Our team is dedicated to raising the standards of joint care, including developing new advanced surgical protocols and designing better joint implants. Hundreds of arthritis patients return to full, active lives each year thanks to the joint replacement surgeries provided by our experienced and skilled orthopaedic surgeons.
Learn more about elective joint replacement surgery at the Brigham.
Some patients with less severe joint damage may be able to avoid or delay joint replacement surgery with other surgical joint repair techniques and nonsurgical treatments. Cartilage repair surgery is available for patients who have early arthritis in the knee or whose cartilage is wearing away.
For patients seeking surgery for replacement or repair of damaged joints, the Brigham has a staff of more than 25 orthopaedic specialists at four locations in the greater Boston area. Our orthopaedic surgery staff provides patients with expert, comprehensive care, and encourages patients to be active participants in their own care and recovery. The Department of Orthopaedic Surgery is part of the Brigham and Women’s Orthopaedic & Arthritis Center of Excellence, where every year our specialists in orthopaedic surgery, physiatry, rheumatology, and rehabilitation, work together with dedicated nurses, physician assistants, and other professionals, to provide accurate diagnosis and innovative treatment for thousands of patients.
Orthopaedic surgeons and researchers at our research laboratories are constantly developing and testing new treatment options for patients with bone and joint conditions like arthritis. Our research approach is to translate new findings from clinical investigations into innovative treatment options for bone and joint health, including a range of joint replacement and repair surgeries. We conduct research around acute and chronic orthopaedic and joint conditions, including osteoarthritis, rheumatoid arthritis, fractures, sports injuries, bone cancers, spine diseases, osteoporosis, and skeletal aging.
Learn more about our orthopedic surgical specialties at Brigham and Women’s Hospital.
A surgeon may perform surgical repair of a joint with arthroplasty in two ways: total joint arthroplasty or partial joint arthroplasty. In total joint replacement surgery, all components of the joint are replaced, while partial joint replacement only replaces some of them.
For example, in a hinge joint like the knee, a total joint arthroplasty replaces the kneecap, or patella, and resurfaces the end of the thighbone, or femur, and the top of the lower leg bone, or tibia. In a partial knee replacement, the surgeon only replaces or resurfaces the damaged portion, such as the kneecap or patella, the inside of the knee, or the outside of the knee.
The main distinction in arthroplasty is partial vs. total joint replacement. Apart from these two broad categories—based on how much of the joint gets replaced—arthroplasty can be subdivided by joint.
Any major joint in your body is a candidate for joint replacement. Hip and knee replacements are the most common, but a surgeon can also replace elbows, shoulders, ankles, wrists, and some smaller joints in the hands and feet.
The surgeons at Brigham and Women’s offer many innovative approaches for total joint replacement surgery. Learn more about our team’s approach to:
Joint arthroplasty is a major operation, so it isn't often a first-line treatment. Before you have a joint replacement procedure, your doctor may recommend more conservative therapies like pain management and physical therapy for osteoarthritis of the hip or knee arthritis. When these therapies are no longer effective in managing your symptoms, you may consider a joint replacement.
Before your operation, you'll meet with an anesthesiologist to discuss what kind of anesthetic they'll use, when you should stop eating and drinking before the surgery, and what to expect in terms of recovery time. The surgeon may also perform tests like a physical exam to ensure you're healthy enough for surgery or imaging like an MRI to assess the condition of your damaged joint.
When you go to the hospital for the operation, you'll need a friend or family member to accompany you since you won't be able to drive home. Bring comfortable, loose-fitting clothing and your insurance information.
After check-in, you'll receive anesthetic—usually spinal anesthesia—to ensure you don't feel any pain during the procedure. Then, the surgeon will remove the damaged parts of the joint, install the prosthetic, and adjust the prosthesis or the healthy part of the joint to ensure a good fit.
The whole process usually takes several hours, but the exact length of the procedure depends on the joint being replaced.
Many modern joint replacements are now performed as minimally invasive surgeries. In this type of arthroplasty, the incisions are smaller and the surgeon uses special tools to work through the small openings. As a result, the operation does less damage to the surrounding tissues (such as your hip or leg muscles), and your surgery site heals more quickly. Your surgeon may also use robotic assistance to guide the surgical tools and implants during joint replacement.
Joint arthroplasty is a well-established type of surgery with a good safety record. However, all surgery carries the risk of complications such as infection, blood clots, nerve damage, or complications from anesthesia.
The recovery timeline, physical therapy protocols, and other aspects of recovery for joint replacement differ depending on which joint you replace. After the operation, your doctor will prescribe physical therapy and outline a recovery program. Usually, they'll encourage you to start using your new joint soon after the surgery, and in most cases, there are few post-surgical limitations.
Exercise is an essential part of recovery from joint replacement surgery, so it's crucial to follow your therapy program to get moving again.
Total joint replacement describes any procedure in which a surgeon replaces all the components of a damaged joint with prosthetic implants made of metal, plastic, or ceramic.
The most common types of joint replacement surgery are hip and knee replacement.
Studies show that when a joint replacement fails, it's often the result of multiple causes. Some of the most common causes of failure include normal wear and tear on the prosthetic, infection, and loosening of the prosthetic from the bone.
All joint replacement surgeries are hard on the body. Knee replacements generally have the longest and most involved rehabilitation process.
That depends on the joint. Recovery from a knee replacement takes around three months, while hip and shoulder replacement patients see improvement in about two months. Full and complete recovery can take up to a year.
It's common for joint replacements to be painful for several weeks after the surgery. However, once the healing process is underway, your joint replacement should reduce or eliminate your joint pain—that’s the main reason to perform a joint replacement.
The most painful joint replacement surgery is usually a total knee replacement since it's a complicated joint with more surfaces to replace or adjust.
The average age for a joint replacement varies according to the individual joints, but most people who get one are in their mid-60s.
No. Joint replacement can relieve symptoms and restore mobility and independence but doesn't cure arthritis completely. Some people still experience pain and stiffness after a joint replacement procedure, though it's significantly less severe. Your condition may continue to progress even after your joint replacement surgery, but many patients report a dramatic reduction in arthritis pain in the years following the procedure.
How does arthritis affect your joints? How does joint replacement work? What is recovery like after a joint replacement? Learn about the most common joint replacements and the best things people can do to return to the activities of daily life quickly and safely after surgery.
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