Total Joint Replacement
At Heartland Orthopaedic & Sports Medicine Clinic, L.L.C.,
we do three types of common types of total joint replacements,
HIPS, SHOULDERS and KNEES.
Total Hip Replacement -
Designed to replace the damaged hip joint. Various prosthetic designs
and types of procedures are available to the surgeon. Our surgeons
carefully evaluate the patient to: 1) determine if surgery is indicated;
2) determine the most appropriate type of procedure; and 3) develop
a plan of treatment. The types of replacement, methods of fixation
and new alternate bearing materials are discussed below:
Stem Type
with Acrylic Cement Fixation
Stem Type without Cement Fixation
Stem Type with Hybrid Fixation
Bearing Materials Used in Joint
Replacement
Metal-on-Metal Bearings
Ceramic-on-Ceramic Bearings
Hemi-Surface Replacement for Osteonecrosis
Surface Replacement
of the Hip
Total Hip Replacement
Stem Type with Acrylic Cement
Fixation
Shoulder Replacement -
The shoulder joint is a complex ball and socket joint which owes
much of its stability to the muscle surrounding it (called the
rotator cuff) and to the capsule and ligaments. When the head of
the humerus (the ball) and the glenoid fossa (the socket) become
injured or diseased, the smooth surfaces become rough and irregular
(arthritis). This causes grating, limitation of movement and, above
all, pain.
Technically, the most significant differences relate
to the anatomy and function of the shoulder joint as it has the
greatest mobility of any joint in the body and, correspondingly,
the least anatomical constraint built into the geometry of the
joint itself. Joint stability in the shoulder is provided principally
by the capsule, ligaments and other soft tissue structures which
surround and support it. Hence, the results of total shoulder replacement
are more heavily dependent on patient selection and the surgeon’s
success in reconstructing the soft tissue structures rather than
on the prosthetic device itself.
Total shoulder prostheses generally
consist of two components, a humeral component and a glenoid component.
Since the rough, diseased joint surfaces have been replaced with
smooth articulating surfaces, good relief from pain is expected.
An increase in range of motion is also expected, however this is
very dependent on the muscle power around the shoulder and the
capacity to rehabilitate weak muscles. Therefore, postoperative
physical therapy is of prime importance. Furthermore, many people
who need total shoulder replacement have very weak muscles around
the shoulder preoperatively. Consequently, the increase of range
of motion is variable and in part depends upon the zealousness
of the patient regarding his or her physical therapy.
Like replacement
procedures in other major joints, total shoulder arthroplasty may
be associated with complications, including prosthetic loosening,
glenohumeral instability, tears of the rotator cuff, periprosthetic
fracture, infection, neural injury, and dysfunction of the deltoid.
The results are surprisingly good with few complications. Ninety
per cent were good or excellent and some patients have been functioning
very well for 20 or more years.
Total Knee Replacement - Total
knee replacement is one of the most successful of all surgical
procedures, and a virtual medical miracle. Prior to the development
of total knee replacement technology, patients with advanced arthritis
of the knee suffered from chronic pain and loss of functional independence.
Following total knee replacement, more than 90% of patients have
no pain, or only slight pain, and their walking is no longer limited
by their knee. Most patients can live a full and independent life.
The goals of total knee replacement are, in order of priority:
1. pain relief
2. standing/walking that is not limited by the knee
3. improved knee motion
4. improved knee strength
Total knee replacement
is major surgery, which usually involves a 3-4 day stay in the
hospital and a period of rehabilitation which takes about 3 months.
A team of health professionals will work with you to guide your
recovery, but you are the most important member of the team! We
believe that an informed patient is the best ally in achieving
success with total knee replacement surgery.
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