Total knee, total hip or total shoulder arthroplasty (joint replacement) are surgical procedures that replace damaged or diseased parts of the joint with artificial components made of metal and plastic known as a prosthesis (implant). In certain instances only a portion of the joint can be replaced which is called a hemiarthroplasty.

The surgery is performed under general anesthesia. The surgeon removes the damaged cartilage and bone from the joint and replaces them with the prosthetic components. The new components are designed to mimic the shape and function of the natural joint, allowing for improved range of motion and reduced pain.

Total joint replacement is often recommended for people with severe arthritis or other conditions that have not responded to other treatments.

The recovery period after surgery can take several weeks to months and physical therapy is required to help regain strength and mobility.

1. Indications: Joint replacement surgery is performed for the following joints and conditions:

      • Total Hip Replacement (Total Hip Arthroplasty): Indications include severe hip arthritis, hip fractures, and avascular necrosis. The procedure involves replacing the damaged hip joint with a prosthetic implant.
      • Total Knee Replacement (Total Knee Arthroplasty): This is primarily performed for end-stage knee arthritis, severe knee pain, and limited mobility. During the surgery, the damaged knee joint is replaced with an artificial knee joint.
      • Total Shoulder Replacement (Total Shoulder Arthroplasty): Shoulder arthritis, rotator cuff tears, and severe shoulder pain may necessitate this procedure. The damaged shoulder joint is replaced with an artificial implant.
      • Total Elbow Replacement (Total Elbow Arthroplasty): Conditions like severe elbow arthritis or fractures can require elbow replacement, which involves replacing the damaged elbow joint with an artificial one.

2. Preoperative Evaluation: Before surgery, patients undergo a thorough evaluation, which includes a physical examination, medical history review, and various imaging studies (X-rays, CT scans, MRI) to assess the joint’s condition and plan the procedure accordingly.


3. Anesthesia: Joint replacement surgery is typically performed under general anesthesia or regional anesthesia (spinal or epidural) based on the patient’s overall health and surgeon’s recommendation.


4. Surgical Procedure:

      • Incision: An incision is made over the affected joint. The size and location of the incision depend on the joint being replaced.
      • Joint Exposure: The surgeon carefully exposes the joint, removes damaged cartilage and bone, and prepares the joint surface for the prosthesis.
      • Implant Placement: The prosthetic components (metal and plastic parts) are inserted into the joint space. In hip and knee replacements, these components typically consist of a femoral component, a tibial component, and a plastic spacer. In shoulder and elbow replacements, the components may vary.
      • Closure: Once the prosthetic components are securely in place, the incision is closed with sutures or staples.

5. Recovery and Rehabilitation:

      • After surgery, patients are closely monitored in the recovery area.
      • Physiotherapy and rehabilitation play a crucial role in the recovery process, helping patients regain joint function, strength, and mobility.
      • Full recovery can take several weeks to months, and the timeline varies depending on the joint and individual patient factors.

6. Potential Benefits:

      • Relief from severe joint pain and improved joint function.
      • Enhanced quality of life and increased mobility.
      • Long-lasting results, with many joint replacements lasting 15-20 years or more.

7. Risks and Complications:

      • Potential complications include infection, blood clots, implant loosening, dislocation (common with hip replacements), nerve or blood vessel injury, and joint stiffness.
      • There is also a risk of wear and tear on the prosthetic components over time, which may require revision surgery.

Joint replacement surgery has been a transformative treatment option for individuals suffering from debilitating joint conditions. It can significantly improve patients’ quality of life allowing them to regain mobility and reduce pain.