Joint replacement surgery has increased in popularity over the last five years. People have become more involved with sports, exercise, and
recreational activities and are staying active later in life. These patients often have old joint injuries that never healed completely, and others have had arthroscopic
surgery.
At a certain point, the pain, stiffness, and other symptoms in their joints begin to limit function and patients' ability to participate in the activities that
they enjoy. There are many non-operative treatments for arthritis and joint pain; however many patients with arthritis eventually require joint replacement surgery to
regain function in their injured or worn out joints.
Arthritis is the primary reason for joint replacement surgery. The knee, hip, and shoulder are the joints that
most commonly need replacement. Arthritis can have many different causes, but the end result is the same - irreversible joint damage that causes pain, stiffness, and
limited function.
The three most common types of arthritis are osteoarthritis, post-traumatic arthritis, and rheumatoid (inflammatory) arthritis. Osteoarthritis is a
generalized wear-and-tear disease of joints. The knees, hips, and spine are most commonly affected, but any joint in the body can be affected. Although osteoarthritis
is considered to be a wear-related disease, not everyone will suffer from it.
Some very active patients live their whole lives without a problem, while other
patients get severe osteoarthritis at an early age. In general, the longer you live, the higher your chances of developing arthritis. However, age and activity level are
not the only factors. Some people are genetically predisposed to developing arthritis - that is, it runs in families. If your mother has bad knees or hips, you may develop
the same problems.
The first signs of arthritis are usually mild and may go unnoticed. The motion of the affected joint may become increasingly limited. After
extended or strenuous activities, mild aches and swelling may be apparent at the end of the day. As the disease progresses, the symptoms become noticeable on a
daily basis. Regular activities, such as walking up or down stairs and getting up from a seated position, become more difficult. Crouching to pick up an object from the
floor or putting on socks and shoes are often difficult. Patients can no longer enjoy recreational activities like golf or tennis. This is when people usually seek medical
help.
For those who do not seek help, the disease may continue to worsen to the point that they need to use a cane or walker to get around. They are no
longer able to leave their homes or do common household activities like cleaning or going upstairs. This severe stage is known as end-stage disease. It is best to
seek medical advice before the disease becomes severe, because the earlier your treatments begin, the better your results. You may suffer unnecessarily by waiting
too long.
Post-traumatic arthritis has the same symptoms and appearance as osteoarthritis. The main difference is the cause. In post-traumatic arthritis, there
is a clearly identified injury to the joint. Common injuries that result in arthritis include fractures, dislocations, cartilage tears, and ligament injuries. Patients with cartilage
(meniscus) tears or ligament injuries, such as the anterior cruciate ligament (ACL), of the knee develop arthritis at a high rate even if the injuries are properly treated
with surgery.
Having joint surgery for any reason may increase the chance of developing arthritis in that joint. Post-traumatic arthritis seems to affect younger
patients more than osteoarthritis does, because it is related to injuries that are common in young adults. Patients in their 30s and 40s may develop arthritis from injuries
that they sustained in their 20s and 30s.
Inflammatory arthritis includes rheumatoid arthritis and many similar diseases. Approximately ten percent of patients
with arthritis have an inflammatory disease, which is caused when the body's immune system attacks the joints. Rheumatologists can treat inflammatory arthritis with
powerful medications. Many patients eventually develop severe disease and require joint replacement surgery.
Many recent advances in joint replacement
design, surgical technique, and pain management strategy have improved results for patients. As joint replacements have begun to function better and last longer,
they have helped the lives of patients who were not traditionally considered candidates for joint replacement. Younger patients recover quickly from joint replacement
surgery and can often return to work and recreational activities in 4-6 weeks.