Joint Replacement News:
Glass and Radioactive Glass Spheres May Be Used to Mend Joints:
The spheres, about one-fifth to one-tenth the diameter
of a human hair, would be injected into the joint. Once
the radiation is delivered, the spheres react with body fluids,
eventually disappearing from the body.
Joint Replacement News:
Materials Produce Longer Life for Artificial Knees:
New Oxinium femoral components, made out of
an exclusive oxidized zirconium material, have been shown in knee
simulator wear last longer.
Take Guesswork Out of Incisions for Joint Replacement:
Software creates three-dimensional muscle and bone
models of each patient prior to surgery, letting doctors see the
size and orientation of the muscles before the first cut.
Set on Instrument to Aid Minimally Invasive Knee Replacement:
Howmedica Osteonics Scorpio® Total Knee instrumentation is designed
to complement the surgical technique pioneered by Dr. Peter Bonutti
and used in a less invasive knee replacement procedure.
Far Less Likely to Seek Hip Replacement Surgery:
With insurance not the issue, researchers speculate Hispanics who
need hip replacement may not know anyone else who has had the surgery.
Replacement Surgery for Ankles Is Becoming More Common:
But the procedure has lagged behind joint replacement surgery for
hips and knees due to problems with the designs of the artificial
Option for Patients With Early Stage Knee Arthritis:
The UniSpacer, a small, minimally invasive device that fits between
natural bone structures of the knee, allows surgeons to preserve
the patient's bone by replacing only damaged cartilage.
Approves $1 Billion Settlement for Faulty Joint Replacements:
Patients who had implants replaced without complications will receive
about $200,000 each. The payment will be higher for patients suffering
in Need Have Limited Access to Joint Replacement Surgery:
Researchers report Canadians with a lower income and lower level
of education have a higher incidence of osteoarthritis but have
a more limited access to joint replacement surgery.
Cartilage May Be Option to Total Joint Replacement:
A synthetic cartilage now available in Europe for cartilage repair
that may be an option for patients requiring a total joint replacement.
Trials Underway on New Type of Total Knee Replacement: In
most knee prostheses, the tibial polyethylene is firmly attached
to a metallic tibial base plate. In the new rotating platform design,
the tibial polyethylene is free to rotate about a central axis..
Surgeons Perform Minimally Invasive Knee Replacement Procedures:
surgeons performed the procedures using Zimmer's NexGen® Legacy
® LPS-Flex Knee, using techniques researchers hope may make
knee replacement a much less daunting operation.
Approves Replacement for Middle Joint in Arthritic Fingers: The
U.S. Food and Drug Administration has approved a total replacement
joint for patients suffering from arthritis of the proximal interphalangeal
When all attempts
to alleviate hip or knee pain have been exhausted by your doctor,
your next option may be a total joint replacement. Approximately
150,000 total hip replacements and 90,000 total knee replacements
are now performed annually.
Replacement. Hip replacement, or arthroplasty, is a surgical
procedure in which the diseased parts of the hip joint are removed
and replaced with new, artificial parts. These artificial parts
are called the prosthesis. The goals of hip replacement surgery
are to improve mobility by relieving pain and improve function of
the hip joint.
The most common
reason that people have hip replacement surgery is the wearing down
of the hip joint that results from osteoarthritis. Other conditions,
such as rheumatoid arthritis (a chronic inflammatory disease that
causes joint pain, stiffness, and swelling), avascular necrosis
(loss of bone caused by insufficient blood supply), injury, and
bone tumors also may lead to breakdown of the hip joint and the
need for hip replacement surgery.
In the past,
hip replacement surgery was an option primarily for people over
60 years of age. Typically, older people are less active and put
less strain on the artificial hip than do younger, more active people.
In recent years, however, doctors have found that hip replacement
surgery can be very successful in younger people as well. New technology
has improved the artificial parts, allowing them to withstand more
stress and strain. A more important factor than age in determining
the success of hip replacement is the overall health and activity
level of the patient.
For some people
who would otherwise qualify, hip replacement may be problematic.
For example, people who suffer from severe muscle weakness or Parkinsons
disease are more likely than healthy people to damage or dislocate
an artificial hip. Because people who are at high risk for infections
or in poor health are less likely to recover successfully, doctors
may not recommend hip replacement surgery for these patients.
The hip joint
is located where the upper end of the femur meets the acetabulum.
The femur, or thigh bone, looks like a long stem with a ball on
the end. The acetabulum is a socket or cup-like structure in the
pelvis, or hip bone. This ball and socket arrangement
allows a wide range of motion, including sitting, standing, walking,
and other daily activities.
During hip replacement,
the surgeon removes the diseased bone tissue and cartilage from
the hip joint. The healthy parts of the hip are left intact. Then
the surgeon replaces the head of the femur (the ball) and the acetabulum
(the socket) with new, artificial parts. The new hip is made of
materials that allow a natural, gliding motion of the joint. Hip
replacement surgery usually lasts 2 to 3 hours.
surgeon will use a special glue, or cement, to bond the new parts
of the hip joint to the existing, healthy bone. This is referred
to as a cemented procedure. In an uncemented procedure,
the artificial parts are made of porous material that allows the
patients own bone to grow into the pores and hold the new
parts in place. Doctors sometimes use a hybrid replacement,
which consists of a cemented femur part and an uncemented acetabular
were developed 40 years ago. Uncemented prostheses were developed
about 20 years ago to try to avoid the possibility of loosening
parts and the breaking off of cement particles, which sometimes
happen in the cemented replacement. Because each persons condition
is unique, the doctor and patient must weigh the advantages and
disadvantages to decide which type of prosthesis is better.
For some people,
an uncemented prosthesis may last longer than cemented replacements
because there is no cement that can break away. And, if the patient
needs an additional hip replacement (which is likely in younger
people), also known as a revision, the surgery sometimes is easier
if the person has an uncemented prosthesis.
disadvantage of an uncemented prosthesis is the extended recovery
period. Because it takes a long time for the natural bone to grow
and attach to the prosthesis, people with uncemented replacements
must limit activities for up to 3 months to protect the hip joint.
The process of natural bone growth also can cause thigh pain for
several months after the surgery.
proven the effectiveness of cemented prostheses to reduce pain and
increase joint mobility. These results usually are noticeable immediately
after surgery. Cemented replacements are more frequently used than
cementless ones for older, less active people and people with weak
bones, such as those who have osteoporosis.
allowed only limited movement immediately after hip replacement
surgery. As early as 1 to 2 days after surgery, a patient may be
able to sit on the edge of the bed, stand, and even walk with assistance.
Usually, people do not spend more than 10 days in the hospital after
hip replacement surgery. Full recovery from the surgery takes about
3 to 6 months, depending on the type of surgery, the overall health
of the patient, and the success of rehabilitation.
Knee Replacement. A
knee replacement is an operation to remove a knee joint that has
become so damaged that it causes pain and loss of mobility. In its
place, an artificial joint is inserted, allowing the knee to become
functional and removing the discomfort of the original knee.
that leads to a damaged knee joint may eventually result in the
need for a knee replacement. Hence, people who suffer from osteoarthritis,
rheumatoid arthritis and other joint diseases are more likely to
need joint replacements. People who have damaged their knees, either
in an accident or through continued wear and tear (for example,
those working in heavy manual jobs) may also find that their knees
The most common
symptoms in the knee that indicate damage to its structure are pain
on moving it and standing on it, stiffness in the joint (especially
in the morning) and inability to bend or straighten the knee completely.
Pain can be felt within the knee joint itself, but also in the hip
and thigh above it or in the calf and ankle below.
Once knee ligaments
have been damaged, a person's knee becomes very painful and he or
she is unable to walk unaided. If medical attention is not sought,
damage can be done to other joints. As the individual tries to walk
with minimum weight on his or her 'bad' knee, so extra force on
the other leg may lead to damage to the 'good' knee or hip.
operation usually lasts about an hour and a half. During that time,
the damaged ends of the bones that form the knee joint are removed
and replaced with metal ends covered in a durable plastic coating
that will form the new surfaces. The incision is closed with metal
clips. Occasionally, a small plastic tube may be left in the wound
for 24 hours after surgery to allow fluid to drain from the new
hours after the operation, an X-ray is performed to check the position
of the joint replacement. If this is satisfactory, a specially planned
physiotherapy program begins. Special knee exercising machines gently
bend and straighten the knee joint without force for the first day
or two after surgery and you are gradually allowed to bear weight
on that leg again, at first with a frame or crutches. By the time
of discharge from hospital, you should be using a single crutch.
After you leave hospital, outpatient physiotherapy often continues
until you can walk unaided. The clips are removed about seven days
after the operation when the wound has healed.
For the majority
of people, the knee replacement allows a return to a good quality
of life with full mobility and without pain. Often the opposite
knee is also affected by the same condition, such as osteoarthritis.
In this case, the second knee may also have to be replaced at a
provided by: The National Institute of Arthritis and Musculoskeletal
and Skin Diseases, , National Institutes of Health, Bethesda, MD
20892 and BUPA.