Joint Replacements in the Elderly
By Doctor Roque Pinilla
Orthopedics and Traumatology
Joint Replacement Sub-Specialist
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Total joint replacement is one of the safest and most reliable treatments in any area of medicine. Today, hip or knee replacement surgery can last 20 years or more. In fact, in most patients, total joint replacement surgery will be a definitive solution for arthritis of the hip or knee.
Total joint replacement should be considered a possible treatment option only after determining that nonsurgical treatment has been unsuccessful.
In general, joint replacement surgery is recommended for patients who have tried nonsurgical treatment but continue to experience joint pain. Although it is a very effective surgical treatment, total joint replacement should be the last treatment option, not the first, for patients with advanced arthritis of the hip, knee, or shoulder.
Modern joint replacement surgery involves the removal of worn cartilage from both sides of the joint and the placement of a prosthesis that covers the joint with a metal and plastic implant that has an appearance and function similar to that of the normal joint. While almost every joint in the body can be replaced, most surgeries are hip or knee replacement.
Over the past 30 years, new, improved surgical techniques and new implant materials have been developed, making total joint replacement one of the most reliable and long-lasting procedures in any area of medicine.
What determines the need for joint surgery?
Severe or “terminal” arthritis can be caused by osteoarthritis, rheumatoid arthritis and other inflammatory joint conditions, previous joint injuries and fractures, joint infections and other rare conditions such as osteonecrosis also called avascular necrosis). All of these problems cause damage to the cartilage that usually covers the end of the bones and allows the joints to move smoothly and painlessly.
For certain types of arthritis, such as rheumatoid arthritis and other inflammatory types of arthritis, treatment by a rheumatologist who specializes in these disorders is the best option. Other more common joint problems, such as osteoarthritis, are usually treated by a GP, rheumatologist, or orthopedic surgeon. When the medical treatment for arthritis recommended by your doctor proves ineffective, joint replacement surgery may be an option. These professionals are best qualified to determine whether joint replacement therapy is an appropriate treatment option for you.
While some patients are in perfect health, most people who undergo joint replacement surgery must be healthy enough or medically fit for the surgery to be performed safely. Before having joint replacement surgery, talk to your GP to find out if you are in good health for anesthesia and post-surgery rehabilitation.
How is the need for joint surgery diagnosed?
In almost all patients, arthritis and other joint problems that are usually treated with joint replacement surgery can be diagnosed with a simple X-ray study. Other causes of joint pain should be considered, as referred low back pain It can be easily confused with the pain associated with arthritis of the hip or knee, and pain from an arthritic hip can affect the knee.
Inflammation of the soft tissues surrounding the joint can also lead to tendonitis or bursitis, which can be mistaken for pain associated with arthritis. Generally, a careful evaluation by your doctor and routine x-rays can determine the true cause of your pain.
Living with a joint replacement
After a relatively short period of recovery after surgery, patients who undergo joint replacement surgery often return to their normal activities. How quickly you recover after surgery depends on your level of activity before surgery, your general health and general physical conditions, the degree and duration of the physical problem before surgery, the type of surgery and its effects. expectations and motivations. Physical therapy after joint replacement is very important.
High-impact activities or overloading the joint with activities such as weight lifting, running, or jumping are not advised. However, some patients experience significant restrictions in their normal activities of daily living after hip or knee replacement surgery.
Although patients often regain functional movement after hip replacement surgery, the limits of motion of a total hip replacement can sometimes be exceeded, causing a dislocation from its normal position. Educating patients and understanding the limitations of a total hip replacement, especially regarding possible dislocation and range of motion restrictions, can help to minimize the existence of this complication.