Guide to Total Joint Replacement
Arthritis of the knee or hip, also known as degenerative joint disease of the knee or hip, occurs when the protective cartilage on the ends of your bones Arthritis of the knee or hip, also known as degenerative joint disease of the knee or hip, occurs when the protective cartilage on the ends of your bones wear down over time, leading to exposed bone rubbing against bone . This eventually leads to pain, joint stiffness, reduced flexibility, and joint swelling which is frequent in the knee.wear down over time, leading to exposed bone rubbing against bone . This eventually leads to pain, joint stiffness, reduced flexibility, and joint swelling which is frequent in the knee.
Osteoarthritis is the most common form of arthritis affecting over 21 million Americans . Other types of arthritis include:
- Post-Traumatic arthritis, which develops at some time after an injury to the knee or hip joint, such as a fracture in the knee or hip bones that did not heal properly .
- Inflammatory arthritis, such as rheumatoid arthritis, which results from an inflammatory condition or autoimmune disease.
Total Knee Replacement
Total knee replacement is a resurfacing procedure where the diseased surfaces are removed and replaced with metal and plastic . The plastic, made of strong polyethylene, ensures a gliding surface onto which the knee joint bends smoothly . Metallic implants are securely fixed to the femur (thigh bone) and tibia (shin bone) to form a new joint that is held in place by surrounding muscles and soft tissue . The smooth gliding motion is made possible by inserting a special polyethylene (plastic) liner between the two metal implants, which enables you to bend your knee without friction . These implants are usually secured to your bone using bone cement or they can be press fit into your bone
Total Hip Replacement
In total hip replacement surgery, the portions of the hip joint that contain thedamaged surfaces are replaced with precision metal and plastic parts accepted by the body which provide a smooth and painless range of motion. Your surgeon will make every effort to restore your hip to a condition that resembles its healthy preoperative status and to correct any deformity that may have existed. You should discuss what realistic outcomes to expect with your surgeon.
Metallic implants are fixed securely inside the femur (thigh bone) and acetabulum (socket in the hipbone) to form a new ball and socket joint that is held in place by muscles and soft tissue. Implants may be secured to your bone by cement, or they may have textured surfaces that promote bone growth into new parts.
Anesthesia
Anesthesia is the process of inducing a pain-free, tranquil, sleeplike state for your surgery . Your anesthesiologist has several techniques to carry you through surgery comfortably and without pain. The current best practice in anesthesia strongly recommends doing total knee replacement surgery under a combination of regional anesthesia (typically a spinal and/or epidural and a nerve block). However, your medical team will help determine what the safest and best choice is for you.
Regional Anesthesia
Two types of regional anesthesia are commonly used: spinal and epidural, which temporarily numbs the lower half of your body.
In addition, regional nerve blocks (commonly referred to as local anesthetics) are increasingly being used to minimize postoperative pain . Some patients think they’ll be awake during the procedure; however, this is not true . In regional anesthesia, you also receive sedation medication that allows you to sleep peacefully throughout the operation . Unlike general anesthesia, when sedation anesthesia is discontinued, you will awaken almost immediately and without pain because the regional anesthesia is still working . Throughout your procedure you will be monitored closely as our main goal is to have you undergo surgery with the utmost safety, with your pain under control, and in a comfortable environment.
In some rare instances, there may be situations preventing you from receiving a combination of regional anesthesia. In that case, your surgery will be done under general anesthesia.
General Anesthesia
In this instance, you will be given medication to induce a sleep-like state, followed by a gas anesthetic administered via a breathing device into your lungs. Throughout the operation you are attached to monitors that display information on your heart rhythm, heart rate, oxygen level in your bloodstream, body temperature and blood pressure. Your anesthesiologist will continually check these monitors during surgery.
Prior to your surgery, your anesthesiologist will also discuss the various options available to you to control your postoperative pain Together, you and your anesthesiologist will implement the options best suited for you.
If you have any loose teeth, there is a possibility of injuring them while under anesthesia and/or during the procedure. We strongly advise you to see your dentist prior to your procedure to have any loose teeth repaired, strengthened or removed.
Our Team
Attending Orthopedic Surgeon
An attending orthopedic surgeon is a medical doctor who has received extensive training in the art and science of performing surgery to treat diseases, injuries and deformities of the musculoskeletal system . Your surgeon will be your main contact if you have any questions regarding your surgery.
Anesthesiologist
An anesthesiologist is a perioperative physician who provides medical care to each patient throughout his or her surgical experience . This includes medically evaluating the patient before surgery (preoperative), providing a pain-free state and supporting life functions during surgery (intraoperative), supervising care including providing pain control after surgery (postoperative) and discharging the patient from the recovery unit .
Certified Registered Nurse Anesthetist (CRNA)
A CRNA is a registered nurse certified in providing anesthesia under the immediate and direct supervision of an anesthesiologist.
Physician Assistants (PAs)
A CRNA is a registered nurse certified in providing anesthesia under the immediate and direct supervision of an anesthesiologist.
Nurses
Registered nurses (RNs) or licensed practical nurses are responsible for your bedside nursing care following your surgery . The nurses caring for you will follow the surgeon’s instructions to guide your care, and will provide education to you and your family about your health and safety needs related to your surgery.
Recovery Coach
Your “Recovery Coach” will be someone that you will elect to be your coach throughout your recovery phase – typically a family member, friend or caregiver. This person will assist you in your transition from the hospital to your home as well as with needs you may have during recovery while at home.
Case Manager / Social Worker
A registered nurse case manager/ social worker will monitor your hospital stay from admission to discharge and will work closely with your doctor to expedite your hospital care. Your social worker will assist with arranging accommodations to suit your needs at home and/or with placement in a rehabilitation facility if necessary. He or she can also provide counseling services for patients and their families.
Occupational & Physical Therapists (OTs & PTs)
OTs, PTs and PT assistants are licensed professionals that will work with you to restore your function, improve mobility and decrease pain with the goal of reestablishing your prior level of function . They will focus on activities of daily living and mobility in the home, workplace and community while maintaining your physical, physiological and emotional health .