Joint Replacement Surgery

Joint replacement surgery is a surgery done to replace the damaged parts of a joint with prosthetic/manmade parts. The artificial joint is designed to replicate the function of a natural healthy joint. During the surgery, various biomechanical forces acting upon the joint are balanced to aid in smooth function.

Replacement surgery is one of the most common surgical procedures performed by orthopaedic surgeons. Hip and knee joints remain the most commonly replaced joints. Although numerous joints including shoulder, elbow, ankle and finger joints can be replaced. Hip replacement is considered the most successful surgery in the entire history of medicine.

According to research, the number of patients receiving total hip (THR) and knee replacements (TKR) is projected to grow. By 2030, THR  and TKR are expected to grow by 171 percent and 189 percent respectively1. Arthritis remains the most common cause of joint dysfunction requiring replacement surgery. Any patient with joint pain that is not relieved with less invasive treatments is a candidate for joint replacement.

Total Knee Replacement

Total Knee Replacement

Anatomy

A joint is formed when ends of two bones meet. Depending upon the anatomy they could be ball and socket joint (hip, shoulder, etc), hinge joint (knee, elbow, etc). Other types of joints are pivot joint, saddle, plane, and condylar joint. Besides the bones, various structures form a vital part of a joint. 

Articular cartilage is a glistening white smooth tissue covering the ends of the bones. The tissue is flexible and cushions the smooth gliding of the bones during the joint motion. Apart from reducing friction, it acts as a shock absorber for the joint. Damaged cartilage may lead to arthritis of the joint.

Ligaments are tough fibrous tissues holding the bones together. They maintain stability and prevent the bones forming the joint to pop out of the joint. Ligament damage could lead to instability and laxity in a joint.

Synovium is a thin tissue that lines the inner surface of the joint. Synovial fluid is severed by the lining, which is watery thin, sticky and a clear fluid. The synovial fluid provides nourishment to the articulating cartilage and helps reduce friction during joint movements. 

Bursae are small fluid-filled sacs present around the joint. They help in the smooth gliding of various structures crossing the joint. The knee joint in addition has special pads of tissues known as a meniscus. Meniscus dampens the impact of the bones of the joint.

Causes

Osteoarthritis also known as wear and tear arthritis is the most common of joint dysfunction. With growing age, there is degeneration of the structures forming the joint. The wear and tear of the articulating cartilage cause loss of smooth gliding of the joint. Although the exact cause is unclear, Osteoarthritis sometimes runs in the family.

Some individuals have abnormal development of the joint leading to arthritis. Inflammatory conditions such as rheumatoid arthritis can cause damaged joints if not managed properly. In the case of rheumatoid arthritis, multiple joints are involved such as hips, fingers, knees, toes, etc. 

Sports injuries to the joints can lead to instability of the joint and early onset of arthritis. Major injuries involving joint surfaces can lead to arthritis secondary to incongruous joint surfaces. Obesity may contribute to joint problems which may lead to early onset of arthritis.

Procedure & Materials

Joint replacement surgery involves replacing/resurfacing the damaged parts of the joint. The forces of the tissues acting on the joints are balanced. The prosthetic/manmade parts are then attached to the resurfaced bone with or without cement. 

The prosthetic parts forming the joint may be made of alloys of titanium, cobalt-chromium, polyethylene, ceramic or stainless steel. The prosthetic joint is attached either with special bone cement or is press-fit in the bone. The press-fitted implants allow the bone to grow onto them.

Candidates

The patients with arthritis are usually given a trial of conservative management. Conservative management includes physical therapy, heat pads, medications, visco-supplement injections, or cortisone injections. Unfortunately, arthritis is a progressively worsening condition. At some point the patients may have exhausted all less invasive treatment options, they are a candidate for joint replacement.

Before the Surgery

The patients requiring joint replacement are evaluated and assessed for any medical conditions. Baseline tests which are performed before the surgery include blood tests and EKG. The patients are also assessed for the kind of anesthesia they would be receiving. Surgery is usually performed under general anesthesia or regional anesthesia, such as spinal anesthesia.

After the Surgery

In the case of more commonly performed replacement surgeries, the patients are allowed to walk the same day of the procedure. They are usually discharged the next day of the surgery if stable. The patients undergo extensive physical therapy and rehabilitation. 

Gait training and muscle strengthening exercises are usually advised to the patients. Most patients are able to walk without support (cane or walker) by the end of 8-12 weeks. They are advised to avoid high impact activities such as running or jumping. Most casual activities such as walking, navigating stairs, riding a bicycle, and golf are allowed.

Complications

As with any surgical procedure, joint replacement surgery may have potential complications. There may be medical complications including stroke, heart attack, pneumonia or urinary tract infections. During the surgery, there may be complications such as fractures, nerve damage, blood vessel damage, shortening, instability or dislocation. 

After the surgery, during the first few weeks, there is an increased risk of infections which may be superficial or deep. There may be complications of joint dislocation or blood clots in the blood vessels. Blood thinners are usually prescribed after the surgery to prevent blood clots. 

In the long term, there may be persistent pain, weakness, dislocation or loosening of the implant. Implants like any man-made parts have a lifespan. Towards the end of the lifespan, they may wear out or become loose.

Success

Successful joint replacement surgery lasts for many years. On average, a total hip replacement or total knee replacement would last for the next 15-20 years or more. The patients report an increased range of motion about the joint which relieves pain caused by arthritis. They are able to get back to their baseline daily activities with a high quality of life.

Patients report satisfaction on account of increased mobility and leading a pain-free lifestyle. A greater number of patients today are undergoing joint replacement surgeries owing to the successful outcomes. 

References:

  • https://aaos-annualmeeting-presskit.org/2018/research-news/sloan_tjr/

Call Us Now!

4.9
Based on 93 reviews
Dr Vaksha, is a great doctor very professional knows what he talking about. Treat patient with upmost respect. Thank You
Troy Spencer
16:46 19 Jan 23
Dr. Karkare is an amazing doctor, very caring and attentive, the girl at the front desk is very kind and helpful. .elizabeth .thank you so much .
blanca ventura
21:32 26 Oct 22
Been going to this place before my accident and after I had my knee surgery. So happy how I been treated and how well I am getting. Thank you all and specially Dr. VAKSHA for everything and getting back on track.
Ita Opico
19:01 25 Oct 22
Love this place From the minute I called I was treated kindly. When I arrived The Dr saw me right away he was compassionate and ordered the appropriate tests for me. I came back in for my follow up and had the same great experience.
Christine Rostock
21:28 23 May 22
Dr Vaksha and Dr karkare are 2 of the best orthopedic doctors around my wife Susan had a very serious broken ankle in March of 2019 she didn't think she was going to walk again Dr vaksha did an excellent surgery on her ankle he said it was his toughest he ever did he put a lot of hardware in her ankle and told her she would be alright she made remarkable recovery thanks to his surgery as of now she regained 100 percent use of her ankle she would highly recommend him to anyone. My own experience with Dr karkare has been wonderful he takes his time with you listens to what you have to say and prescribes various treatments and is very caring I would highly recommend him to anyone I would give both doctors a 10 plus rating we are very happy with them the best.
Harry Jones
23:31 19 May 22
Complete orthopedics is a wonderful place to go when you hurt or injured a great staff and wonderful doctors very knowledgeable and helpful I would recommend this place to all of my family and friends that is in me of orthopedic care I give them 10 thumbs up
Wayne Pemberton
17:39 18 May 22
The staff is very professional and helpful. Dr. Vaksha is excellent. He takes time to listen and offer suggestions to help you get better. I’m very thankful and happy to be a patient here at Complete Orthopedics.
Phoenix Rising
19:54 16 May 22
Dr.Karkare is the best. He listens to everything and explains everything I recommend him to everyone. I am so happy he is my doctor.
Myrna James
00:48 13 May 22
Dr.Kuo is amazing very attentive,caring,and passionate and staff is awsome too.Thank you for everything Dr.kuo.
Erick Murillo
23:17 12 May 22
I was in a car accident November 1 I was referred to Dr. Vaksha For shoulder surgery . I he was amazing he made me feel very comfortable and explained everything that was going to happen from surgery all the way through my physical therapy highly recommend Dr. Vaksha
Yolanda Ojeda
19:37 09 May 22
My appointment with Dr. Vaksha was amazing. Dr. Vaksha was very thorough and kind. I would refer this office to anyone who needs a great orthopedic doctor.
John Senechal
19:54 05 May 22
Scheduling my appointment was quick and easy. The staff was super friendly and down to earth. I was seen on time. The appropriate test, “x-rays” were taken before the conversation with doctor, something I really liked, test for analysis and conversation was done upfront. Dr. V had a great personality and was no BS, straight forward diagnosis and a play on next steps. I am happy I found them and would refer them to friends and family.
Sam
00:46 03 May 22
I have seen Dr. Kuo two times already and he's awesome along with his staff. Very friendly office and I'm glad to be a patient here.
Camaris A
20:01 28 Apr 22
Amazing team!! Very caring, profesional, and friendly!! Dr. Kevin Kuo, you are the best, very passionate, caring, and helping thank you for getting me better and being so kind to me! Elizabeth you the best thank you for you help always and you big smile and positive actitud❤️🙏🏼
breidy valerio
19:01 22 Apr 22
The staff is truly exceptional, they make you feel comfortable and welcomed. The doctors are amazing,always professional, compassionate and great listeners.
Elizabeth Collado
03:25 09 Apr 22
What a great place! The place is clean and organized.The staff is wonderful. Setting up physical therapy is right there as well.I'm so glad I found this place.
Donna Anne
22:45 05 Apr 22
This was my 1st time breaking something in my 27 years on this planet. I was recommended here by a friend Dr. Vashka helped me from day 1 and still continues to check in on me and my healing ankle. Would highly recommend
tyron davis
16:06 01 Apr 22
Brand new office, same great doctors! Rooms are clean, plenty of parking, physical therapy attached, Dr. Karkare and his staff are awesome. Thank you!
Emily B
02:49 24 Mar 22
Dr.VAksha is the best, I love the way he treats me as his patient, he is caring,understanding and very attentive to my needs
Mirna Caballero
14:53 03 Mar 22
Great staff. Dr. Vaksha is awesome and takes the time to listen to his patients. He is very compassionate. I would highly recommend this office.
Bebe Doyle
01:24 23 Feb 22
After suffering from a severe ankle injury Dr. V was able to help me heal and return back to work completely to a job where I stand for 12 hours a day. The office is very clean and I appreciated the reminders of my appointments via phone call and through text. The patient portal made it easy for me to access all my documents including work notes. The office staff is wonderful and Rebecca was able to schedule me with a busy schedule and awesome at answering all of my questions including referring me to a great physical therapy office. I highly recommend this office to anyone who’s looking for knowledgeable and kind orthopedic office.
Elizabeth Birchwell
21:31 28 Jan 21
The staff here are great, I was seen at the time of my appointment and was well taken care of!
Shaun Berry
18:14 07 Jan 21
They are an excellent practice. The front and back office people are amazing and so helpful. Rebecca is such a kind and understanding person. I had an issue with paperwork and she cleared it right up. Dr. Karkare is very knowledgeable, helpful, and caring.
Matt S.
19:31 18 Nov 20
Rebecca K. - What a true burst of sunshine. Very friendly and definitely an asset to the practice!
Laura Aston
18:17 17 Nov 20
Great experience, the Doctor is nice but the staff is incredible. I worked with Linda, who was profession and assisted me beyond what any person has done at other practices. Complete Ortho should be complimented for having such a person on their staff.I highly recommend this place!!!
Joe Allen
17:26 17 Nov 20
Linda and Becca they are so good ever time I come they are very nice I would tell everyone I no to come to this office..
Barbara Victor
16:45 17 Nov 20
I was rear ended in an auto accident , Dr Vashka was recommended by a friend of mine .I was experiencing Back , neck , and shoulder pain . After a thorough examination and given exercises to do at home , I am feeling much better , and I ended up avoiding surgery . The staff at Complete Ortho is extremely attentive and show great care when making an appointment and are very friendly and i never waited more than 5 minutes for my appointment . So I would strongly recommend Complete Orthopedics for any aches and pains that one might be experiencing.....
Bill Becht
04:44 17 Nov 20
It was the afternoon of Friday Sept. 24. We were in Pt. Jefferson and my wife, Mary Ann, broke her hip. We went to Mather Hospital and it was determined that she would have to have an operation to have it repaired. This would be her third time under the knife in the past year. It just so happened that we were very fortunate enough to have Dr. Karkare, who was on standby, perform the surgery. He put in a rod and two screws in her hip. She spent a few days in the hospital and then went to Gurwin rehabilitee for another few weeks.It has now been almost six weeks and we both worked the election the other day. If it wasn’t for Dr. Karkare’s expertise she never would have been able to work. She is able to walk with a walker and is doing physical therapy three times a week.We can not thank the doctor enough for the compassion and dedication that he puts into his work. It allows Mary Ann do the things that she likes to do, even on a limited basis for a while. I know that with her will, perseverance and the great work that the surgeon performed she will be back on her feet in no time.Sincerely:John V. PlumpEast Northport, NY 11731
Jack Harris
14:36 06 Nov 20
In the year of 2018 I was referred to Dr. Karkare because I was experiencing severe knee joint pain. After exhausting physical therapy and trying to labor through the pain, I had to make a quality of life decision. Total knee replacement was the only viable option. Dr. Karkare made my decision easy as he walked me through the whole process from surgery to recovery.On 12/13/19 ( Friday the 13th) I enter Lenox Hill Hospital in great hands. From the time I entered Dr. Karkare’s office for the first time until now, his staff has been amazing. Andrea the medical coordinator walked me through all the paper work and necessary preparations for the surgery. Courtesy and kind would be an understatement. Dr. Karkare went over and beyond from the wellness checks and phone calls all to assure me that I was important to him. This was the right decision no pain and no limp. Complete Orthopedics should be your choice!
Kenneth Randolph
22:18 25 Sep 20
Dr. Vadshka has a great bedside manner. He really takes his time and explains treatment options.
T Lee
12:33 09 Sep 20
I suffered with pain in both knees for years. My orthopedic doctor kept recommending knee replacement . I fought it for years, as I was just afraid. When I had no choice and could barely walk , it was recommended I see Dr. Karkare. We set up a consultation and my wife and I left his office feeling totally confident and comfortable with moving ahead with the surgery. He explained everything to us, and the office staff set everything up for us and made the process easy. So about one month after our initial meeting I had the first knee done. I was up walking mere hours after the surgery, and on the workout machines the next morning. I went home two days after the surgery, and yes walked my daughter down the aisle at her wedding only one week after the surgery without even a cane! Three months later I had the other knee done and went home the very next day. Dr. Karkare put my fears to rest . I would highly recommend him. His expertise gave me my life back. Thank you Dr. Karkare.SincerelyVito Congro
Ethel Congo
23:58 12 Aug 20
Dr Rhodin really cares for his patients. When I see him he makes sure to review my progress in detail.
Micki Cahill
15:03 08 Feb 20
My mom had a total hip replacement by dr karkare. He is the BEST orthopedic doctor.Her incision is almost invisable.She is going back for her other hip next week. The office staff is the best, love Andrea.You wont find a better doctor.
Ryan Brigandi
21:06 13 Jul 18
There is no better Orthopedic doctor you will find. Broke my ankle three places on a Saturday. Called Dr. Karkare. He had is team ready at the hospital and operated on me within 6 hours after my injury. Now After 3 months of great care by him and his staff, I am walking to normalcy.
Spacecom Tel
04:13 23 Mar 18
js_loader

My name is Dr. Suhirad Khokhar, and am an orthopaedic surgeon. I completed my MBBS (Bachelor of Medicine & Bachelor of Surgery) at Govt. Medical College, Patiala, India.

I specialize in musculoskeletal disorders and their management, and have personally approved of and written this content.

My profile page has all of my educational information, work experience, and all the pages on this site that I've contributed to.