Common questions about Joint Surgery asked and answered

Common questions about Joint Surgery asked and answered

We address some of the common questions that are asked about Joint Surgery and provide the answers for you.

What is joint replacement surgery?

Joint replacement surgery is when a painful, stiff and deformed natural joint is replaced by a synthetic joint.

Why are our natural joints so amazing?

Natural joints such as the shoulder, knee or hip have biologically perfect qualities. These joints contain oily synovial fluid that provides lubrication. This fluid is produced and replaced constantly and is always “new”. A layer of cartilage cells covers the contact surfaces. This layer is extremely strong, super smooth and slippery, and allows near frictionless pain-free movement.

Joints are stabilised with ligaments and moved by muscles. Amazingly both of these respond to being used vigorously by becoming stronger, not weaker. Ligaments and muscles also contain nerves that provide proprioception that allows us to know where our limbs, hands and feet are at all times even when our eyes are closed. 

Synthetic joints with these qualities cannot be produced yet, but we have been able to imitate them with great success.

Total shoulder replacement
Total knee replacement
Total shoulder replacement

Why would someone need joint replacement surgery?

Natural joints, like our skin and eyes and other organs, undergo degeneration over time. It could be due to normal “wear and tear” which results in osteoarthritis,  in osteoarthritis, injuries to the joint in the past, and inflammatory conditions like rheumatoid arthritis.

When a joint is destroyed in such a way, it causes pain and it can become stiff and deformed. It ultimately restricts a person’s ability to be active and sporty, and even our ability to perform very basic activities such as walking, washing or getting dressed. 

We cannot reverse the damage to severely destroyed joints, but we can replace them with synthetic materials. These joint replacements will relieve the pain, correct any deformities, and often improve the range of movement. When joint replacement surgery is done for the right indications, it is often life-changing. 

What are synthetic joints made of? 

There are up to 4 different components in most synthetic joint replacements. Metal, ceramic, plastic and bone cement. All 4 of these components are extremely safe and each one comes in different forms. The metal could be stainless steel, titanium or a metal alloy such as cobalt chrome molybdenum. Ceramic components are harder, smoother and more resistant to scratching than metal. The plastic is a highly cross-linked polyethylene compound that is very resistant to wear and imitates cartilage. If bone cement is required, it is prepared during the operation in theatre to stabilise the implants.

Will the surgery be painful?

The surgery is performed under general or spinal anaesthesia and there is no pain during the operation. After the operation, while in hospital, the pain is relieved by using a combination of nerve blocks, intravenous and oral pain killers, and after discharge, your surgeon will prescribe oral pain killers to keep you comfortable at home. You should never feel severe pain after joint replacement surgery but it is major surgery and you should expect to feel discomfort at times. 

How long will the synthetic joint last?

Different joints last longer than others. A shoulder replacement should last longer than 10 years, and knee hip replacements for 15 to 20 years. There is a small risk of early complications during the first 6 months to 1 year after surgery. These include dislocation, infection and fracture. If early complications do not occur and the patient looks after themselves, the joint’s long term survival is high.

What will I be able to do once I have healed, and what should I avoid?

The ultimate goal is to get every patient back to usual activities for their age group and fitness level, but there are a few caveats. Each joint has different do’s and don’ts. You should be able to cycle, swim and walk long distances with either a hip, a knee or a shoulder replacement.

Before your surgery, your surgeon will discuss the details of what you can do with your new joint, but also what you should best avoid.

When should I have a joint replacement?

This is a very personal question, but the following factors should play a part in your decision making: 

  • When you cannot perform your normal daily activities without difficulty. For everyone, this is getting dressed, personal hygiene and walking, but for some it also includes golf, cycling or hikes in the mountains. We each define “quality of life” differently.
  • When you need daily pain killers to get by. 
  • When the benefits of a joint replacement outweigh the risk of surgery for you personally.
  • When the family and friends you trust start suggesting it because they can see you are struggling.
  • When the cause of your pain has been accurately diagnosed and clearly defined. Arthritis of the shoulder versus referred neck pain. Hip and knee arthritis versus referred to lower back pain.

Should you plan surgery at Midlands Orthopaedics, you will be provided with a detailed booklet that covers the surgery, hospital admission, possible complications and a guide to rehabilitation, amongst others.

For more information about the kinds of surgery we undertake, you can visit our website. If you want to discuss your joint care going forward, please contact us.