What is arthroplasty?
Arthroplasty is the removal of damaged joints and their replacement with artificial joints, made of chromium, cobalt and titanium, and together with high density plastics. Its objective is to correct deformities and mitigate pain in the affected areas, necessary for the mobility of the body, such as the hip, knee, elbow, shoulder or ankle, among others.
It is performed to replace the damaged joint with a healthy one.
There are different types of arthroplasty, depending on the technique used:
- Joint replacement or prosthetic arthroplasty, in which a joint is totally or partially replaced with an artificial implant or prosthesis.
- Interposition arthroplasty, in which a joint surface is resected and, in the defect created, a biological structure is placed to fill the space of the removed bone. Thanks to this structure the bones will make contact.
- Resection arthroplasty, in which one of the bony epiphyses is totally or partially resected, so that the two joint surfaces will no longer be in contact.
Also, depending on the area to be treated, arthroplasties can be:
- Hip arthroplasty (cemented, cementless or hybrid).
- Knee arthroplasty (total or partial).
- Shoulder arthroplasty
- Elbow arthroplasty
- Ankle arthroplasty
Why is it performed?
It is performed to replace the damaged joint with a healthy one, allowing you to live a full and active life, with adequate mobility.
In most cases the joint damage is due to rheumatic disease processes such as rheumatoid arthritis, osteoarthritis or osteoporosis. Also due to avascular necrosis, oncological reconstructions…
What does it consist of?
The process of placing the prosthesis will be different depending on the type of arthroplasty and the patient’s own situation:
- Hip arthroplasty. There are three types:
- Cemented: The components are fixed using methyl methacrylate, a type of surgical cement. It is a technique recommended for elderly patients who have suffered a fracture due to processes related to osteoporosis, arthritis, arthrosis…
- Uncemented: The prosthesis is attached directly to the bone. It is a practical operation for young adults with optimal bone density who suffer a fracture or a rheumatic disease.
- Hybrid: Cement is only placed in one of the components of the prosthesis, usually the one attached to the femur. It is a procedure recommended for older adults.
- Knee arthroplasty: It replaces the diseased knee with a metallic system, replacing the damaged parts with a metallic and mechanical part. It can be:
- Total: the damaged joint is totally replaced by a prosthesis. Both parts will be fixed to the bones, the femur and the tibia, using cement to glue them. It is recommended in patients with osteoarthritis and arthritis.
- Partial: part of the damaged knee is replaced. Subsequently it is replaced by a plastic and metal implant, which is fixed with surgical cement.
- Shoulder arthroplasty: It consists of replacing the shoulder joint. It is usually performed for complex fractures, arthritis, humeral head necrosis and tumor processes. The process is usually similar to that of the hip.
- Elbow arthroplasty: It consists of replacing the bones of the joint with artificial pieces. There are two cemented parts, both to the humerus and ulna: connected with a hinge that allows mobility. It is also intended for patients with rheumatoid arthritis.
- Ankle arthroplasty: It is the replacement of the joint with a prosthesis. It is connected to the tibia and fibula, removing the damaged parts. Once this is done, the artificial joint is fixed and the two parts are connected.
Preparation for arthroplasty
No special preparation is required for arthroplasty, other than notifying the specialist of the possibility of being pregnant and the medication that the patient is taking, which can be strong in cases of rheumatic diseases and must be withdrawn or replaced during the operation.
Care after the operation
After the operation it is possible that the patient may feel pain, which is normal in any operation. In case of pain, the specialist will recommend the best treatment.
Also, during hospitalization, the specialists will start moving the joint as soon as possible, so that the recovery is as effective as possible and the patient recovers mobility as soon as possible.
Afterwards, and once the patient is discharged from the hospital, he/she will have to undergo rehabilitation for a few months to fully recover the mobility of the joint and also to check that the prosthesis has been perfectly attached to the bones.