Joint replacement surgery has given a new lease of life to many who have suffered from pain due to damaged joints. Commonly replaced joints are the hip, knee, shoulder, ankle, elbow, wrist and the finger joints. Thousands of hip and knee joints are replaced every day all over the world. Joint replacement has enabled arthritic patients to lead a more active life. Jack Nicklaus, the famous golfer, who had his hip replaced and is actively competing is a classical example.

What is joint replacement?

The ends of two bones which form a joint are covered by smooth tissue known as cartilage. This tissue is damaged by various diseases or injury, which in turn produces pain. Eventually the cartilage is totally worn out and the bone ends rub against each other causing severe pain and disability. In joint replacement surgery the damaged surface of the joint is removed and replaced with an artificial joint called ‘prosthesis’.

What are the common causes of joint damage?

Osteoarthritis is the commonest cause of damage requiring joint replacement. Other causes are rheumatoid arthritis, fracture involving the joint causing arthritis, poor blood supply (avascular necrosis) and various childhood problems causing delayed arthritis.

Hip replacement

There are two types of hip replacement; the traditional total hip replacement and the newer surface replacement. In the traditional hip replacement, the diseased ball along with the top part of the thigh bone and the surface of the socket are removed and replaced with artificial components. These can be fixed either with a type of glue known as bone cement or without any such material and bone is allowed to incorporate in the specially made components. In surface replacement which is meant for younger patients, very minimal bone is removed from the thigh bone.

Before surgery	After surgery
Hip replacement

Knee replacement

This is the commonest joint replaced in India. Here the diseased ends of the thigh and leg bones and sometimes the surface of the knee cap are replaced. The components are made of alloys and poly ethylene.

Dr.Vinodh is engaged in performing various joint replacement surgeries regularly.

Before surgery	After surgery
Knee replacement

Articular surface replacement of the hip is a recent addition to the various types of hip replacements. It was  popularized in Birmingham and is suitable for younger patients involved in more active life. Unlike the traditional hip replacement where the replaced ball is much smaller than the original head of femur, in surface replacement the original head is preserved and only the surface is replaced with a metal component. Therefore the range movement is  much more and the chances of dislocation are negligible. The patient will be able to take part even in sporting activities and will be able to squat. There is no polyethylene liner as in a traditional hip replacement and therefore the wear of the components is also considerably reduced. In case the patient requires a revision in future, it is much easier as most of the bone is preserved. Earlier we were advising younger patients to post pone the hip replacement as much as possible in order to reduce the chances of revision. Surface replacement has allowed the patients to get back to a normal life in the most active and productive phase of their life.