Knee Replacement

What is knee replacement surgery?

Knee replacement surgery is a surgery to replace parts of your knee joint with new, artificial parts. You may need a knee replacement if you have knee damage that causes severe pain and difficulty doing daily activities, such as walking and climbing stairs. It is usually done when other treatments for knee pain haven't helped enough. The goal of a knee replacement is to relieve pain and help you move better.

People of all ages may have knee replacement surgery. But it is more common in older people. The decision whether to have surgery is based on your overall health and how much your knee bothers you.

What conditions does knee replacement surgery treat?

Knee replacement surgery treats conditions that cause the cartilage of the knee joint to wear away. These include:

• Knee osteoarthritis. This is the most common reason for knee replacement surgery. It usually develops over time after an injury or with aging.
• Knee damage from other types of arthritis.
• Problems from knee joints that aren't formed correctly.

What happens during knee replacement surgery?

During the surgery, a surgeon removes damaged cartilage and some bone from the surfaces of your knee joint. Cartilage is tissue that covers your bones where they meet. Healthy cartilage is smooth and helps the bones glide over each other when you move. When cartilage becomes rough and wears away, the bones rub against each other, causing pain.

After removing the damaged knee cartilage and bone, the surgeon attaches the artificial parts to your bones. The artificial parts are made of metal and plastic. They will give your knee new, smooth surfaces.

Knee replacement surgery may replace all the damaged parts of your knee (total knee replacement) or just part of your knee (partial knee replacement). In a total knee replacement, the surgeon replaces 3 surfaces:

• The end of the shinbone
• The end of the thighbone
• The back of the kneecap

What happens after knee replacement surgery?

Some people go home the same day they have surgery. Other people will stay in the hospital a few days. To help prevent blood clots, you'll most likely take blood thinners and wear special socks or coverings on your legs for a short time after surgery.

The success of your surgery depends a lot on what you do at home to help yourself recover. A physical therapist will teach you exercises to make your knee stronger and help it bend. It is important to do these exercises regularly. You may need to use a cane or walker for several weeks after the surgery. It will probably also be several weeks before you can drive. Your doctor will tell you when you can start driving again.

Most people who follow their recovery instructions can get back to nearly all of their normal daily activities within 3 to 6 weeks after surgery.

What is life like after a knee replacement?

After recovering from surgery, most people can move better with less pain than before surgery. But having an artificial knee is not the same as having a normal, healthy knee.

You need to protect your new knee by:

• Staying at a healthy weight.
• Getting regular physical activity.
• Not doing any high-impact activities, such as jogging, running, and jumping. Instead, you can try low-impact activities that are good for your knee, such as walking, biking, and swimming

What are the risks of knee replacement surgery?

The chance of having problems after knee replacement surgery is low. But there are risks after any surgery. Possible problems after knee replacement surgery include:

• Infection
• Blood clots
• Heart attack
• Stroke
• Nerve damage
• Scarring that limits how far you can bend your knee

Your age, general health, and how active you are can all affect your risk of having a problem after knee replacement surgery.

How long does a knee replacement last?

A knee replacement doesn't last forever. After 15 to 20 years, the artificial knee parts may become loose or worn. If that happens, you may need another surgery on the same knee.

If you're thinking about having knee replacement surgery, talk to your doctor about the risks and benefits. Together you can decide if a knee replacement is right for you.

Hip Replacement

Hip replacement is surgery for people with severe hip damage. The most common cause of damage is osteoarthritis. Osteoarthritis causes pain, swelling, and reduced motion in your joints. It can interfere with your daily activities. If other treatments such as physical therapy, pain medicines, and exercise haven't helped, hip replacement surgery might be an option for you.

During a hip replacement operation, the surgeon removes damaged cartilage and bone from your hip joint and replaces them with new, man-made parts.

A hip replacement can:

• Relieve pain
• Help your hip joint work better
• Improve walking and other movements

The most common problem after surgery is hip dislocation. Because a man-made hip is smaller than the original joint, the ball can come out of its socket. The surgery can also cause blood clots and infections. With a hip replacement, you might need to avoid certain activities, such as jogging and high-impact sports.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases

Finger Injuries and Disorders

You use your fingers and thumbs to do everything from grasping objects to playing musical instruments to typing. When there is something wrong with them, it can make life difficult. Common problems include:

• Injuries that result in fractures (broken bones), ruptured ligaments and dislocations
• Osteoarthritis - wear-and-tear arthritis. It can also cause deformity.
• Tendinitis - irritation of the tendons
• Dupuytren's contracture - a hereditary thickening of the tough tissue that lies just below the skin of your palm. It causes the fingers to stiffen and bend.
• Trigger finger - an irritation of the sheath that surrounds the flexor tendons. It can cause the tendon to catch and release like a trigger.

Joint Disorders

What are joints?

Your joints are places where two or more bones come together. Your shoulders, elbows, hips, knees, and knuckles are all joints. Your spine has joints, too.

But joints are more than bones. They include the soft tissues around them, such as cartilage, tendons and ligaments. Cartilage is the hard slippery flexible tissue that covers the ends of your bones at a joint. Tendons are tough, flexible bands that connect your muscles to your bones so you can move your joints. Ligaments connect the bones of the joint to each other to keep them stable when you move.

What are joint disorders?

Joint disorders are diseases or injuries that affect your joints. Injuries can happen because of overuse of a joint. Or you could have a sudden injury, such as an accident or a sports injury.

What diseases can affect the joints?

Many diseases can affect the joints. They often cause joint pain and make your joints stiff, red, or swollen. Most of them are chronic. That means they last a long time. Some may never go away completely. Some of the diseases that affect the joints include:

• Arthritis. Arthritis may cause joint pain and swelling. There are many types of this disease. Osteoarthritis is the most common type. Over time, arthritis can cause severe joint damage. It can affect people of all ages. A joint injury when you're young may cause osteoarthritis later in life.
• Lupus. This autoimmune disease affects many parts of the body and can cause joint and muscle pain. Some types of lupus often cause arthritis.
• Sjögren's Syndrome. This autoimmune disease affects glands that make moisture in many parts of the body. The main symptoms are dry eyes and mouth, but it often causes joint pain, too.

Treatments are different depending on the disease. But most treatments include medicines and therapies to relieve pain and other symptoms.

What types of joint disorders happen from sudden injuries?

Joint disorders from sudden injuries include:

• Sprains and strains. Sprains are stretched or torn ligaments. Acute strains are stretched or torn muscles or tendons that happen from a sudden injury or movement, such as lifting a heavy object.
• Dislocated joints. A joint is dislocated when the bones are pushed or pulled out of position. A joint dislocation is a medical emergency.

Treatment depends on the type of injury. You can treat many sports injuries at home. But you should call your health care provider if you:

• Have a lot of joint pain, swelling or numbness
• Can't put weight on the joint
• Have pain from an old injury with more swelling, an unstable joint, or a joint that isn't normal in another way

What types of joint disorders happen from overuse?

Overuse injuries usually damage the soft tissues of the joint. They can happen when you work a joint too hard by doing the same movements over and over. For example, you could get an overuse injury from playing a musical instrument, playing sports, or doing certain jobs, such as carpentry or painting.

Joint overuse injuries include:

• Bursitis. The bursa is a small fluid-filled sac. It works as a pad between the bones of a joint and the moving parts around it, such as muscles, tendons and skin. With bursitis, the bursa becomes irritated and swollen with extra fluid. Overuse is the most common cause, but injuries, infections and other conditions, such as arthritis, can cause bursitis.
• Tendinitis. This condition happens when you overuse a tendon. It swells and makes the joint painful to move.
• Chronic strain. A strain becomes chronic when your muscles or tendons stretch or tear slowly over time from repeating the same movements.

The treatments for bursitis, tendinitis, and chronic strain are often the same. They usually include rest, keeping the injured joint higher than your heart, and taking medicine to reduce swelling. Your provider may recommend gentle exercise and other treatment. In some cases, your provider may suggest an injection (a shot) of medicine into the joint. If these do not help, you may need surgery.

How can I keep my joints healthy?

Getting enough physical activity is one of the most important things you can do to prevent or slow joint disorders. Activity strengthens the muscles around your joints and helps them work better.

When you play sports, wear the right equipment to protect your joints, such as knee pads. If you already have joint problems, ask your provider what type of activities are best for you.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases

Osteoarthritis

What is osteoarthritis?

Osteoarthritis, sometimes called OA, is a type of arthritis that only affects the joints, usually in the hands, knees, hips, neck, and lower back. It's the most common type of arthritis.

In a healthy joint, the ends of the bones are covered with a smooth, slippery tissue called cartilage. The cartilage pads the bones and helps them glide easily when you move the joint. With osteoarthritis, the cartilage breaks down and becomes rough. Sometimes, all the cartilage wears away and the bones rub together. Bumps of extra bone called bone spurs may grow in the joint area.

There is no cure for osteoarthritis. It usually gets worse slowly. But there's a lot you can do to manage the symptoms.

What are the symptoms of osteoarthritis?

Osteoarthritis affects people in different ways, and not everyone has pain. The most common symptoms are:

• Pain when you move, which often gets better with rest
• Stiffness, especially for the first 30 minutes after you get up from resting
• Swollen joints, especially after using the joint a lot
• Less movement in the joint than normal
• A joint that feels loose or unstable

What causes osteoarthritis?

Researchers aren't sure what causes osteoarthritis. They think that it could be caused by a combination of factors in the body and the environment. Your chance of developing osteoarthritis increases with age. They also know that some people are more likely to develop it than others.

Who is more likely to develop osteoarthritis?

Things that make you more likely to develop osteoarthritis include:

• Aging. Osteoarthritis can happen at any age, but the chance of getting it increases in middle-aged adults and older. After age 50, it is more common in women than in men.
• Being overweight. Extra weight puts more stress on your joints.
• Having a past injury or surgery on a joint. This is often the cause of osteoarthritis in younger adults.
• Doing a lot of activities that overuse the joint. This includes sports with a lot of jumping, twisting, running, or throwing.
• Having a joint that doesn't line up correctly.
• A family history of osteoarthritis. Some people inherit genetic changes that increase their chance of developing osteoarthritis.

How is osteoarthritis diagnosed?

There is no specific test for osteoarthritis. To find out if you have osteoarthritis, your provider:

• Will ask about your symptoms and medical history
• Will do a physical exam
• May use x-rays or other imaging tests to look at your joints
• May order lab tests to make sure that a different problem isn't causing your symptoms

What are the treatments for osteoarthritis?

The goal of treating osteoarthritis is to ease your pain, help you move better, and stop it from getting worse.

Treatment usually begins with:

• Exercises to improve strength, flexibility and balance
• Weight loss, if needed, to improve pain, especially in your hips or knees
• Braces or shoe inserts (orthotics) that a health care provider fits for you

You can buy some pain relievers and arthritis creams without a prescription. They can be helpful, but it's best to talk to your provider about using them. If they don't help enough, your provider may prescribe injections (shots) into the joint or prescription pain relievers.

Complementary therapies may help some people. Massage can increase blood flow and bring warmth to the area. Some research shows that acupuncture may help relieve osteoarthritis pain. Simple things like heat and ice can help, too.

If none of these treatments help enough, surgery may be an option. You and your provider can decide if it's right for you.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases