When alternative treatment options no longer provide relief, joint replacement may be recommended. The surgical procedure involves replacing a portion or the entire damaged joint with prosthesis to create a healthy joint. Puget Sound Orthopaedics joint replacement surgeons are dedicated to restoring function, relieving pain and returning patients to prior levels of activity.
A “joint” is defined as the point where the ends of two or more bones are joined together. The two more prevalent joints in the body are “hinge joints” and “ball-and-socket’ joints. “Hinge joints” are found in the knee and elbow that bend and straighten and work much like the opening and closing of a door. “Ball-and-socket” joints are those found in the hip and shoulder that consist of a rounded end of one bone that fits into a cup-shaped portion of the accompanying bone.
INJURIES TO THE JOINTS
Inflammation of one or more joints causing pain and stiffness typically is caused by one of many forms of arthritis.
Joint fractures occur when a fracture line extends into the joint.
A joint dislocation occurs when a displaced bone loses contact with the accompanying joint.
SURGICAL CARE OPTIONS
Total joint replacement: A surgical procedure performed in a hospital or outpatient surgery center by an orthopedic surgeon. Repairs are made to the damaged cartilage and bone is removed from the joint and replaced with prosthetic components made of metal, plastic or ceramic.
Partial joint replacement: If disease in a joint is limited to only one area, only a portion of the joint will be resurfaced with either metal or plastic parts.
Total joint revisions: Over time the original replacement may fail causing pain or instability. Some or all of the parts of the original prosthesis are replaced with new components.
Minimally invasive surgery: Unlike traditional total joint replacement, the surgeon uses a shorter incision and a different, less-invasive technique to expose the joint – with the goal of reducing postoperative pain and speeding recovery.
Outpatient total joint replacement: Joint replacement performed with minimally invasive techniques in an ambulatory surgery center where the patient returns home the same day.
UPPER EXTREMITY TREATMENT OPTIONS
Shoulder replacement: Damaged parts of the shoulder, the head of the humerus bone and/or the socket of the glenoid bone, are removed and replaced with artificial components called a prosthesis. The bone becomes damaged for many reasons, including arthritis where the cartilage that cushions the bone wears away. Shoulder joint replacement may be recommended if the shoulder pain is severe enough to interfere with everyday activities, is severe while resting, there is loss of motion or weakness in the shoulder, and if there is failure of conservative treatment options.
Reverse shoulder replacement: The socket and metal ball are actually reversed. The metal ball is fixed to the socket and the plastic cup is fixed to the upper end of the humerus. This procedure changes how the shoulder powers and positions by using the deltoid muscle instead of the rotator cuff muscles. Reverse total shoulder replacement may be recommended for patients with a completely torn rotator cuff that cannot be repaired, who have a chronic shoulder dislocation or tumor located in the shoulder, who have a complex fracture of the shoulder joint or who have found that other treatments do not or no longer relieve shoulder pain.
Finger joint replacement: There are many joints in the hand that can be replaced: finger joints (called PIP), knuckle joints (called MP) and wrist joints. The damaged parts of the bone are removed and replaced with components made of metal, plastic or carbon-coated implants.
Thumb joint replacement: The carpometacarpal (CMC) joint is usually damaged due to arthritis. Some or all of the arthritic bone is removed and then the joint is stabilized using different methods.
Wrist joint replacement: Most surgical candidates are those suffering from severe arthritis in the wrist joint, resulting in pain, stiffness and swelling. It also may affect the strength of the fingers and hand causing problems with gripping or pinching.
Elbow joint replacement: The surgical replacement procedure involves removing scar tissue and spurs around the joint and a metallic piece is fitted into the stem of the humerus. The same procedure is done on the ulna. Both new stems are kept in place with bone cement.
LOWER EXTREMITY TREATMENT OPTIONS
Hip replacement: Hips that have received damage due to arthritis, fractures or other diseases may have sustained irreversible damage to the bone. When this happens, a total hip replacement might be the best available treatment. A prosthetic hip is placed into the pelvis and the head of the femur to recreate the ball-and-socket joint, which remobilizes the hip and stops pain and bone spur formation.
Knee replacement: A total knee replacement is the procedure performed when a knee is damaged beyond repair. Major injuries and various diseases can damage the knee to this point and the best treatment option is to replace the knee joint. The goal of a knee replacement is to reduce pain and improve function and mobility of the knee.
Unicompartmental (Partial) knee replacement: Only a portion of the knee is resurfaced due to the joint disease being limited to just one area of the knee.
Ankle joint replacement: Relieves pain and maintains motion in the arthritic ankle joint and is an alternative to ankle fusion, which typically eliminates motion in the joint, but still relieves pain.
"Dr. Krumins and his PA were amazing. Both were patient and answered all my questions and concerns to completion." - Stephen
"Dr. Coray is an excellent doctor. I have total trust in him!" - Larry
“I go to Dr. Blair first regarding my back. I had surgery with him 11 years ago, and he gave me my life back.” - Judith
"Maggie, Dr. Thomas' PA, is great. Really knows what she is doing. The whole staff is very good." - Diana
"Dr. Gray is a very empathetic man and has genuine concern for his patients." - Dave
"I have the upmost respect for Dr. Martin and Nick. The whole office personnel treats you with kindness and respect. I would gladly tell a friend to try Puget Sound Orthopaedics before going to any other place."
"Dr. Martin is an excellent surgeon and has shown me great kindness and respect. I can not thank him enough for his care and concern given to me before, during, and after the two surgeries he performed." - John
"Dr. Bargren shows concern and empathizes with my issues. He asks questions and listens when I talk. I have the utmost confidence in his abilities and knowledge. He is a great doctor and a warm, friendly care provider. He always takes time to explain things clearly." - Gary
“Dr. Phil Yearian is so good at knowing feet! He is efficient at what he does.” - Verna
"Dr. Vaughan is always friendly, engaged, and excellent at explaining what's going on. I trust him." - Barbara
"Dr. Thomas is a peach. One of the nicest, most thoughtful, and personally engaged doctors we have seen." - Sheila
"He saw my problems and even researched dates of things I had forgotten. He saw that I needed a more updated EMG done and referred me back to my rheumatologist." - Carolyn
"I am so grateful for Dr. Yearian. I have seen many foot doctors and none of them have even came close to the care I have received from Dr. Yearian. I consider Dr. Yearian a miracle worker. He gave me my life back. I am even back to work after many other doctors told me that I would never work again."
"Dr. Coray provided a series of constructive actions to take and explained them in clear and concise terms." - Alexander
"Dr. Bede explained my condition and showed me the x-rays, explaining what he was doing in a manner that I understood." - Jerry
"Dr. Vaughan is a fabulous surgeon and 12 years later his work is still performing great. At that time I was 105 lbs heavier than I am now, even under the weight strain of the past my knees today work perfectly fine. I sincerely thank Dr. Vaughan for his excellent care and workmanship." - Kerri
“Dr. Blair explained my condition to me with ease and care. I felt like he really cares about me and helping make my life better! He took his time and answered all my questions.” - Karin
"My foot surgery went great. Dr. Yearian is a very knowledgeable and personable doctor. He makes his patients feel at ease and comfortable. I would definitely recommend Dr. Yearian to my friends."
"I was so impressed by the staff. Everyone was professional and made me feel safe. I was impressed by Dr. Ghidella and felt fortunate to be able to have found him."
"I thought Dr. Jenkins did a very good job. I have a lot of confidence in him. I’m thankful that I’m going to be able to get my shoulder fixed. I highly recommend your office to anyone else and I already have." - Anonymous
"This was my first visit with Dr. Ghidella. He was very professional and explained thoroughly what the issue was with my thumb. We went over the possibilities of treatment. I was very satisfied with the procedures recommended."
"I have every confidence in Dr. Arroyo. He comes with the highest recommendations. His personality is superb!" - Don
"I was greatly impressed by Dr. Smith's competence and friendliness. He always addressed me by my first name and carefully listened to what I had to say." - Joan
"Dr. Bargren was refreshing to meet. He was thorough and pleasant." - Lauren
"Dr. Ghidella was very informative and answered all my questions. He explained the process of surgery, should that be necessary. I highly recommend him to anyone looking for answers that have the same problems I have experienced."
“Dr. Blair is always professional, always interested in my conversation, very reassuring and direct. He is willing to spend as much time as necessary to ensure I know all the options.” - G. Evans
"I just love Dr. Thomas. He's very friendly with a wonderful sense of humor." - Colleen
"My experience in your office was very pleasant. It is a nice office with very friendly and knowledgeable associates. The X-ray technician was very nice. I was nervous about seeing the doctor, but Dr. Coray made me feel at ease and put my worries about my knees to rest. Thank you all so much."
“I have given out your business cards to co-workers and others; this is the best practice I have ever been to!” - Bill
“Sean is an awesome doctor. I am glad he and the clinic are my surgery team.” - James