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.
"Thank you for my shoulder surgery and rehabilitation. Before my surgery, I was unable to sleep and the use of my right arm was painful. After 6 weeks in a sling and 2 1/2 months of physical therapy I am pain free...sleeping in comfort and using my arm with ease and no pain. Although Dr. Jenkins said I still have a couple of months to go for full recovery (so I should not be moving couches around), I can perform most activities I used to do...swimming breaststroke, running, hiking, paddle boarding, etc. New lease on life! At 72 much more fun to be had!!!" - Anonymous
"Nick was wonderful and gave a detailed explanation. He made me feel informed with the knowledge of what I need to do next.” - Jocelyn
"Dr. Thomas is an excellent physician. I highly recommend him." - Lisa
"I wouldn’t trust anyone else. Dr. Arroyo was very professional, concerned for my problem, and thoroughly explained all my options, including my best option and length of recovery." - Constance
"Dr. Hassan is always polite, understands my problems, and explains treatment in a way I can understand." - Dennis
"Dr. Coray was tremendous: caring, gentle, and very informative for me. He walked me through every step." - Deborah
“I am so happy I was referred to this well-qualified provider.” - Lora
"My experience was very much appreciated! The receptionist and the complete staff was very friendly! We new that Dr. Martin is one of the best in his field!"
"Dr. Vaughan is a very knowledgeable and thorough doctor. I feel he really cares for all his patients, treating them with respect and explaining everything." - Johanna
"Dr. Martin did my back surgery 10 years ago. I'm still doing okay and I still thank him almost every day." - Bill
“Dr. Martin examined and listened closely to identify the extent of my injury, then clearly explained the projected next steps.” - Ed
"Dr. Arroyo was awesome, friendly and helped my son quickly with his broken arm." - Simon
"Dr. Hassan has saved my hands and eliminated a great deal of pain from my life. His knowledge and his professional manner is superior. He has also done my rotator cuff. I recommend him to people all the time. Your office staff is very efficient and always informative and kind." - Marla
"Dr. Gray replaced both of my knees. He did an excellent job surgically as well as preparing me for this surgery through his staff and the joint class and preoperative meeting with Sarah PA-C. I was standing the day of surgery and walking within 24 hours. I was back at work and driving within 3 weeks. Physical therapy and a successful surgery made all the difference. Dr. Gray and his staff have been great answering questions and support. I would highly recommend Dr. Gray and I am very glad that I did a double knee replacement." - Francea
"Dr. Vaughn has done knee replacement on both of my knees. He is very courteous and has answered every question I have ever had. I would recommend him to everyone." - Elaine
"Wonderful bedside manner, quite accommodating, agreed to the type of surgery I wanted and explained the risks well." -Anonymous
“I enjoyed talking with Dr. Bede. He looks at you like he is there for you and is in no rush to get to the next 'thing'.” - Allison
"Dr. Jenkins is a superb physician who is always up-to-date with my condition and helpful in explaining my problem." - George
“I have been with Dr. Michael Martin and Nick Harrison for many years and I would not trust the care of my back to any other clinic nearly as much.” - Wendy
"Maggie was very good at her job and very friendly." - Robin
"Dr. Thomas explained things to me very thoroughly, which put me at ease." - Anonymous
"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."
"Dr. Gray and his staff are terrific. I am very confident in how he addressed and treated me." - Jim
"Dr. Yearian and his surgical team were amazing! All my questions were answered and I felt very comfortable throughout my procedure. Every need was taken care of before I even asked! Compassion and commitment is evident!!"
“It doesn’t get any better than Dr. Bargren! He’s been my doctor since around 1992." - William
"Maggie was very professional and honest. It was a pleasure to know that there are still good providers who take pride in caring for their patients first. Thank you for that.” - Jose
"Easy check-in, on time appointment, friendly personnel, and great orthopedic surgeon who has a plan to greatly benefit me. I’m excited for what’s next. Thanks y’all."
"I would highly rate this staff at this office and look forward to having them take care of me as needed in the future." - Adam
"Overall, I have been very satisfied with my care and promptness of all my appointments, prior to and after my surgery." - Diane
"Maggie is awesome. Friendly, understanding, and a great person." - Michele