ANATOMY OVERVIEW OF THE JOINTS
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.
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.
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.
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.