Total Joint Replacements
Joint Replacement involves the complete removal of the damaged joint and tissues, and the subsequent replacement of that joint with an artificial prosthesis. This often happens when the joint has been damaged by arthritis, aging, avascular necrosis, injury or overuse. Surgery may end up being your best option if the pain and swelling in your damaged joint have become unbearable and your body no longer responds to conservative treatment.
Inland Orthopaedic Surgery and Sports Medicine Clinic providers have a long history of performing successful hip, knee and shoulder replacements. The goal of the procedure is to relieve pain and restore a sense of normal function and mobility into the damaged joint. Our providers are committed to providing the highest-quality care in a compassionate environment – and getting you back to an active lifestyle, doing the things you enjoy with friends and family. We take an individualized and team approach with every patient, including using the most appropriate joint replacement technique. We offer personalized education for the patient and caregivers, developing a rehabilitation plan of care to meet each patient’s lifestyle needs. Each individualized plan involves integrated pain management and complementary healing techniques to optimize the patient’s comfort and recovery.
The most common replacement procedures our surgeons perform are:
Partial Knee Replacement Surgery
During knee replacement surgery, bone and cartilage damaged by osteoarthritis are resurfaced with metal and plastic components. In unicompartmental knee replacement (also called Partial Knee Replacement) only a portion of the knee is resurfaced. This procedure is an alternative to total knee replacement for patients whose disease is limited to just one area of the knee.
With proper patient selection, modern unicompartmental knee replacements have demonstrated excellent medium- and long-term results in both younger and older patients.
Total Knee Replacement Surgery
A total knee replacement (also called total knee arthroplasty) might be more accurately termed a knee "resurfacing" because only the surfaces of the bones are replaced.
There are four basic steps to a knee replacement procedure:
- Prepare the bone. The surgeon removes the damaged cartilage surfaces at the ends of the femur and tibia, along with a small amount of underlying bone.
- Position the metal implants. The surgeon replaces the removed cartilage and bone with metal components that re-create the surface of the joint. These metal parts may be cemented or "press-fit" into the bone.
- Resurface the patella.The surgeon cuts the undersurface of the patella (kneecap) and resurfaces it with a plastic button. Some surgeons do not resurface the patella, depending upon the case.
- Insert a spacer. The surgeon inserts a medical-grade plastic spacer between the metal components to create a smooth gliding surface.
Total Hip Replacement Surgery
In a Total Hip Replacement (also called total hip arthroplasty), the damaged bone and cartilage is removed and replaced with prosthetic components.
The damaged femoral head is removed and replaced with a metal stem that is placed into the hollow center of the femur. The femoral stem may be either cemented or "press fit" into the bone. A metal or ceramic ball is placed on the upper part of the stem. This ball replaces the damaged femoral head that was removed.
The damaged cartilage surface of the socket (acetabulum) is removed and replaced with a metal socket. Screws or cement are sometimes used to hold the socket in place.
A plastic, ceramic, or metal spacer (also called a liner) is inserted between the new ball and the socket to allow for a smooth gliding surface.
Total Shoulder Replacement Surgery
The standard Total Shoulder Replacement involves replacing the arthritic joint surfaces with a highly polished metal ball attached to a stem, and a plastic socket.
These components come in various sizes. They may be either cemented or press fit into the bone. If the bone is of good quality, your surgeon may choose to use a non-cemented (press-fit) humeral component. If the bone is soft, the humeral component may be implanted with bone cement. In most cases, an all-plastic glenoid (socket) component is implanted with bone cement.
Implantation of a glenoid component is not advised if:
- The glenoid has good cartilage
- The glenoid bone is severely deficient
- The rotator cuff tendons are irreparably torn
Patients with bone-on-bone osteoarthritis and intact rotator cuff tendons are generally good candidates for conventional total shoulder replacement.
Reverse Shoulder Replacement Surgery
- Completely torn rotator cuffs with severe arm weakness
- The effects of severe arthritis and rotator cuff tearing (cuff tear arthropathy)
- Had a previous shoulder replacement that failed
For these individuals, a conventional total shoulder replacement can still leave them with pain. They may also be unable to lift their arm up past a 90-degree angle. Not being able to lift your arm away from the side can be severely debilitating.
In reverse total shoulder replacement, the socket and metal ball are switched: A metal ball is attached to the shoulder bone, and a plastic socket is attached to the upper arm bone. This allows the patient to use the deltoid muscle instead of the torn rotator cuff to lift the arm.