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Orthopedic Procedures

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As the home of the region's most experienced orthopedics team, we can return you to the comfort and quality of life you deserve.Our orthopedists are specialists in treating arthritis-related joint degeneration:

  • Fractures
  • Sprains
  • Back and neck problems
  • Foot, ankle, shoulder and hand injuries
  • Sports injuries
Orthopedic Procedures

Hip Joint Replacement

Total Hip Replacement, THR, Total Hip Arthroplasty

Definition  Hip joint replacement is a surgical procedure to replace the hip joint. The new joint is artificial and has two parts. The first part is the hip's socket, called the acetabulum. This is a cup-shaped bone in the pelvis. The second part is the "ball" or head of the femur, also called the thighbone.

These artificial parts together are called a prosthesis. The artificial socket is made of high-density plastic. The artificial ball, which is attached to a stem is usually made of a strong, stainless metal. The goal of the surgery is to relieve pain and improve mobility and function in the hip joint.

Who is a candidate for this procedure?

This surgery is most commonly done to relieve severe arthritis, which can wear down the hip joint. People with other conditions, such as injury, bone tumors and avascular necrosis, or a loss of bone caused by a lack of blood supply also need a hip joint replaced. An individual is usually advised to consider surgery when the following conditions apply:

  • The pain is severe enough to restrict not only work and recreation but also the normal activities of daily living.
  • The pain is not relieved by arthritis medications.
  • The person is not helped by the use of a cane or walker.
  • There is significant stiffness of the hip that limits activities.
  • Joint X-rays show advanced arthritis or other severe problems.

How is the procedure performed?

The surgeon first removes the diseased bone and cartilage. Replacement parts are implanted into healthy areas of the pelvis and thighbone. The surgery is done in the operating room under general anesthesia or regional anesthesia. General anesthesia means the person is put completely to sleep, regional anesthesia means the person will be awake but numb below the waist. A drug may be given to make the person drowsy. The procedure usually takes 2 to 3 hours to perform.

What happens right after the procedure?

After the surgery, the person is taken to the surgery recovery room for a brief period of close observation. Vital signs, such as the blood pressure and pulse, are checked frequently. Close attention is paid to the circulation and sensation in the legs and feet. The hip is usually braced with pillows or a special device that holds the hip in the correct position. The person is given fluids through an intravenous tube, or IV, to replace fluids lost during surgery. A tube may have been placed near the incision to drain fluid. Pain medication will be given as needed.

While in the hospital, the individual will begin physical therapy to strengthen the hip. He or she will also learn how to perform the activities of daily living in ways that can prevent injury to the new hip. For example, proper ways to bend and sit are taught. Most people are sent home from the hospital in 2 to 3 days.

What happens later at home?

By the time the person leaves the hospital, he or she should be able to get around using crutches or a walker. Physical therapy may be continued after discharge.  Complete recovery from this surgery usually takes 3 to 6 months.

What are the potential complications after the procedure?

Surgery may cause bleeding, infection, and allergic reactions to anesthesia. Pain medications or antibiotics may cause stomach upset, allergic reactions, or rash.

Following are the most common complications of a hip joint replacement:

Blood clot in the leg, or deep venous thrombosis. To prevent blood clots, medications called blood thinners may be given. The person is asked to become mobile shortly after surgery.

Wound infection. To prevent this complication, antibiotics may be given.

Bleeding. Sometimes a blood transfusion may be needed.

Hip dislocation, which means the ball becomes dislodged from the socket. This may occur if the hip is placed in certain positions. The person is taught exercises before leaving the hospital to help prevent this. The individual will also learn which activities to avoid, such as crossing the legs, to prevent hip dislocation.

To prevent infection in the future, people will need to take antibiotics beforehand whenever they have any dental work done.

Any new or worsening symptoms should be reported to your doctor.

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Knee Joint Replacement

Total Knee Replacement, TKR, Total Knee Arthroplasty, Total Knee Joint Replacement

Knee joint replacement is surgery to replace a damaged or diseased knee with an artificial joint, or prosthesis. The goal is to improve the main function of the knee joint and reduce pain.

Who is a candidate for the procedure?

Knee joint replacement may be used for long-standing knee pain or arthritis that has not responded to treatment with medication. It may also be used when arthritis causes the knee to function poorly, or for some knee fractures. The procedure is used for people who have a great deal of knee pain. This pain is so severe that the person cannot work, has trouble sleeping, and cannot walk more than three blocks. Most people who have a knee joint replacement are over the age of 55, but it can be done for anyone.

How is the procedure performed?

Knee joint replacement is performed under general anesthesia or regional anesthesia. General anesthesia means the person is put to sleep with medications. Regional anesthesia means the person will be awake, but numb below the waist. A drug may be given to make the person drowsy. The ends of the thighbone, or femur, and the shinbone, or tibia, are removed. The underside of the kneecap, or patella, may also be removed. The new knee consists of a metal shell on the end of the femur and a metal and plastic piece on the tibia. If needed, there is also a plastic button in the kneecap. The surgery itself takes about two hours. In many cases people donate two units of their own blood in the weeks before surgery to be used during or shortly after the operation.

What happens right after the procedure?

After the surgery, the person will be taken to the surgery recovery room to be watched closely for a short time. Vital signs, blood pressure, pulse, and breathing will be checked frequently. Close attention will be paid to the circulation and sensation in the legs and feet. The person will receive intravenous fluids to replace those lost during surgery. There may be a tube near the incision to drain the fluid.

While in the hospital the person will have physical therapy to learn exercises to strengthen the knee. The person will start bearing weight on the knee, using a walker, the first day after surgery. He or she will also be taught using the most appropriate assistive device. Most people are discharged from the hospital 2 to 3 days after the operation.

What happens later at home?

By the time the person is ready to go home, he or she should be able to get around with a walker. People use a walker initially, and then progress to other more appropriate assistive devices such as crutches or a cane. No walking aids are typically needed after 3 weeks to 2 months. Physical therapy is continued after leaving the hospital.

Sometimes people need to go to a rehabilitation center after the hospital. There they can gain the independence they need to be able to get around at home. Recovery from knee joint replacement usually takes from 3 to 6 months.

About 90% of artificial knee joints last for 10 years, and 80% last for 20 years. This often depends on the person's activity level.What are the potential complications after the procedure?

There are complications with any surgery or anesthesia. These include bleeding, infection, and reactions to the anesthesia drugs. Other possible complications are blood clots in the leg or the lung. To prevent infection in the future, people will need to take antibiotics beforehand whenever they have any dental work done. 

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