Joint Replacement: Should I or Should I Not?

Joint replacement is a breakthrough in medical science as a means for long term pain relief.  The benefits are seen worldwide and patients are able to do more than what they could prior.  Advancements in the technology used joint replacements have been and will continue to make a difference in the lives of the recipient.

            Since the first successful joint replacement in the 1940s this surgical procedure has been proven very effective in relieving the pain and discomforts associated with arthritis or injury.  That is a good thing too, after working nearly nineteen years at the physically demanding job of a corrections officer back in my hometown, my dad received a total knee replacement after receiving treatment for severe arthritis and calcium buildup in his left knee.  In the nearly five months since his surgery and after rigorous physical therapy my dad’s titanium and polyethylene plastic mobile implant is, slowly but surely, improving his mobility and function.  Just a few years prior to this I almost received a partial knee fallowing a devastating horse accident; fortunately all I really needed was a couple screws and a few ligaments and tendons repaired.  The process that goes with replacements is quite graphic and includes cutting out the affected cartilage and bone, doing as little damage as is necessary to the surrounding tissues.  Without the state-of-the-art technology that many larger hospitals have, my dad’s surgical scar measures out to be nearly five inches in length and required just over two-dozen staples.  He was walking and ready to go home the next day.

Both total and partial replacements come in a variety of combinations and materials.  Lightweight metals such as titanium and titanium alloys and cobalt-chromium alloys, both of which are corrosion resistant and biocompatible metals, encourage bone growth creating a potentially permanent bond with the skeleton.  Much improved weight bearing surfaces have been shown to last several more years before wearing down, and some may never wear down in some patients.  These include ceramic metals such as zirconium alloy and very dense polyethylene plastics.  When these plastics are soaked in Vitamin E during manufacture, they resist oxidation and last longer.  Other common materials include Tantalum, which has excellent biological and physical properties, namely flexibility, corrosion resistant and biocompatibility.  One metal that is also used though, less so due to the fact of its limited ability to withstand corrosion within the human body in the long term, stainless steel is more properly suited to being used as temporary implants such as facture plates and screws.

            However, no medical procedure is without risks.  The overall health of the patient has to be taken into consideration before beginning any type of surgery.  The stress of the operation itself may result in stroke, heart attacks, pneumonia, etc.   Complications that could happen on the operating table are nerve damage, insatiability/dislocation, fracture of the adjacent bone, and damaged blood vessels.  These operations involve making very serious decisions and shouldn’t be done upon impulse, only as a final option.  If a person is diagnosed with a mild case of osteoporosis in the shoulder he/she isn’t in dire need of a shoulder replacement right then and there.  Financial status also plays a role in deciding whether or not the replacement is an option for that point in time.  Might that person need one in the future?  Probably so, but the need isn’t immediate.  The possibility of allergic reactions to the anesthesia or metals such as nickel are also possible.  Other problems not relating to the operation itself, but to certain painkillers have also been noticed.  One drug in particular, which both me and my dad were prescribed immediately following after our knee operations affected us psychologically in a way that we would think, “If I fall asleep, I’m going to stop breathing!”  Making both of us understandably paranoid and irritable.  This continued for about three weeks before I completely refused to take it and was prescribed another set of painkillers to replace the last.

            In the last ten years major technological advancements to joint prosthesis not only make the replacement itself last longer, but the operation is also less invasive.  Special cameras and tools have been developed to reduce the size of the incision and the surrounding tissues can be peeled back in such a way that little to no cutting is required, decreasing recovery time.  The materials developed are designed to last longer than they did in the past.  A titanium hip could last twenty to twenty-five years at the least and some may never need to be replaced in the future.  Artificial ligaments have also been developed to improve movement immediately after surgery to support the already existing ligaments as they repair themselves.  Veterinary science has also recently taken prosthesis and put it into use.  Pets that would have otherwise been euthanized if they had a disease or injury that ultimately lead to deformities get the help that they need and are able to live a happy life despite their handicap. 

            Based on my personal experience, there is no question that the benefits of joint replacement outweigh the risks and as long as people are able to function better than they have before there will be no shortage of patients waiting to receive one.  Those who once were not able to do very much can now to a whole lot more of what they would like to do or could do in the past and living fuller more active lives.