Hip and Knee Surgery

A total hip replacement is a surgical procedure whereby the diseased cartilage and bone of the hip joint is surgically replaced with artificial materials. Total hip replacements are performed most commonly because of progressively severe arthritis in the hip joint. The most common type of arthritis leading to total hip replacement is degenerative arthritis (osteoarthritis) of the hip joint. This type of arthritis is generally seen with aging, congenital abnormality of the hip joint, or prior trauma to the hip joint. Other conditions leading to total hip replacement include bony fractures of the hip joint, and death (necrosis) of the hip bone. Hip bone necrosis can be caused by fracture of the hip, drugs (such as alcohol or corticosteroids), diseases (such as systemic lupus erythematosus), and conditions (such as kidney transplantation).

The progressively intense chronic pain together with impairment of daily function including walking, climbing stairs and even arising from a sitting position, eventually become reasons to consider a total hip replacement. Because replaced hip joints can fail with time, whether and when to perform total hip replacement are not easy decisions, especially in younger patients. Replacement is generally considered after pain becomes so severe that it impedes normal function despite use of anti-inflammatory medications. A total hip joint replacement is an elective procedure, which means that it is an option selected among other alternatives.

Total knee replacement is generally done when a person has a severe degenerative joint disorder such as osteoarthritis in which the articular, or moving, surfaces of the knee deteriorate, leading to severe pain, limitation or loss of function and/or deformity of the joint. The surgery is also performed to replace a badly fractured knee and when previous joint replacements have failed. Bilateral replacement means that both knees are replaced at the same time.

Other treatments are usually used before knee replacement surgery. These include:

acetaminophen or anti-inflammatory drugs if the joint has degenerated
a procedure called synovectomy, which is
surgical removal of inflamed synovial tissue, the tissue that lubricates moving parts of a joint osteotomy, which is restructuring of the bones to shift stresses from diseased tissue to more healthy tissue

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