An Overview of Arthroplasty

What happens before, during, and after this procedure?

In This Article

Arthroplasty is a surgical procedure that can help to restore joint function. There are more than 7 million Americans who have undergone some type of arthroplasty according to the American Academy of Orthopaedic Surgeons (AAOS). Hip and knee arthroplasties are the two most commonly performed surgeries in the United States—estimates show that up to one million procedures are performed yearly.

Preparing for surgery, having surgery, and recovering will be hard work, but an arthroplasty will mean less pain, more mobility, and the freedom to participate in your life. 

How to prepare for arthroplasty
Illustration by Brianna Gilmartin, Verywell  

Overview

Hips and knees are not the only joints on which doctors perform arthroplasties.  Arthroplasty can repair or replace any joint in the body, including the shoulders, elbows, and ankles. 

The most common type of arthroplasty is a total joint replacement, and this involves surgical replacement of a problem joint with a prosthesis. For example, a hip joint affected by rheumatoid arthritis may be replaced in its entirety—this is called a total hip arthroplasty

This would involve replacing the hip socket and the head and neck of the femur joint. In doing so, the goal is to relieve a person’s pain, restore range of motion, and help her or him to walk better and improve the strength of the affected area.

Your doctor may recommend an arthroplasty when medical treatments are no longer relieving joint pain and disability is imminent.  

Risks 

Arthroplasty carries the same risks as other major surgeries, including risk for infections and blood clots. People at risk for complications are those who have heart problems, diabetes that isn’t well-managed, and weak immune systems. A surgeon may prescribe antibiotics and blood thinners in hopes of preventing complications. 

Nerve injury, while rare, can occur if the nerves surrounding the replaced joint become damaged during surgery. Another common risk associated with arthroplasty is the new joint not working well and feeling weak and stiff. This usually occurs if a person doesn’t participate in active rehabilitation or follow other aspects of their treatment plan. 

It is also possible for implants to become loose or dislocated. Replacement joints may need to be replaced down the road due to wear and tear. 

There may be other risks of the procedure based on a person’s overall health and any medical conditions. Be sure to discuss all concerns with your surgeon prior to the day of surgery. 

Preparation

Arthroplasty is major surgery and recovery will take a month or more. You will also be in pain during recovery, so it is a good idea to be prepared for what is to come. 

Make the Time Commitment

In general, you will be up and moving the first day after the procedure—however, recovery will still take time. Plan on taking the necessary time off from work and making sure you have help with responsibilities, including caring for children or pets.

Schedule Physical Therapy

Oftentimes, physical therapy is part of your rehabilitation. If this is the case, make plans for where you will be undergoing therapy and how you will get there—you will not be able to drive during recovery from arthroplasty.

Order Assistive Devices

Work with your medical team to determine what medical equipment you will need once you get home after surgery. This may include devices such as a cane or walker, a chair for support in the bathtub, or grab bars for the toilet.

Rearrange Your Home

If everything in your home is not already accessible to you with limited movement, you will need to reorganize so that everything is on one floor and within reach. This is especially important during the first few weeks after surgery. You want to ensure that you are able to easily access everything you'll need in your home without the potential to strain your surgery site.

Address All Medical Issues

If you have other medical concerns, such as a toothache, make sure these are addressed prior to surgery. Recovery from surgery will take significant time. If you have a prior medical concern or issue, it is crucial to treat it before arthroplasty so that recovery from this procedure will be your main priority when the time comes.

During Surgery 

Arthroplasty requires a hospital stay. The procedure may be done when a person is asleep under general anesthesia. Sometimes, a person is awake under local anesthesia. This is something that will have to be determined based on the extent of the surgery and your doctor’s practices and specific recommendations. 

While you are still awake, you will remove clothing and change into a gown. An intravenous (IV) line is started in the arm or hand.  Next, you will be positioned on the operating table in a way that allows access to the joint to be operated on. Anesthesia is started through the IV line and the anesthesiologist will monitor your heart rate, blood pressure, blood oxygen, and breathing throughout the surgery. 

Any excessive hair at the surgical site is shaved off. The skin over the surgical site is then cleaned. Surgery can take up to two hours. The doctor will make an incision around eight to 12 inches in the surgical area. Then the surgeon will repair and/or replace the damaged part of the joint. For example, knee surgery involves taking out the damaged part of the knee and the surfaces of the thigh bone and shin bone next to the affected joint. The surgeon then implants the artificial knee joint prosthesis. 

In knee arthroscopy, the prosthesis is made up of three parts: a tibial component (bottom part) to replace the top of the lower bone (tibia), a femoral component (top part), which replaces the femur (upper bone where the patella fits), and the patellar part (knee cap) to replace the surface of the patella. The femoral part is made of metal and the tibial part includes a metal tray and a plastic spacer. The patellar part is made of plastic, but can also be both plastic and metal.

If your surgeon performs a minimally invasive procedure, a smaller incision means less damage to muscles and tendons. Once the damaged joint is repaired, removed and/or replaced, the incision is closed with surgical staples or stitches. Lastly, dressing and a bandage are applied. 

Recovery 

After the surgery, you will be observed for several hours in the recovery room. Once blood pressure, pulse, and breathing are stable and you are awake, you will be taken to a hospital room where you will stay for a few days. 

A physical therapist will meet with you shortly after the surgery and discuss an exercise rehabilitation plan. Since your pain will be managed with various pain relief therapies, including prescription and over-the-counter pain relievers, you will be up and moving right away. You will follow the rehabilitation plan in the hospital and after discharge. You will either be discharged to your home or to a rehabilitation center and continue physical therapy to regain strength and range of motion. 

Once you get home, the surgical area will need to be kept dry and clean. You will be given instructions on bathing. Stitches will be removed when you go for your follow-up visit.  

Only take the pain medications recommended by your doctor. Aspirin and other over the counter (OTC) pain relievers may cause bleeding or other adverse reactions. 

Keep an eye out for signs of infection, including: 

  • Fever/chills
  • Redness or swelling
  • Bleeding or drainage at the surgical site
  • Increased pain at the surgical site
  • Numbness or tingling in the affected joint

There is no need to change your diet unless your doctor has told you to. You will be advised of any activity restrictions, including driving. Your doctor may have additional recommendations and instructions based on your unique situation.  

Depending on the type of arthroplasty you have, your full recovery can take up to four months. You will be walking with a walker, crutches, or a cane in the first few days after surgery. Your doctor will evaluate you a week after surgery and determine the specifics of your physical therapy program. 

In the next two to six weeks after surgery, you will participate in physical therapy and work towards resuming normal activity. You should not resume any sports until you get approval from your doctor to avoid injury. For the next three to four months, you will notice improvements in strength and range of motion in the repaired/replaced joint. 

Pain and swelling should be completely be gone by this point and your doctor will approve your return to favorite sports and high impact activities. 

A Word From Verywell 

Arthroplasty can drastically improve your quality of life and help you to enjoy the activities you previously enjoyed, including walking, biking, running, swimming, and so much more. The surgery is generally safe—millions of procedures are performed yearly and very few people experience complications. 

Regardless, it is still a good idea to talk to your doctor about all the risks and benefits associated with arthroplasty and how they apply to your unique situation. You should also consider the time commitment for your recovery and rehabilitation. 

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