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Joint Replacement

Introduction

Joint replacement surgery removes damaged or diseased parts of a joint and replaces them with new, man-made parts.
Replacing a joint can reduce pain and help you move and feel better. Hips and knees are replaced most often. Other joints that can be replaced include the shoulders, fingers, ankles, and elbows.
Joint replacement surgery removes damaged or diseased parts of a joint and replaces them with new, man-made parts.
The hip joint is made up of a ball-and-socket. The socket is made of bone and cartilage, and the ball is the top of the thighbone, also known as the femoral head.
Hip replacement surgery is an operation used to replace the damaged ball-and-socket with new and durable artificial synthetic parts that mimic the ball-and-socket.
Sometimes, either the socket of the hip or the thighbone is injured or becomes diseased. This can result in pain, trouble with walking, or difficulty with everyday tasks. You may have already tried pain relief methods such as medications, physical therapy, supports, or braces. If the pain doesn’t subside, your doctor may recommend hip replacement surgery.
Normal joints have "articular cartilage," and are coated with synovial fluid which allows them to move smoothly. When this cartilage erodes or is damaged due to disease, trauma, or age, or the fluid is reduced, joints become stiff and painful. This condition with symptoms such as pain and stiffness, is called arthritis.
Your doctor will first suggest non-surgical treatments to reduce pain and help you move better, often with the use of walking aids, exercise, or medications. If these do not work, the joint may be too compromised to be resolved with any other treatment, and surgery becomes necessary.
In joint replacement, abnormal bone and lining structures are surgically removed and replaced with new parts constructed of metal, plastic or carbon-coated implants. These new parts restore mobility to the joints, and are usually painless.

Types of Joint Replacement Surgery

The most common joint surgeries are performed on hips and knees. However, replacement surgery can be and is conducted on other joints as well
Hip Replacement Hip replacement can be total or hemi (half). A total hip replacement addresses both the acetabulum and the femoral head. Hemiarthroplasty only replaces the femoral head.
Knee Replacement The knee is the largest and most complex joint connecting major limbs and bearing the total weight of the body. It is susceptible to multiple injuries and ailments. Knee surgery options depend on the portion that needs to be treated – from a torn ACL, to partial or total knee replacement, to microfracture surgery.
Shoulder Replacement Shoulder joint replacements include the deltopectoral approach to save the deltoid. And the transdeltoid approach, at the glenoid. Reverse Total Shoulder Replacement is an option in severe cases.
Elbow Replacement The elbow bones are replaced with an artificial joint made from implants that attach to the bones in the arm. A metal and plastic hinge joins the implants together.
Wrist Joint Replacement (Wrist Arthroplasty) In wrist joint replacement surgery, the damaged parts of the wrist bones are removed and replaced with artificial components.
Ankle Replacement Total Ankle Arthroplasty (TAA) is a surgical procedure used by orthopedic foot and ankle specialist surgeons to treat ankles affected by severe arthritis.
Finger Replacement A finger joint (PIP) and knuckle joint (MP) replacement involves removal of the damaged joint and replacement with an artificial implant. This replicates normal joint function. The specific goals are to relieve pain, restore joint stability and mobility.
Total Joint Replacement TJR is an orthopedic procedure in which an arthritic or dysfunctional joint surface, usually in hip or knee, is replaced with a prosthesis. Joint replacement is an option when severe pain or dysfunction fails to respond to less-invasive therapies.

Risk Factors

Risk factors include:

  • During a hip or knee replacement, a surgeon removes the damaged surfaces of the joint and replaces them with plastic or metal implants. This gets rid of the pain because the diseased cartilage and bone are no longer there.
    The second reason is to improve how well your joint works, but these results are less predictable. After a new hip or knee is put in, many people can walk more easily. Some may be able to ride a bike or play golf. But there are no guarantees.
  • Joint replacements carry the same dangers as other major surgeries, like a chance of infections or blood clots. You're most at risk for these problems if you have heart disease, diabetes that's not well controlled, or a weak immune system - your body's defense against germs. Your surgeon may prescribe antibiotics and blood thinners to try to prevent some complications.
  • The other major risk is that the new joint may not work as well as you hoped. It might feel weak or stiff, particularly the knee. "Patients who don't actively rehabilitate will not regain the maximum range of motion. To get the best results from your knee surgery, stick carefully to your rehab schedule of exercise, rest, and medicines.
  • Change in leg length. Your surgeon takes steps to avoid the problem, but occasionally a new hip makes one leg longer or shorter than the other. Sometimes this is caused by a contracture of muscles around the hip. In this case, progressively strengthening and stretching those muscles might help. You're not likely to notice, small differences in leg length after a few months.
  • Although this complication is rare with newer implants, your new joint might not become solidly fixed to your bone or might loosen over time, causing pain in your hip. Surgery might be needed to fix the problem.

Procedure

Procedure include:

  • Joint replacement surgery is designed to replace the damaged cartilage and any bone loss. During the procedure, the damaged joint is resurfaced, and the patient's muscles and ligaments are used for support and function.
    The prosthesis (replacement joint) is made of titanium, cobalt chrome, stainless steel, ceramic material, and polyethylene (plastic). It can be attached to the bone with acrylic cement or it can be press-fit, which allows bone to grow into the implant. Once the joint replacement is in place, the patient has physical therapy to be able to move and use the joint.
    The 3 most common joint replacement surgeries are hip, knee, and shoulder.
  • Hip replacement Total hip replacement is a surgery for replacing the hip socket and the "ball" or head of the thigh bone (femur). The surgeon resurfaces the socket and ball where cartilage and bone have been lost, and then inserts an artificial ball and socket into healthy bone.
    Most people who have total hip replacements have serious changes in the hip joint caused by arthritis. A hip replacement is recommended if the person cannot bear the joint pain, and when the person can't perform activities of daily living because the damaged hip is preventing it.
  • Knee replacement Knee replacement surgery is performed to treat advanced or end-stage arthritis. When arthritis in the knee joint or joints has advanced to the point where it cannot be treated with medicine alone, or the deformity has become severe and keeps the patient from using the knee, replacement surgery may be recommended.
    The need for knee replacement surgery is the damage to the coating or gliding surface called the articular cartilage. Depending on the amount of damage, ordinary activities such as walking and climbing stairs may become difficult. Damage to the knee joint cartilage and bone may also cause deformity. Knock-knee or bow-legged deformities and unusual knee sounds (crepitus) may become more noticeable as the deterioration gets worse.
    Knee replacement surgery is designed to replace this damaged cartilage or gliding surface, as well as any loss of bone structure or ligament support. The material used for knee replacement is similar to that used for hip replacements.
  • Shoulder replacement Total shoulder joint replacement is usually needed for people who have advanced forms of osteoarthritis or rheumatoid arthritis, and sometimes for those who have had severe injury from a shoulder fracture. The main goal of total shoulder replacement surgery is to relieve pain; other goals include improving motion, strength, and function.
    Similar to the hip joint, the shoulder is a large ball-and-socket joint. The main reason for a total shoulder replacement is pain that is not being relieved with therapy or other treatment methods.

Range of Treatment Cost

Procedure Duration In Hospital Min Cost (INR) Max Cost (INR)
Total Knee Replacement
TKR (Unilateral) - PFC Sigma Implant 7 320000₹ 500000₹
TKR (Unilateral) - Hi Flex Implant 7 300000₹ 600000₹
TKR (Unilateral) - Uni Knee 5 307260₹ 500000₹
TKR (Bilateral) - PFC Sigma Implant 9 550000₹ 770000₹
TKR (Bilateral) - RPF 9 570000₹ 870000₹
Total Hip Replacement / Resurfacing
THR (Unilateral) - Routine 1 7 280000₹ 350000₹
THR (Unilateral) - Routine 2 7 350000₹ 550000₹
THR (Unilateral) - ASR 7 390000₹ 700000₹
THR (Unilateral) - Unipolar ASR 7 405000₹ 600000₹
THR (Unilateral) - Proxima 7 429000₹ 629000₹
THR (Bilateral) - Routine 1 9 470000₹ 670000₹
THR (Bilateral) - Routine 2 9 550000₹ 850000₹
THR (Bilateral) - ASR 9 700000₹ 900000₹
THR (Bilateral) - Unipolar ASR 9 720000₹ 820000₹
THR (Bilateral) - Proxima 9 700000₹ 900000₹
Ankle Replacement Surgery 5 420000₹ 620000₹
Elbow Replacement Surgery  5 420000₹ 620000₹
Total Hand Surgery 5 210000₹ 350000₹
Ankle Replacement Depends upon the treatment 1800000₹ 2500000₹
Shoulder Replacement
Single (Including Implant) 7 490000₹ 750000₹
Double (Including Implant) 14 900000₹ 1200000₹
Arthroscopic
Menisectomy Depends upon the treatment 450000₹ 650000₹
Shaving of cartilage Depends upon the treatment 500000₹ 700000₹
Ligament Reconstruction - ACL, PCL Depends upon the treatment 1100000₹ 1400000₹
Ankle Arthroscopy Depends upon the treatment 540000₹ 640000₹
Knee Arthroscopy Depends upon the treatment 590000₹ 790000₹
Elbow Arthroscopy Depends upon the treatment 500000₹ 800000₹
Shoulder Arthroscopy Depends upon the treatment 600000₹ 900000₹
Hip Arthroscopy Depends upon the treatment 500000₹ 700000₹
Tendon Repair Depends upon the treatment 540000₹ 750000₹
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