Dr. Roy Endenburg

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Hip and Knee Replacement Overview

What is a Total Joint Replacement?

A Total Joint Replacement is a surgical operation aiming to replace a damaged or diseased joint. The procedure is designed to improve the quality of life by reducing pain, restoring mobility and correcting deformities, for example, equalising leg lengths.

What are the indications for Surgery?

The most common cause of joint failure is wear and tear arthritis, although sometimes the joint is congenitally malformed or damaged as a result of an accident. The symptoms experienced are usually caused by the wearing away of the articular cartilage which is the gristle covering at the end of the bone. This results in bone rubbing against bone (friction) which is both painful and restricts movement. Unfortunately most joint pathologies are progressive in nature and cause eventual disablement. Surgical intervention is then required.

What is the life expectancy of a Hip or Knee Replacement?

The operation carries a high rate of success. About 97% will last at least 1O years, and 20% will require revision by 13 to 15 years. Age, activity and load have a direct influence on this. Failure is generally caused by wear particles, generated from the articulating surfaces, which accumulate around the prosthesis causing an inflammatory process. This causes bone destruction, known as osteolysis, which results in loosening of the components. When loose, the joint once again becomes symptomatic and painful. Revision surgery is undertaken to replace the components, accommodating for bone loss which will have occurred. The amount and integrity of the remaining bone determines the type of revision prosthesis to be used, and the life span of the proposed procedure. It is this factor which must be taken into account when doing joint replacements on young patients. The timing of surgery is important: you have to be bad enough to be made better.

Aims of the procedure

To improve the quality of life by:

  • Relieving pain
  • Restoring function with mobility
  • Correcting deformities, for example, equalising leg lengths
  • Maintaining an independent lifestyle
  • Reducing the amount of costly and often harmful medications

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