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Conditions & Treatments

Total Shoulder Replacement

Although not as common as knee or hip replacements, shoulder replacement surgery is a successful treatment option for people suffering from osteoarthritis and other joint disorders. This procedure was first used in the 1950s to treat shoulder fractures, but can now be used for arthritis, rotator cuff tears or osteonecrosis.

Like the hip joint, the shoulder is a ball and socket joint that provides a full range of motion allowing you to raise, twist and bend your arm. Replacement surgery includes the placement of an artificial metal ball and plastic socket.

Shoulder replacement surgery is performed under general anesthesia through an incision in the front of the shoulder. The procedure usually lasts about two hours and requires a short hospital stay. Full recovery can take two to three months.

The replacement helps restore movement and reduce pain. Although successful and safe, joint replacement is usually reserved for patients who have not found relief from more conservative treatment. It is important to consider the risks of surgery before undergoing this procedure. Complications of total shoulder replacement include infection, dislocation and nerve damage. Talk to our doctor today to find out if you can benefit from total shoulder replacement.

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Total Hip Replacement

The hip is a "ball-and-socket" joint where the "ball" at the top of the thigh bone (femur) fits inside the "socket" in the pelvis (acetabulum). A natural substance in the body called cartilage lubricates the joint. When the bone and/or cartilage of the hip becomes diseased or damaged from arthritis, hip fractures, bone death or other causes, the joint can stiffen and be very painful. A total hip replacement may be recommended for patients who experience severe hip pain and whose daily lives are affected by the pain.

In a total hip replacement, the diseased bone and cartilage are replaced with a metal ball and plastic cup. The artificial joint, called a prosthesis, may be cemented in place, may be cementless, or may be a hybrid of both. The surgery takes from two to four hours, followed by another few hours spent under observation in a recovery room. Patients usually enjoy immediate relief from joint pain after the surgery.

Physical therapy starts as soon as the first day after surgery with the goal of strengthening the muscles and preventing scarring (contracture). Therapy begins with the patient sitting in a chair and progresses to stepping, walking and climbing stairs, first with crutches or walkers and then without supportive devices. Occupational therapy and at-home exercises help patients learn how to use the prosthesis in everyday activities.

Total hip replacement is successful in over 95% of well-selected patients. On average, replacements last 15-20 years. Some patients enjoy full use of the prosthesis after 25 years or longer.

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Total Knee Replacement

The knee is a hinge joint where the thigh bone (femur) and the bone of the lower leg (tibia) meet. Arthritis (particularly osteoarthritis) and certain knee injuries and diseases can damage the cartilage that normally cushions the joint, leading to pain and stiffness. A knee replacement may be recommended when more conservative treatments -- such as anti-inflammatory medications and cortisone injections -- fail to relieve pain or improve movement.

During a total knee replacement, the entire joint is replaced with an artificial prosthesis. The end of the femur is replaced with a metal shell. Then the end of the tibia is fitted with a plastic cup and a metal stem that fits into the shell on the femur. This reduces friction in the joint, easing pain and allowing a greater range of movement. The main ligament of the knee (the posterior cruciate ligament) may be left in place, removed or replaced with an artificial post. The kneecap may also be replaced with, or supported by, a piece of plastic. The surgery itself lasts between one-and-a-half and three hours.

After the procedure, the patient rests in a recovery room and then in a hospital room. Patients usually experience immediate relief from the joint pain suffered before the replacement. However, there will be some post-operative discomfort. Physical therapy starts right away to speed healing and to ensure that the patient enjoys full use of the joint. Therapy progresses from use of walkers and crutches to walking on stairs and slopes, with home exercises to supplement formal sessions. In addition, continuous passive motion (CPM) machines can reduce recovery time and the risk of muscle contracture without straining the joint.

Knee replacements today last about 20 years in 85-90% of well-selected patients.

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