Osteoarthritis Health Center

Surgery for Osteoarthritis Joint Pain

Total Joint Replacement (Arthroplasty) for Joint Pain continued...

What Happens During Total Joint Replacement

Since each type of joint replacement is different, let's assume you're having total knee replacement.

Once you're under general or regional anesthesia, an orthopedic surgeon first resurfaces the knee joint. Next comes replacement of the weight-bearing parts with an artificial joint. The new joint is made of metal, ceramic material, or high-density plastic parts, which may be joined to bone using acrylic cement. The surgery usually takes about two hours or less if there are no complications.

You may spend three to five days recovering in the hospital before going home.

Recovery After Joint Replacement Surgery

While you're still in the hospital after joint replacement surgery, expect to begin walking with crutches or a walker. Medicines are available to help relieve pain. Physical therapy often begins the day after surgery. The gentle exercises help strengthen the muscles around the new joint and improve your ability to move it.

Once you're home, follow your health care provider's instructions and advice about eating, medication, and exercise.

Osteotomy for Joint Pain Relief

Because osteotomy is done more often on the knee, this section focuses on the knee. 

Osteotomy may be an alternative to joint replacement when certain conditions are met including:

• There is more knee joint damage on one side than the other, leading to a bow-legged or knock-kneed deformity.
• There is abnormal bone alignment of the hip joint.
• You are too young for joint replacement.

In the knee, osteotomy involves removing a wedge of shinbone from an area below the knee. This changes the angle the shinbone makes, causing a shift in weight bearing across the knee joint. As a result, the shinbone and thighbone bend away from the direction of the deformity.

In the hip, osteotomy is usually done for people with early arthritis of the joint -- for example, infants with hip dysplasia (abnormally formed hip joints) that leads to osteoarthritis.

Benefits and Risks of Osteotomy

Besides helping to correct the knee deformity, osteotomy may help:

• Relieve joint pain and symptoms
• Slow the progression of osteoarthritis by changing bodyweight stress on the damaged portion of the knee
• Delay the need for joint replacement in younger, active people with painful osteoarthritis

Unfortunately, it's difficult to know for sure who may benefit from osteotomy. Poor outcomes are seen in people who are not good candidates for osteotomy, including those with:

• Osteoarthritis throughout the knee, not just on one side
• Knee instability or shinbone dislocation
• Severely restricted knee movement
• Inflammatory arthritis (such as rheumatoid arthritis)
• Severe, hard-to-correct deformity

What Happens During Osteotomy

Using a 4- to 5-inch incision for an osteotomy, the surgeon removes a small wedge of your shinbone from below the knee. This lets the shinbone and thighbone bend away from the damaged cartilage. It also helps keep damaged knee and shinbone surfaces from rubbing against each other.