Is Joint Replacement An Option For The Treatment Of Osteoarthritis Symptoms?

Currently, medical science provides no cure for OA. Nevertheless, many therapies can reduce OA-related pain and increase joint function, including anti-inflammatory agents, painkillers, physical therapy, braces, orthotics, and lifestyle changes. All of these measures have been shown to reduce the symptoms of the disease. However, when these conservative treatments no longer provide relief, surgery is an option. This includes joint replacement surgery.

When conservative treatments for osteoarthritis no longer provide relief, surgery—including joint replacement—is an option.

The replacement of a natural joint with an artificial joint (i.e., prosthesis) is carried out through a surgical procedure called an arthroplasty. The two most commonly performed joint replacement procedures are hip and knee arthroplasties. Both are very successful procedures and are associated with high rates of patient satisfaction. They are by no means the only joint replacement procedures, however: Shoulder, elbow, wrist, and finger joints can also be replaced.

Not every person with an arthritic joint is a candidate for joint replacement. Joint replacement surgery is indicated for people who are in pain and have significant limitations of movement in the affected joint. These patients have usually failed to respond the more conservative treatment options. Even if a person meets all of these criteria, however, surgery may not be the most appropriate option.

If the patient has other conditions that would increase the risk of complications or of prosthetic failure or that would render the individual unable to participate in a rigorous rehabilitation program, then he or she is unlikely to be considered for this type of surgery. For example, people with severe neurological, intellectual, or psychiatric impairment would not be able to participate in rehabilitation, nor would patients with severe heart or lung conditions. People with severe osteoporosis or obesity would also be at high risk for a failure of the prosthesis. Those with blood clotting disorders could be at excessive risk of pulmonary embolism (blood clots in the lung), strokes, or bleeding after surgery.

The timing of the surgery is important. For example, studies suggest that if a joint replacement is delayed too long, patients may become too debilitated to participate in their physical therapy after surgery. If a young person needs a joint replacement, his or her orthopedist will delay this surgery for as long as possible, because the implanted prosthesis will wear out. Thus a younger patient may eventually require one or more additional replacements in the future. Ideally, as surgical techniques and materials science improve over time, newer prostheses will be more durable and will require fewer replacements.