Joint Replacement: Treatment, Procedure, Cost and Side Effects
What is the treatment?
Joints are those parts of the body where the bones of our body meet. Joints make it possible for human being to move. The different joints that are present in our body are the shoulder, elbow, hip and knee joints. Many people all over the world are afflicted by joint pain and in most cases, the pain is addressed with the help of lifestyle changes and some medicines. However, joint replacement surgery is required in some critical cases. The most common cause of joint pain is arthritis, which occurs when there is inflammation in the joints. Osteoarthritis and rheumatoid arthritis are the two most common forms of arthritis.
Some of the other causes of joint pain include gout, lupus, infectious diseases like mumps and influenza, cancer, osteoporosis, rickets, infection of a bone or even overuse of a joint. The cartilage is a connective tissue and normal wear and tear of this tissue can cause osteoarthritis. Arthritis generally occurs when there is some damage to the cartilages. Rheumatoid arthritis is an autoimmune disorder and it occurs when the body’s immune system attacks the tissues of the body.
Parts of an arthritic or damaged joint are removed in a joint replacement therapy. Some of the reasons that may warrant a joint replacement surgery are arthritis, excessive use of a joint or any disease. This is a process where the removed joint is replaced with a metal, plastic or ceramic device called prosthesis. The prosthesis is designed in such a manner so that it can perform the functions of a healthy and normal joint.
How is the treatment done?
The joint replacement surgery is generally performed at an hospital or outpatient surgery center and it generally takes a few hours. The damaged cartilage and bone is removed from the joint and then replaced with prosthetic components made of ceramic, metal or plastic. The prosthesis replaces the damaged joint and helps to perform most of the functions that could have been done with an actual joint. For example, in hip replacement surgery, the damaged ball or the upper end of the femur is replaced with a metal ball. This metal ball is attached to a metal stem that is fitted into the femur bone. Finally, a plastic socket is inserted into the pelvis to replace the damaged socket.
The three most common types of joint replacement therapy are hip replacement, knee replacement and shoulder replacement. In hip replacement surgery, the socket and ball where cartilage and bone have been lost are treated and an artificial ball and socket are inserted into the healthy bone. Knee replacement surgery and shoulder replacement surgery are generally done to treat end-stage arthritis
It is possible to replace even ankle and finger joints if the need arises. Installing an artificial joint greatly reduces the pain that a patient may have been experiencing and also helps to revive some mobility in the treated joint. Research has shown that obese and overweight people are more likely to require a joint replacement surgery compared to a person of normal weight.
Who is eligible for the treatment? (When is the treatment done?)
A person suffering from joint pain will first be recommended nonsurgical treatments like medications, physical therapy and lifestyle changes. A person, whose joint pain cannot be addressed by resorting to these non-surgical treatments, is eligible for joint replacement surgery. A doctor can recommend use of walking aids, medications like analgesics and immunosupressants, physical therapy and an exercise program to deal with joint pain. A person becomes eligible for this treatment only after the non-surgical therapies have failed.
Who is not eligible for the treatment?
A joint replacement surgery is basically the last resort for a person suffering from joint pain. A doctor usually recommends non-surgical treatments like use of medicines, making some lifestyle changes, exercising and may also advice a person to get massages or to undertake some other physical therapy. If a person gets relief or his condition is managed with the help of these non-surgical methods, he/she is not eligible for joint replacement surgery.
Are there any side effects?
A joint replacement surgery can have a number of side effects. They can be infection, blood clots in the deep veins of the legs that may cause pain and swelling, pulmonary embolism that may result in one or more arteries in the lungs getting blocked by a blood clot and damage to the nerves and other tissues. Other side-effects may include bone fracture, dislocation of bones, bleeding and wound haematoma and pain.
What are the post-treatment guidelines?
A person who has undergone a joint replacement surgery should voluntarily lead an active life. This will help the artificial joint to respond better and also be beneficial for you in the long run. It is to be kept in mind that rehabilitation and recovery will vary from person to person. As the surrounding muscles of the replaced joint get weak due to inactivity, the patient may feel some pain. Thus doctors will recommend some exercises to deal with it. A person may start to walk the very day of undergoing hip or knee replacement surgery. However, he might need to take the help of a walker or crutches. A shoulder replacement surgery will require the patient to do some gentle, range-of-motion exercises.
How long does it take to recover?
The time required to recover from a joint replacement surgery will vary from person to person. A person generally has to stay in the hospital for a few days. A person can stand or walk with the help of walker or crutches on the day of the surgery itself in case of hip or knee replacement surgeries. It generally takes about 6 weeks to resume normal activities. However, recovering fully from a joint replacement surgery may take a year.
What is the price of the treatment in India?
The cost of knee replacement surgery can vary according to the city or hospital where the treatment is being done. Knee replacement surgery can cost between Rs 4 lakhs – 6 lakhs while hospitals in Gujarat do not cost more than Rs 4 lakh. A hip replacement therapy costs something around Rs 4 lakhs.
Are the results of the treatment permanent?
A joint replacement therapy helps to replace a worn out or damaged joint. An artificial prosthesis is installed that helps to reduce the pain and to restore some of the mobility of the affected joint. An artificial joint may help a person to lead a normal life. However, a young person may have to undergo a joint replacement surgery as they may get affected with rheumatoid arthritis at an early age. That person might have to get his/her artificial joint replaced as the previous one can undergo wear and tear due to continuous use over a long period of time.
What are the alternatives to the treatment?
In recent times, doctors are trying to use stem-cell therapy as an alternative to knee replacement surgery. Other alternatives to knee replacement surgery include arthroscopic washout and debridement, osteotomy, autologous chondrocyte therapy and microfracture. However, other joint replacement surgeries are done only after non-surgical methods have been tried and they have not provided the intended results. So there are no alternative treatments to joint placement surgery (except knee).
Rs 4 to 6 lakhs