Arthroplasty is the reconstruction or reshaping of a damaged or diseased joint. This elective surgery most often involves joint replacement, the implantation of an artificial joint (prosthesis).

Only certain patients are good candidates for the procedure, such as those who are in otherwise good health but experience osteoarthritic pain that has not responded to other treatments and that is interfering with daily activities and decreasing quality of life. The relief of joint pain is often considered a driving factor for many patients who receive arthroplasty.

In addition to osteoarthritis, arthroplasty can be a treatment for conditions including hip fractures, other source of acute trauma and rheumatoid arthritis.

Arthroplasty may be used to:

• Replace all or part of a joint with a prosthesis
• Resurface a joint with the patient’s own tissue
• Reshape the bone and cartilage that make up the joint

When prostheses are used, they may be made of polyethylene, metal, ceramics or silicone. The most common design is metal-on-polyethylene, although metal-on-metal designs have become more popular in recent years.

Arthroplasty is performed under anesthesia and may last several hours. During the procedure, the joint is fully exposed and the damaged bone and cartilage are cut away or reshaped. When prostheses are used, they are inserted after measurements are taken to ensure proper fit. The joint is tested before the incision is closed.

Arthroplasty is typically followed by several days in the hospital. Medications may be given to ease pain and prevent infection and blood clots. Extensive physical therapy is employed to bring the joint to near-normal function while avoiding complications. Occupational therapy may be prescribed to maximize the patient’s independence in daily activities. Patients typically resume normal activities after two to three months.

Arthroplasty is usually employed as a last resort. Alternatives include physical therapy and arthroscopy. Variations of arthroplasty include minimally invasive surgery with smaller incisions, working on multiple joints during a single surgery, and replacing only parts of the affected joints. Arthroplasty may greatly improve a patient’s quality of life but is not without risks.