Joint replacement surgery, or arthroplasty, is substitution of the affected joint with the artificial implant. This type of surgery pursues a few aims. The first one is the alleviation of the disturbing symptoms, like pain and stiffness. The second one is restoring the normal extremity function, avoiding any possible postoperative limitations.

Advances in the orthopedic surgery have minimized the procedure risks, like bleeding, postoperative pain and neurological deficits. It is also possible to perform bone-sparing superficial interventions that demonstrate better long-term results in young and physically active patients. Nevertheless, total joint replacement is indicated to the strictly selected patients. Initially, all the doctor’s efforts are aimed at preserving the patient’s own joint.

Causes of joint problems

Joint problems typically arise against the background of cartilage dysfunction or irregular joint development. Main causes of the joint function violation include:

• Birth trauma, congenital joint malformations.
• Heredity, genetic predisposition to the cartilage degeneration.
• Severe mechanical trauma or repetitive minor injuries.
• Advanced osteoarthritis, rheumatoid arthritis.
• Osteonecrosis with the cartilage and bone surface destruction.

Obviously, some of these conditions are inherited (these are non-modifiable causes), while others can be successfully treated or even prevented. The modifiable (those ones that can be excluded) risk factors of joint diseases include:

• Obesity or the excess body mass (the BMI over 25 kg/sqm) causes the excessive load on the weight-bearing joints (hip, knee, and ankle ones).
• Lack of physical activity leads to a decrease in the joint blood supply, depriving it of the necessary nutrients.
• Certain professional occupations or sporting activities that imply constant intense exercise, unusual load on the joints (e.g. in mountain climbers).
• Smoking or using other tobacco products causes direct damage, affecting the joint arteries and the cartilage structure.

Modification of the risk factors is the first-line recommendation in patients with joint diseases. Sometimes simple lifestyle changes are totally enough for joint health improvement.

When is the joint replacement surgery needed?

Despite all its benefits, joint replacement surgery is a second-line treatment option. It is performed in the poor effect of less invasive measures, like drug therapy with painkillers and physical therapy. The intervention is inevitable in patients with severe arthrosis or arthritis, traumatic joint fractures, dysplasia or other types of abnormal joint development.

Artificial joint solves a number of problems:

• Eliminates or, in severe cases, alleviates pain.
• Corrects joint deformity in dysplasia or mechanical trauma.
• Improves the range of motions, the patient can move or perform other actions without limitations.
• Eliminates joint stiffness and swelling.
• As the secondary action improves muscles strength and general fitness.

Total joint replacement is mainly performed in adult patients. In children and teenagers, this procedure is highly undesirable, as the revision surgery is usually required in order to adjust the implant size and form to the constantly growing bones. In older patients, the revision surgery is indicated only in case of prosthesis displacement, wearing out, etc.

In certain clinical situations, a surgeon recommends postponing the intervention regardless of the symptoms. Particularly, these include acute joint infections, severe and resistant osteoporosis, and decompensated heart failure.

The most common joint replacement surgeries

There are over 250 joints in the human body. Fortunately, most of them will never require arthroplasty due to the location, size and function specifics. The total joint replacement is usually performed in three large joints.

1. Hip replacement includes resurfacing of the acetabulum (pelvic part of the joint) and replacing the femur head and neck. In young patients, preference is given to the more sparing McMinn’s procedure. This surgical technique allows saving the femoral neck and most part of the femoral head, affecting only the surface of the bone.
2. Knee replacement includes resurfacing the femur, tibia, and the patella. Typically, an additional medical plastic spacer is put between the prosthesis parts in order to improve the properties of the gliding surface.
3. Shoulder joint replacement is somewhat similar to the hip arthroplasty due to the joints anatomical structure. The head of the humerus and the glenoid articular surface are substituted with the implant. Another, although rarer, the surgical technique is the reverse shoulder joint replacement. In this case, the prosthesis parts switch places – the ball-shaped part, which is typically connected to the humerus, is attached to the glenoid articular surface.

Replacement surgery is always followed by a rehabilitation program that makes the new joint work properly. Comprehensive rehabilitation and using qualitative prostheses are the important conditions of the beneficial long-term result.

Treatment of joints in Germany

Patients, who are in seek of the best healthcare facility for the arthroplasty, usually have a long medical history and are perfectly aware of all the possible conservative options. When it comes to surgical treatment, the situation is somewhat different. Successful total joint replacement requires a combination of a few factors:

• Qualification of an orthopedic surgeon.
• Availability of qualitative implants with long service life.
• Presence of up-to-date surgical equipment for minimally invasive and sparing robotic interventions.
• Thorough postoperative pain management.
• Early rehabilitation and fully functional restoration.

Treatment in Germany fully meets all these strict requirements. German doctors combine recognized around the globe treatment approaches with own medical developments, like hip resurfacing procedures with the help of Prof. Derek McMinn’s technique. In addition, Germany offers comprehensive postoperative care in orthopedic rehabilitation centres. Here, the patient performs all the procedures under the close supervision of the experienced physical therapist and restores the necessary skills.

If you are not a German citizen, it will be more comfortable and safe for you to use the help of the certified medical tourism operator – Booking Health. Booking Health is authorized to arrange treatment on international patients from 75 countries in the leading German orthopedic hospitals and rehabilitation centres.

Booking Health specialists guide a patient through all steps, from the hospital selection to translating medical reports after returning to the native country. Also, you will receive the support in the financial questions (exclusion of fees for the foreign patients will allow you to save up to 50% of the total price), services of the interpreter (he will accompany you during communication with medical specialists), arrangement of transfer and accommodation, and support of your personal manager 24/7.