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Primary total hip and total knee replacements are among the most common and successful orthopedic procedures worldwide. These surgeries replace damaged or arthritic joints with prosthetic implants, aiming to relieve pain, improve function and enhance quality of life.
Osteoarthritis is the leading condition affecting knee and hip joints.
While both procedures have high success rates, they carry risks. Understanding indications, techniques, benefits and challenges is essential for achieving optimal outcomes.
Total hip replacement
The hip joint is a ball-and-socket joint that deteriorates due to osteoarthritis, rheumatoid arthritis, traumatic injury, or avascular necrosis. Over time, cartilage loss causes pain, stiffness and limited mobility.
Indications for total hip replacement include:
Osteoarthritis: The most common reason, caused by cartilage wear and tear, leading to pain and loss of mobility
Rheumatoid arthritis: An autoimmune disease that damages joint lining, causing deformity
Avascular necrosis: A condition disrupting blood supply to the femoral head, leading to bone death and collapse. Causes include steroid use, smoking, sickle cell disease, and alcohol use, though many cases are idiopathic
Hip fractures: Displaced femoral neck fractures, particularly in elderly patients, may require hip replacement
Benefits include pain relief, improved mobility, and enhanced function. Modern implants and techniques can last 20-30 years.
Risks include infection, dislocation, blood clots, pulmonary embolism, and implant wear or loosening, which may require revision surgery.
Marc Goldman Total knee replacement
Total knee replacement follows a similar concept but involves different anatomy and techniques. The femoral condyles, tibial plateau, and patella are replaced with prosthetic components.
Osteoarthritis is the primary cause, but rheumatoid arthritis, post-traumatic arthritis, and avascular necrosis can also necessitate surgery.
In total knee replacement, the surgeon removes damaged portions of the femur, tibia, and patella and replaces them with metal and plastic components designed to mimic natural knee motion.
The patella is resurfaced, and a plastic liner cushions the joint.
Benefits include reduced knee pain, restored function, and increased mobility, allowing patients to resume daily activities.
Risks are similar to hip replacement, including infection, stiffness, implant wear, and blood clots.
Comparing hip and knee replacements
While both procedures aim for pain relief and improved function, they differ in anatomy and recovery.
The hip is a ball-and-socket joint, while the knee is a hinge joint, impacting surgical approach and rehabilitation.
Hip replacements typically allow for quicker mobility recovery, while knee replacements require prolonged rehabilitation due to the knee’s complex motion.
Patient selection and surgical approach
Ideal candidates experience significant joint pain and disability that has not improved with conservative treatments like medication, physical therapy, or injections. Age, activity level and overall health are also factors.
I take an individualized approach to total joint replacement, selecting implants tailored to each patient and managing their comorbidities before and after surgery.
With modern advancements in surgical techniques and materials, total hip and knee replacements continue to evolve, providing lasting benefits to millions worldwide.