Excerpt from Total Joint Replacement Rehabilitation
Synonyms, Key Words, and Related Terms: total joint arthroplasty, total hip replacement, total hip arthroplasty, total knee replacement, total knee arthroplasty, cemented joint replacement, cemented joint arthroplasty, ingrowth joint replacement, ingrowth joint arthroplasty, cementless joint replacement, cementless joint arthropathy, primary joint replacement, primary joint arthroplasty
Total joint replacement, or arthroplasty, represents a significant advance in the treatment of painful and disabling joint pathologies. Total joint replacement can be performed on any joints of the body, including the hip, knee, ankle, foot, shoulder, elbow, wrist, and fingers. Of these procedures, hip and knee total joint replacements, which are the focus of this article, are by far the most common. The number of joint replacements that are performed annually has been increasing steadily. In 2004, 234,000 total hip replacements (THRs) and 478,000 total knee replacements (TKRs) were performed in the United States. Treatment of the diseased hip or knee joint does not end with surgical replacement. The ultimate goal is ensuring pain-free function of the joint to improve the patient's quality of life (QOL). Postoperative rehabilitation is of the utmost importance. (Also, see the eMedicine article Total Knee Arthroplasty.) For excellent patient education resources, visit eMedicine's Foot, Ankle, Knee, and Hip Center; Arthritis Center; and Breaks, Fractures, and Dislocations Center. Also, see eMedicine's patient education articles Knee Joint Replacement and Total Hip Replacement. Terminology
- THR, or total hip arthroplasty (THA) - Replacement of the femoral head and the acetabular articular surface
- Hemiarthroplasty - Replacement of only the femoral head
- Bipolar hemiarthroplasty - A specific form of hemiarthroplasty in which a femoral prosthesis is used with an articulating acetabular component; the acetabular cartilage is not replaced. The principle of this procedure is to decrease the frictional wear between the femoral head prosthesis and the cartilage of the acetabulum.
- TKR, or total knee arthroplasty (TKA) - Replacement of the articular surfaces of the femoral condyles, tibial plateau, and patella; the anterior cruciate ligament is excised. The posterior cruciate ligament may be saved in cruciate-retaining systems.
- Unicompartmental knee replacement (unicompartmental arthroplasty) - Replacement only of the medial or lateral tibiofemoral compartment of the knee
- Cemented joint replacement (cemented joint arthroplasty) - A procedure in which bone cement or polymethylmethacrylate (PMMA) is used to fix the prosthesis in place in the joint
- Ingrowth, or cementless, joint replacement (ingrowth, or cementless, arthroplasty) - A procedure that does not involve bone cement to fix the prosthesis in place; an anatomic or press fit with bone ingrowth into the surface of the prosthesis leads to a stable fixation. This procedure is based on a fracture-healing model.
- Primary joint replacement (primary joint arthroplasty) - The first replacement surgery
- Revision - A second or succeeding surgery; it is usually performed for an unstable, loose, or painful joint replacement.
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