spinal anesthesia with sedation for comfort. A
joint replacement operation takes about two
hours, during which the surgeon makes an inci-
sion large enough to adequately expose the joint,
cuts away the damaged joint structures, prepares
the remaining BONEstructure to receive the pros-
thesis, and cements or otherwise attaches the
prosthesis components into place. After the sur-
geon finishes the operation, the person goes to the
recovery unit for close nursing supervision and
care until the anesthesia wears off and PAINcontrol
is satisfactory, usually for two to four hours.
Return to activity begins almost immediately
and is essential for full recovery of joint function.
It is especially important for the person to begin
walking right away for hip and knee replace-
ments. The doctor will prescribe ANALGESIC MEDICA-
TIONS for pain relief. Intensive PHYSICAL THERAPY
moves the new joint through passive and active
range of motion exercises. Frequent walking also
reduces the risk for blood clots. The doctor may
prescribe medication, support stockings, or inflat-
able compression cuffs.
Risks and Complications
All surgeries carry the risk for excessive bleeding
during or after the operation, blood clots, and
INFECTIONof the surgical wound. A particular risk
with joint replacement is infection that infiltrates
the bone, causing more extensive damage than a
repeat joint replacement could repair. Other
potential complications of joint replacement
include failure of the prosthesis, loosening of the
insertion of the prosthesis into the bone ends, DIS-
LOCATIONS, and loss of function due to wear over
time.Outlook and Lifestyle Modifications
A prosthetic joint has a life expectancy of 5 to 15
years, depending on the joint and the person’s
lifestyle. Some strenuous physical activities may
no longer be possible, depending on the replaced
joint. A replacement hip or knee generally cannot
tolerate activities such as running and jumping,
for example, though swimming and bicycling are
excellent alternatives for aerobic conditioning and
improving STRENGTH, ENDURANCE, and FLEXIBILITY.
Most people who undergo joint replacement enjoy
vastly improved QUALITY OF LIFE after HEALING is
complete. Complete rehabilitation and return to
normal activities may take three to six months.
See also PATIENT CONTROLLED ANALGESIA; POSTOPER-
ATIVE PROCEDURES; PREOPERATIVE PROCEDURES; PROS-
THETIC LIMB; SURGERY BENEFIT AND RISK ASSESSMENT.joint replacement 329