Surgical Treatment

When pain and disability interfere with daily life, then surgery is often a good option.

Millions of Americans each year benefit from total joint surgery — replacing a worn and arthritic joint with an artificial joint that functions in much the same way as the original.

In fact, studies have shown that total joint surgery has increased the quality of life relative to cost, more than any other medical intervention.

There have been a number of new developments in joint surgery.

Hip Replacement

Researchers have developed artificial joints that last longer and function more like the original joint. Most hip replacements consist of a metal shaft and metal or ceramic ball, and a moldable plastic socket.

About one third of hip replacements are bonded to the bone by special cement. The rest receive newer artificial joints that are porous, allowing a patient's own bone to grow into the pores and hold the new joint in place.

Early studies show that the cemented procedure works best in older, less active patients, and the uncemented version may work better for younger, more active patients, since bone can grow into the prosthesis and create a stronger bond.

Knee Replacement

Knee replacements are the most common type of joint replacement surgery. New materials have been developed that give the artificial joint better structure and attachment to the thigh bones. Studies have shown that knee replacement surgery provides almost complete pain relief in 96 percent of patients with osteoarthritis and 84 percent of patients with rheumatoid arthritis. Knee replacements are performed twice as often on women, because a woman's bone structure makes her more susceptible to knee degeneration.

New knee surgery: Partial knee replacement is an option for patients who have cartilage damage in just one compartment of the knee joint. Surgeons replace only the damaged part of the knee, preserving most of the knee joint and tissue. Because of this, patients who have this surgery are often walking on the same day and are driving just weeks afterward. This procedure usually provides lasting results for about 10 to 15 years and can be later modified with a total joint replacement if needed.

Another new option is minimal-incision partial knee replacement - a breakthrough in knee surgery that can benefit many patients who have arthritis damage on just one side of the knee joint.

Surgery is performed through a small three- to four-inch incision and just a portion of the worn knee joint is removed and replaced with a plastic and metal prosthesis. The procedure minimizes trauma to the remainder of the knee, meaning postoperative recovery is much quicker and easier. Patients can walk just hours after surgery, usually go home the same or next day and can drive and resume most activities within a couple of weeks.

Patients who have total knee replacement surgery usually are in the hospital for four to five days and then undergo months of rehabilitation before they can resume many activities. Studies by the National Academy of Orthopedic Surgeons estimate that up to 30 percent of joint surgery patients can benefit from this new technique.

Unique Joint Surgery Program

Southcoast recently introduced a new total joint surgery program at the Tobey Hospital site in Wareham offering patients extensive support and education as well as the skill and expertise of a highly trained staff. All services are conveniently located right in the Southcoast community:
• Each patient's care is coordinated by a "total joint nurse" who provides extensive support and education before, during and following surgery.

• Patients receive physical therapy services before surgery to help condition muscles and joints and speed recovery. Therapy continues in the hospital and after discharge.

• Orthopedic surgeons use the latest technology in joint prosthesis and specialized anesthesia during surgery helps reduce post-operative pain and speed the recovery process.

• Staff coordinate post-operative services, including access to a supervised aquatic therapy program, designed to get patients active and mobile as quickly as possible.

Follow Up

Rehabilitation after surgery is crucial in speeding recovery. Patients undergoing a knee replacement now exercise in the hospital just hours after surgery with a "continuous passive motion" machine that gently moves the knee. Hip and knee patients are encouraged to move with a walker as soon as possible.

All patients receive extensive education and a home therapy program to strengthen the new joint and regain mobility.

Southcoast offers physical, occupational and aquatic therapies at convenient sites throughout the region.

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Links

Wareham Orthopedics