Joint Replacement Rehab


Postoperative rehabilitation is of the utmost importance following total joint replacement in order to ensure pain-free function of the joint and improve the patient's quality of life (QOL).

Total joint replacement, or arthroplasty, represents a significant advance in the treatment of painful and disabling joint pathologies. Such surgery can be performed on any joints of the body, including the hip, knee, ankle, foot, shoulder, elbow, wrist, and fingers. Among 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, with 234,000 total hip replacements (THRs) and 478,000 total knee replacements (TKRs) performed in the United States in 2004.

Terminology

Terms pertinent to total joint replacement surgery include the following:

  • Total hip replacement (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.

  • 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) - A patient's first replacement surgery

  • Revision - A patient's second or succeeding surgery; it is usually performed for an unstable, loose, or painful joint replacement.


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