Joint reconstruction & Replacement
Relieving pain. Restoring function.
If you’re living with joint pain in your knees or shoulders, you may be considering surgery as a way to ease your discomfort.
But which surgery is right for you? Joint replacement involves replacing the entire joint with an artificial one. Joint reconstruction, on the other hand, is a minimally invasive surgery that repairs and rebuilds the joint using pieces of your own bone and tissue.
Both are great options that will help relieve pain and restore motion. Which one Dr. Boyett recommends will depend on the degree to which your joint is damaged. He is a leading expert in both treatments, specializing in knee and shoulder joints.
What is joint reconstruction and replacement?
This term can be scary but what does it really mean? Each joint procedure is unique and different and there is a misconception that joint replacement involves excising the bone and joint and replacing it with a hinge-type implant.
That is extremely uncommon these days and is only performed in rare patients. Most joint replacements are more similar to how a dentist might “cap” a tooth. In modern joint replacement surgery, the joint is exposed through a careful surgical approach and the arthritis is cleaned up and ultimately the ends of the bones are resurfaced with a metal cap on each side of the bone preserving the majority of ligaments. Then a plastic (polyethylene) spacer is placed between the caps to function as the new cushion. Additionally, there are procedures that only resurface or replace a part of a joint preserving as much normal tissue as possible.
The procedure that is right for you depends on many factors that include age, x-rays, activity level, deformity, and other factors. Every effort is made by Dr. Boyett’s team to stay on the cutting edge of technology. Our practice incorporates robotics, advanced anesthetics, joint preservation, and minimally invasive surgical approaches.
When is it time to consider Joint Replacement?
Every effort is always made to perform conservative treatment and approach painful arthritis with the least invasive yet effective treatment. We realize that sometimes when you go to a surgeon there is caution that your surgeon may function by the old saying that “if your tool is a hammer everything looks like a nail”. Dr. Boyett and his team perform a comprehensive evaluation and make every attempt to consider all treatment options.
However, some patients need surgery. Surgery should be considered when:
- conservative treatment is not working
- significant deformity is developing (bowleg or knock knee deformity, etc.)
- you have loss of motion
- your joint is limiting your activities of daily living
- you are at risk for falling
- your immobility is making you depressed and withdrawn
- you are requiring narcotic pain medications
What are the top three Joint Replacement advancements?
- Outpatient joint replacement – One good thing that COVID-19 has done is make healthcare rethink its approach and delivery. Approximately 50% of our joint replacements are performed as an outpatient. This is a safe, accelerated alternative to the past. It is proving that surgical complications are reduced for outpatient candidates with less infection risk (due to fewer exposures in the hospital) and earlier, more aggressive range of motion. The earlier range of motion results in fewer blood clots and less stiffness.
- Liposomal anesthetic blocks – The newest technology for post-op pain control includes medications that are encapsulated in a fat globule, called a liposome, which releases the medication in a slower fashion. This slow release allows the numbing medication to be delivered into the tissue over a two-day period. With this adjunct to our pain control, we rarely use intravenous pain medications even when patients are in the hospital. It also results in less pain medication by mouth when home. Less narcotic pain medication results in less constipation, fewer falls, less lethargy, and better participation in physical therapy.
- Robotics – Robotic and computer-assisted surgery allow the surgeon to balance the joint more objectively. Every knee that is replaced must be balanced just like a tire on a vehicle. The robot allows the surgeon to measure the laxity in the joint in all positions of motion and then affords precise adjustments if needed to balance the joint.
- Outpatient joint replacement – One good thing that COVID-19 has done is make healthcare rethink its approach and delivery. Approximately 50% of our joint replacements are performed as an outpatient. This is a safe, accelerated alternative to the past. It is proving that surgical complications are reduced for outpatient candidates with less infection risk (due to fewer exposures in the hospital) and earlier, more aggressive range of motion. The earlier range of motion results in fewer blood clots and less stiffness.