Nivelproteesit

Nivelproteesit (Finnish for joint prostheses) are surgically implanted artificial joints used to replace damaged or diseased joints. They are most commonly used for the hip and knee, but can also involve the shoulder, elbow, ankle, wrist, and temporomandibular joint.

Indications for nivelproteesit include end-stage osteoarthritis, inflammatory arthritis (such as rheumatoid arthritis), post-traumatic arthritis, and certain tumors or congenital deformities when non-surgical treatments fail to relieve pain and restore function. They are typically considered after conservative measures have not provided sufficient relief.

Procedures include total joint arthroplasty, where the entire joint surfaces are replaced, and partial or hemi-arthroplasty, which replaces only one side of the joint. Some joints may employ resurfacing techniques. Implants consist of components such as metal alloys, bearing surfaces in plastic or ceramic, and endoprosthetic cups or trays that suit the particular joint.

Materials and fixation methods have evolved to balance durability and biocompatibility. Common materials include biocompatible metals (e.g., cobalt-chrome, titanium), polyethylene or ceramic bearing surfaces, and bone cement (PMMA) for fixation or cementless designs that encourage bone ingrowth. Hybrid approaches combine cemented and press-fit components.

Outcomes generally include substantial pain relief and improved function for many patients, with a typical longevity of 15–20 years or longer for modern implants. Risks include infection, thromboembolism, dislocation or instability, aseptic loosening, wear or fracture of components, and periprosthetic fracture or nerve injury. Revision surgery may be needed over time.

Rehabilitation involves structured physical therapy to restore range of motion, strength, and gait. Weight-bearing and activity guidelines depend on the implant type and fixation. Advances continue in minimally invasive techniques, robotics, and new bearing materials to improve outcomes.