arthroplasty

Arthroplasty, or joint replacement, is a surgical procedure in which a diseased joint is replaced or reconstructed with a prosthetic implant. The goal is to relieve persistent pain, restore alignment and movement, and improve function when conservative treatments have failed.

Indications include end-stage osteoarthritis, inflammatory arthritis, avascular necrosis, posttraumatic arthritis, deformity, and selected tumors or fractures.

Common approaches include total arthroplasty, which replaces the entire joint; partial or hemiarthroplasty, which replaces one side of the joint; and resurfacing arthroplasty, which caps the original bone surfaces. Small joints such as fingers and large joints such as the hip and knee are treated with joint replacements; the shoulder, elbow, and ankle are also commonly involved.

Implants may be fixed with bone cement (cemented), press-fit to bone with growth (cementless), or used in hybrid combinations. Bearing surfaces include metal-on-polyethylene, ceramic-on-polyethylene, and ceramic-on-ceramic articulations. Modern implants may be modular to tailor fit.

Outcomes typically include substantial pain relief and functional gains, with longevity commonly in the 15–20 year range, though revisions are more common in younger patients. Risks include infection, blood clots, dislocation, loosening, wear-related failure, periprosthetic fracture, and nerve injury.

Recovery involves hospital stay, physical therapy, and a period of restricted or encouraged weight bearing, with gradual return to activities over several months. The modern practice of arthroplasty began in the mid-20th century and has evolved with improved materials, implants, and surgical techniques.