Joint Replacement Center

Our physicians have expertise in shoulder, hip, knee and ankle replacements.  They are trained to provide some of the most advanced solutions in adult reconstruction including Direct anterior Hip arthroplasty, and Custom-fit® knee arthroplasty, as well as Reverse Total Shoulder arthroplasty, and ankle replacements.

Joint Reconstructive Surgery

Through overuse and aging, our joints often become weak and painful, limiting movement and affecting daily lives. Healthy joint ends are covered with a cushioning layer of cartilage that protects the bones from rubbing against each other and causing pain. The effects of time and excessive wear-and-tear causes this cartilage to slowly wear away and leave our joints weak and unprotected.

Joints refer to the area where two or more bones meet. While there are different kinds of joints all over our bodies, the ones most commonly used and more easily damaged are synovial joints. Synovial joints include those in the neck, shoulders, elbows, wrists, hands, hips, knees, ankles and feet.

Joint disorders are common because of the frequent pressure applied to the area throughout our lives. They are most common in athletes and older people. But joint disorders such as arthritis and fractures do not necessarily result in lifelong pain. Joint reconstructive surgery offers relief for many people through safe and minimally invasive procedures by experienced professionals.

Joint reconstruction ranges from minor repairs to the damaged joint to total joint replacement. These treatment options can offer temporary pain relief or permanent solutions to joint disorders. The type of treatment best for you depends on the type and severity of your joint disorder. Together, you and your doctor can develop the most effective treatment option for your needs.
Some of the different types of joint reconstructive surgery include:

• Joint Replacement Surgery – Joint replacement is a complicated procedure that is for severe joint pain that does not respond to more conservative methods. Replacement surgery is usually performed on the hip, shoulder or knee. Prosthetic joints are designed to move just like regular joints and are made of durable metal and plastic to fit together smoothly. The length of relief depends on the individual, but replacement joints tend to last for over 10 years.
• Arthroscopy – Arthroscopy is a minimally invasive procedure that allows your doctor to make minor adjustments to joints through tiny incisions and the use of a camera. This procedure can help release pressure from a tight ligament to increase the range of motion for a stiff joint, remove bone spurs and trim soft tissues like cartilage.
• Osteotomy – Osteotomy or “bone cutting” removes a section of bone near a damaged joint. This shifts the weight away from the damaged cartilage to an area with healthier cartilage, temporarily relieving the pain. This procedure is typically performed on the knee or hip for younger patients who do not want to have joint replacement surgery yet.
• Resurfacing Surgery – Resurfacing is most commonly performed on the hip and is also for younger patients who may not benefit from total hip replacement. It is less complicated than hip replacement and usually retains a more normal feeling after surgery. Results can last up to 8 years, but long-term studies are not yet available.
• Arthrodesis – Arthrodesis fuses together two bones in a damaged joint to prevent the joint from moving and causing pain. This is a more extreme treatment method that is used when medication and other conservative methods are no longer effective.
• Small Joint Surgery – If joints in the hands or feet cannot be used because of damage, they may be replaced to restore limited movement and activities.

Joint reconstructive surgery can provide great relief to patients who suffer from severe pain that affects their everyday lives. Surgery can restore movement and make life easier. Talk to your doctor to find out if joint reconstructive surgery is right for you.

Total Joint Replacement

Sometimes the best way to relieve pain and restore function to a joint is to replace all or part of it with a prosthesis (an artificial joint). Prostheses are intended to restore function to the joint and relieve pain associated with arthritis, other chronic conditions, or traumatic injury.
Prostheses are designed to move like a regular joint. They are made of durable plastic and metal parts that fit together snugly but glide smoothly (as opposed to the painful friction associated with the worn cartilage of arthritic joints). The pieces are shaped like the structures they replace – for example, the damaged bones in a ball-and-socket joint of a hip or shoulder are replaced with a metal ball and plastic socket. They are held to the surrounding bone either with a locking mechanism or with a special bone cement.

The length and difficulty of recovery depend on the location of the joint replaced as well as the patient’s age and overall health. Hip or knee surgery typically requires temporary use of a cane or walker. Some pain and stiffness following surgery is normal. Gradually, the weakened muscles regain strength and flexibility as the patient becomes accustomed to using the joint. The physician will discuss when it is safe to return to any athletic activities. Once in place, prostheses usually perform well for up to a decade or longer.

Which joints can be replaced?

The hip and knee are the most frequently replaced joints, although it is possible to treat many others. Procedures include:

• Shoulder Joint Replacement
• Elbow Joint Replacement
• Wrist Joint Replacement (Arthroplasty)
• Hip Resurfacing
• Total Hip Replacement (THR)
• Total Knee Replacement
• Ankle Joint Replacement

Shoulder

Shoulder Replacement

Severe shoulder conditions with persistent symptoms that have not responded to conservative treatments may benefit from shoulder replacement surgery. Shoulder replacement surgery replaces the damaged joint with an artificial one that allows patients to enjoy painless motion and resume their regular activities.

Shoulder replacement surgery is often performed to treat conditions such as:

• Osteoarthritis
• Rheumatoid arthritis
• Rotator cuff tears
• Osteonecrosis

Patients with severe cases of these conditions often experience pain, limited range of motion, stiffness, swelling and more. These symptoms can be effectively relieved by replacing the damaged bone and cartilage with a metal and plastic implant. Similar to the hip, the shoulder is a ball-and-socket joint that can be significantly improved with joint replacement surgery.

Shoulder replacement surgery takes about two hours to perform and is usually done under general anesthesia. It may be performed arthroscopically or through a traditional open procedure that requires a four to six inch incision.

Patients will be required to stay in the hospital for one to three days and will need physical therapy in order to restore function to the joint after surgery. Most patients are able to return to all of their regular activities after two to three months.

While shoulder replacement surgery has been performed successfully for many years, there are certain risks involved with any surgical procedure. Some of these risks may include infection, blood clots, nerve injury, instability and loosening of the implant. These risks are considered rare, and most patients experience symptom relief and improved range of motion after this procedure.

Reverse Total Shoulder Replacement

Reverse total shoulder replacement is a surgical intervention that aims to repair a condition known as rotator cuff tear arthropathy. This is different than total shoulder replacement because it switches the formation of the glenoid-humeral joint. Naturally, the “ball” of the joint exists as the terminal end of the humerus, but after this procedure the glenoid will be changed into a spherical object that the humerus head can articulate around. This allows the deltoid muscle to lift the arm instead of the torn rotator cuff.

Although this is a very effective method for relieving pain at the shoulder joint, it is normally the last option considered. It is still an invasive surgery that resurfaces the bones, which can be very risky, especially in patients most likely to require this surgery. The bones of elderly individuals are continually weakening as they age, so it is important for doctors to take this into account when determining if the surgery is worthwhile. Additionally, the patient may no longer be able to lift their arm more than a 90 degree angle after this procedure.

Hip

Total Hip Replacement

The hip is a “ball-and-socket” joint where the “ball” at the top of the thigh bone (femur) fits inside the “socket” in the pelvis (acetabulum). A natural substance in the body called cartilage lubricates the joint. When the bone and/or cartilage of the hip becomes diseased or damaged from arthritis, hip fractures, bone death or other causes, the joint can stiffen and be very painful. A total hip replacement may be recommended for patients who experience severe, chronic hip pain and can’t do what they want or need to do in daily life.

In a total hip replacement, the diseased bone and cartilage are replaced with an artificial joint called a prosthesis. The surgery takes from two to four hours. Patients usually enjoy immediate relief from joint pain after the surgery.

Minimally Invasive Total Hip Replacement

Total hip replacement is a common surgical procedure that replaces damaged bone ends within the joints with a metal and plastic prosthetic device. New advances allow for the use of minimally invasive techniques to perform this procedure and offer patients significant advantages over the traditional procedure.

Minimally invasive total hip replacement is done through one or two small incisions into which the implants are placed with special surgical instruments. The muscles and tendons are only slightly detached and then repaired once the implants are placed to encourage quick healing. This procedure is often performed under X-ray guidance to ensure precise placement of the implant.

With minimally invasive total hip replacement, patients can benefit from:

• Less pain
• Less scarring
• Less muscle damage
• Faster recovery
• Shorter hospital stay

This new procedure is often performed on younger, thinner and healthier patients who may be more motivated to achieve a fast and thorough recovery from hip replacement surgery.

Modified, “Direct Anterior” Hip Replacement

Our Physicians have the most extensive experience with Direct anterior approach hip arthroplasty in the Tucson Area, and are amongst the first nationwide to adapt and perform this surgery in their practice.  The direct anterior approach offers the patient a truly Mini-Incision hip replacement with the added benefit of minimal dissection, significantly decreased likelihood of dislocations and “no tendon or muscle resection”.  Out typical Modified direct anterior patient has a faster rehabilitation course as well as shorter hospital stay (1-2 days).

Hip Resurfacing/ Resurfacing Arthroplasty

In patients with increased lifestyle demands and activity requirements, and those who are younger in age with good bone stock Hip Resurfacing offers a fantastic solution that will provide for minimal bone resection and maximal range of motion.

Knee

Total Knee Replacement

The knee is a hinge joint where the thigh bone (femur) and the bone of the lower leg (tibia) meet. Arthritis (particularly osteoarthritis) and certain knee injuries and diseases can damage the cartilage that normally cushions the joint, leading to pain and stiffness. A knee replacement may be recommended when more conservative treatments — such as anti-inflammatory medications and cortisone injections — fail to relieve pain or improve movement.

During a total knee replacement, the entire joint is replaced with an artificial prosthesis. The end of the femur is replaced with a metal shell. Then the end of the tibia is fitted with a plastic cup and a metal stem that fits into the shell on the femur. This reduces friction in the joint, easing pain and allowing a greater range of movement. The main ligament of the knee (the posterior cruciate ligament) may be left in place, removed or replaced with an artificial post. The kneecap may also be replaced with, or supported by, a piece of plastic. The surgery itself lasts between one-and-a-half and three hours.

After the procedure, the patient rests in a recovery room and then in a hospital room. Patients usually experience immediate relief from the joint pain suffered before the replacement. However, there will be some post-operative discomfort. Physical therapy starts right away to speed healing and to ensure that the patient enjoys full use of the joint. Therapy progresses from use of walkers and crutches to walking on stairs and slopes, with home exercises to supplement formal sessions. In addition, continuous passive motion (CPM) machines can reduce recovery time and the risk of muscle contracture without straining the joint.

Knee replacements today last about 20 years in 85-90% of well-selected patients.

Unicondylar Knee Replacement

Also known as unicompartmental knee replacement, unicondylar knee replacement is a less invasive alternative to a total knee replacement. This procedure is designed to replace only the portions of the knee most damaged by arthritis, leaving the healthier portions intact and letting patients benefit from less scarring, shorter recovery times and a fuller range of motion.

This procedure is commonly performed on younger, more active patients who do not wish to undergo a total knee replacement yet, or for patients whose arthritis is localized in one specific area of the knee.

Unicondylar Knee Replacement Procedure

During a unicondylar knee replacement, your doctor will make a small incision in the front of the knee or wherever the damaged area is. Small pieces of bone are then removed from the damaged area of the femur and tibia, and are then replaced by metal prosthetics. The metal pieces are separated by a plastic insert that allows for smooth, fluid motion of the joint after surgery.

Depending on where the damage is, the inner or outer parts of the knee can remain untouched during this procedure, resulting in less bone loss and a greater range of motion. After a unicondylar knee replacement, many patients fully recover within a month and are still able to partake in low impact sports and other activities.

Shape Fitting technologies and Computer Assisted Navigation

Alignment and anatomy are the most important considerations in any joint replacement surgery and specially so in Knee replacement surgery.  The knee is comprised of 3 separate articulations, optimal replacement will have to move in unison and in concert to replicate the motion of the native articulation.  In order to increase satisfaction in our patients, we strive to restore our patient’s native anatomy and  biomechanics.  The initial advance in knee arthroplasty utilized by our surgeons was through use of computer assisted navigation, now with the advent of MRI based native anatomical matching technology such as Stryker® OTIS-Med Custom-fit®,  Smith and Nephew® Visionair®, Depuy® TruMatch®, and Biomet® Signature® our surgeons replace your native worn-out knee with a custom fitted knee replacement in your native alignment.

Ankle

Total Ankle Replacement

Total ankle replacement is a surgical procedure used to relieve pain and restore movement to damaged ankle joints. Damage to the ankle joint is usually caused by injury or age-related degenerative conditions such as arthritis, which tend to get worse if left untreated. These conditions can leave patients with severe pain, stiffness, limited range of motion and an eventual loss of function of the ankle. These symptoms can seriously affect a patient’s quality of life, which is why thorough and effective treatment is necessary.

Ankle replacement surgery is one of the most effective treatment options available for severely damaged ankle joints. Since it was first performed over 30 years ago, this procedure has been constantly evolving to provide the best possible results for patients. While it is difficult to restore full function to the ankle, many patients are able to experience a drastic improvement in ankle function after this procedure.

Who is this procedure recommended for?

Total ankle replacement is often considered a last resort for treating ankle conditions. Your doctor may first recommend conservative treatment to relieve the symptoms associated with your condition. If these treatments are unsuccessful, surgery may be beneficial.

The ideal patient for this procedure is someone who is over the age of 50 and not very active. While total ankle replacement can improve symptoms of arthritis and other painful conditions, it can also leave patients with a limited range of motion and limited support in their ankle joint after the procedure. Patients with severely deformed or unstable ankles, or those whose job requires heavy labor or running should not undergo this procedure. Talk to your doctor to find out more about your treatment options and if this procedure is right for you.

How is this procedure performed?

As with other joint replacement surgeries, total ankle replacement involves the removal of the damaged joint and the implantation of an artificial replacement joint, which helps restore function and support to the joint.

There are several different options FDA-approved for total ankle replacement, depending on the severity of your condition and your goals for after surgery. You can choose the best prosthetic device for you by speaking with your doctor.

The total ankle replacement procedure is performed under general anesthesia to help minimize pain and discomfort during the procedure. Your doctor will make an incision in the ankle and remove the damaged joint surfaces before inserting the artificial replacement to the leg and foot. The incision is then closed and the ankle is usually put in a splint or cast to keep it stable.

This procedure usually requires a short hospital stay and physical therapy to help the ankle heal. Compression stockings may be used as well for some time to help prevent swelling and bruising of the ankle.

What are the results of this procedure?

After a total ankle replacement procedure, most patients experience significant relief from symptoms of arthritis and other painful conditions. Many patients who were unable to walk before surgery can now do so, and can also enjoy simple activities such as bending, exercising and climbing.

What are the risks of this procedure?

Although total ankle replacement is considered to be a safe procedure, there are certain risks involved with any type of surgery. Some of these risks may include infection, bleeding, broken bones, dislocation of the new joint, nerve damage, artery damage or problems with anesthesia.

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Request an Appointment

To request an appointment, call Southwest Orthopaedic Surgery Specialists at (520) 327-9677. Our sports medicine center is opened Monday through Friday from 8:00 a.m. to 5:00 p.m. Alternatively, you may Request an Appointment through our web site.