Joint replacement surgery has been around for decades. Fortunately, the longevity of joint replacements has improved dramatically since the early days, creating successful outcomes for patients.
Orthopedic surgeons secured those early hip joint implants to the bone with cement.
"These would loosen up over time," said Matthew W. Russo, MD, an orthopedic surgeon who's an independent member of the HonorHealth medical staff. The instability would cause the joint implant to fail, requiring additional surgery.
Initial hip implants were made of plastic with a metal head. The metal ball would wear through the plastic over time; in the meantime, it would cause a reaction in the surrounding bone, weakening its connection to the prosthesis. "People would come back early for revision surgery," said Dr. Russo.
Over the years, joint replacement technology advanced significantly. The manufacturing of the plastic improved, boosting joint longevity.
Next came metal-on-metal hip implants. They looked promising at first because the metal allowed larger femoral heads to be used, which, in turn, reduced dislocation rates.
"The problem was, they released metal shavings into the bloodstream," Dr. Russo said. This created a host of other issues for patients, including tissue damage around the surgery site. When the body attempted to wall off metal shavings from the artificial joint, a collection of abnormal tissue formed.
"We now use a ceramic head and a plastic bearing," Dr. Russo said. The specialized ceramic is very strong, and the polyethylene (plastic) is produced in a new way that allows it to wear out much more slowly.
"Hip implants used to wear out over 10 years. Now they wear out at a rate of 0.1mm annually; in theory, it will take around 50 years for one to wear out. However, the technology hasn't been around that long, so we'll have to wait and see."
How to extend the life of a joint replacement
Today, knee implants are mainly made of titanium or cobalt-chromium, an inert substance that doesn't react with the body. Knee implants can last for many years when placed correctly.
"Their lifespan has a lot to do with the alignment of implants, and now robots help ensure they're properly aligned and balanced," Dr. Russo said.
After hip replacement surgery, it's important to give ample time to let the joint heal and the prosthesis to grow into the bone. "It's not the time to go jumping out of airplanes," Dr. Russo said.
Once the recovery process is over, most patients can enjoy an active lifestyle again by participating in low-impact exercise. Cycling, working on an elliptical machine and swimming are great ways to stay fit without stressing the artificial joint.
Check in with your surgeon periodically
After a joint replacement, it's important to see your doctor regularly to have the health of your implant evaluated. Dr. Russo advises his joint replacement patients to see him one year after surgery, at the five-year mark and then every five years after that to make sure everything is going well.
"If you've had joint replacement surgery, and you haven't seen the doctor in five years, you should make an appointment to get an X-ray," he recommended.
If you have any of these symptoms, call your doctor to have your joint implant evaluated:
- Any sign of infection, such as swelling, redness and heat
- A joint that no longer seems secure
"Hips can dislocate, and ligaments can stretch out in the knee," Dr. Russo said. "This can result in instability."
Although joint implants don't last forever, today's technology helps ensure that you can enjoy a comfortable and active lifestyle for many years.