The knee is a hinged joint, formed by the intersection of the femur and tibia and covered by the patella (knee cap). The bone ends of the femur and the tibia are covered with articular cartilage, which allows a gliding motion to take place. Shock absorption is provided by the meniscii, which form a "C" shaped cushion inside the joint. The bones are bound together by supportive ligaments, known as anterior cruciate and posterior cruciate. Surrounding muscles provide additional support, and also help move and decrease stress to the joint.

Total Knee Replacement
A properly functioning knee joint is essential to providing a good quality of life. Because the knee is so important for walking and activity, it experiences a lot of wear and tear throughout ones life. This degeneration through the years can lead to arthritis. The cartilage or smooth portion inside the knee joint can often wear down causing the bone ends of the knee to rub against each other. This causes limited walking distance, pain, swelling, and limitations in function. This can lead to a marked decrease in quality of life for many patients. Because of this, total joint replacement or, total knee arthroplasty is sometimes needed to restore the knee to a functioning level which is less painful and offers more range of motion to the patient. In the past, this procedure was limited for the elderly patient. Because technology has improved, this operation has become more available to the younger more active patient.

Prior to any operation, the conservative treatments need to be performed first. In most cases, degenerative arthritis of the knee can be treated with various conservative measures. These would include activity modification, medication, physical therapy and rehabilitation, walking aides, and sometimes injections. When these conservative measures fail, a joint replacement of the knee may be needed to control the patient’s pain and restore them to an active lifestyle.

The operation involves removal of the degenerative worn out cartilage and bone of the knee. The good bone is retained and a metal joint is placed in the knee. In between the metal is a smooth plastic liner that allows the knee to rotate smoothly for the patient.

Hip
The hip is a ball-and-socket joint formed by the head of the femur and acetabulum of the coxal bone. Unlike the shoulder, the hip sacrifices movement for additional stability, allowing only three planes of motion.

Total Hip Replacement
Hip replacement, or total joint arthroplasty, is a surgical procedure in which diseased or degenerated parts of the hip joint are replaced by new artificial parts. Over a hundred and twenty five thousand hip replacement operations are performed each year because of the degenerative disease of hip joints and osteoarthritis. Other diseases can often lead to the breakdown of the hip joint as well requiring total joint replacement surgery.

Total joint surgery is the last option used in the treatment of patients with severe arthritis of the hip joint. Prior to surgery conservative treatments are use. These include exercise, therapy, medication, walking aides, and sometimes in injections.

When these treatments are not affective in improving the function or relieving the pain of a degenerated hip joint, surgery may be an option to improve the quality of daily life of a patient in pain. The operation involves removal of the diseased bone and cartilage from the hip joint. The healthy bone is left intact. Smooth metal and a special plastic rim are placed into the hip joint creating a new socket. This allows this new hip joint to move freely without pain. Sometimes a special glue or cement may be needed to bond the metal to the healthy bone. The decision to use cement or glue depends on the disease process of the hips. Your surgeon will be able to discuss the advantages and disadvantages of these options.

After the operation, movement is limited because of the surgery. Physical therapy and exercises will help in quickly regaining the strength and motion to the new hip joint. The patient generally spends about 3 or 4 days in the hospital following a total hip replacement. Full recovery takes somewhere between 6 and 12 weeks. The results of the surgery are generally very good and lead to a markedly improved quality of life for the patients undergoing this procedure.