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Joint Resurfacing

Definition

Joint resurfacing is a procedure that removes damaged joint tissue and uses a metal cap to create a new, smooth joint surface.

Resurfacing may be done on the hip, shoulder, or knee joints which are more prone to degenerative arthritis or wear and damage.

Osteoarthritis of the Knee
Knee arthitis
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Reasons for Procedure

Joint resurfacing may be done as part of treatment after an injury or for joints with arthritis or that have worn down over time. In either situation, damaged tissue in the joint is causing pain and making it difficult for normal function.

Joint resurfacing may be considered:

  • When other treatments, such as medications or physical therapy, have failed to improve function or pain.
  • When pain limits your activities and affects your quality of life.
  • As an alternative to joint replacement in people with limited knee damage.

Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:

  • Joint pain, stiffness, or instability
  • Loose joint
  • Dislocation
  • Excess bleeding
  • Infection
  • Blood clots
  • Nerve and/or blood vessel injury
  • Reaction to anesthesia
  • Lack of improvement in physical ability or less than expected

Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:

  • Smoking
  • Drinking
  • Chronic disease, such as diabetes or obesity

What to Expect

Prior to Procedure

Before surgery, you will meet with your doctor for a physical exam, medical history, and tests. You may have blood tests.

Imaging studies that may be done to evaluate the joint and surrounding tissue include:

Talk to your doctor about your medications. You may be asked to stop taking some medications up to two weeks before the procedure.

Anesthesia

You may be given either:

Description of the Procedure

An incision will be made along the joint. Muscles, tendons, and ligaments will be carefully moved aside. The joint may be moved from its normal position so that the surgeon will have access to the damaged area.

Damaged sections of tissue that lies over the bones, called cartilage, may be removed and smoothed down. Any excess build-up of bone will also be removed. A metal cap will be placed over the newly cleaned surface. If needed, a metal cup or plastic surface will be placed on the opposite joint surface as well. This is usually done with the hip or knee, but not the shoulder. When the repairs are done the joint will be returned to its normal place. Muscles and tendons will be moved back into place and the incision will be closed. A bandage may be placed over the incision.

How Long Will It Take?

1-3 hours

How Much Will It Hurt?

Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.

Average Hospital Stay

The hospital stay is usually about 1-4 days. If you have any problems, you may need to stay longer.

Post-procedure Care

At the Hospital

Right after the procedure, you will be in a recovery room where your blood pressure, pulse, and breathing will be monitored. Recovery may also include:

  • Pain medications
  • Antibiotics to prevent infection
  • Medication to prevent blood clots
  • X-rays to evaluate the new joint

Physical therapy will be started soon after surgery to get the joint moving. This therapy will help to regain the range of motion and strength of the joint. The therapist will also help you understand how to use assistive devices you may need as you heal.

During your stay, the hospital staff will take steps to reduce your chance of infection such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered

There are also steps you can take to reduce your chances of infection such as:

  • Washing your hands often and reminding visitors and healthcare providers to do the same
  • Reminding your healthcare providers to wear gloves or masks
  • Not allowing others to touch your incisions
At Home

You may need assistive devices once you are home. The devices will help support your joint until healing can be completed. The length of time you will have the assistive devices will depend on what joint is affected, how much work is done, and your overall health.

You may need assistance with some daily tasks. It may take about 6 weeks before returning to normal activity. The doctor and therapist will give guidance on returning to work.

Call Your Doctor

It is important for you to monitor your recovery after you leave the hospital. Alert your doctor to any problems right away. If any of the following occur, call your doctor:

  • Pain that cannot be controlled with the medications you were given
  • Signs of infections, such as fever and chills
  • Signs of infection at the incision site, such as warmth, redness, or excess drainage
  • Worsening joint stiffness, pain, or instability
  • Numbness or tingling in your arms, fingers, legs, or toes

Call for emergency medical services right away for:

Pulmonary embolism, a blood clot that is lodged in the lungs, which may cause:

  • Shortness of breath
  • Rapid breathing
  • Chest pain that occurs when you breathe or cough
  • Spitting blood

Deep vein thrombosis, an obstructive blood clot (mainly in the leg), which may cause:

  • Leg swelling and tenderness
  • Pain in the groin or buttocks
  • Swelling in the thigh
  • Redness, warmth, or skin discoloration

If you think you have an emergency, call for medical help right away.

Revision Information

  • American College of Surgeons

    http://facs.org

  • Ortho Info—American Academy of Orthopaedic Surgeons

    http://orthoinfo.org

  • Canadian Association of General Surgeons

    http://www.cags-accg.ca

  • Canadian Orthopaedic Foundation

    http://www.canorth.org

  • Hip resurfacing. American Academy of Orthopaedic Surgeons Ortho Info website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00586. Updated June 2010. Accessed February 26, 2014.

  • Joint resurfacing. Colorado Springs Orthopaedic Group website. Available at: http://www.csog.net/AreasofExpertise/JointResurfacing.aspx#HipResurfacing. Accessed February 26, 2014.

  • Knee joint resurfacing surgery. Massachusetts General Hospital website. Available at: http://www.massgeneral.org/ortho/services/sports/rehab/Knee%20Joint%20Resurfacing%20Protocol.pdf. Accessed February 26, 2014.

  • Shoulder joint replacement. American Academy of Orthopaedic Surgeons Ortho Info website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00094. Updated December 2011. Accessed February 26, 2014.

  • Total hip arthroplasty. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 20, 2014. Accessed February 26, 2014.