• LIFE WITH INHIBITORS
  • JUST LIKE YOU
  • ELECTIVE SURGERY
  • THE COALITION
  • SUPPORT PROGRAMS
  • RESOURCES
  • CHANGING POSSIBILITIES


 
 

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    Total joint replacement, or arthroplasty [pronounced AR-thro-PLAS-te], is when the damaged bone and joint tissue is removed. This is replaced with metal, ceramic, and plastic parts. The artificial joint is called a prosthesis. In people with inhibitors, knees and hips have been replaced with good results. Other joints, such as shoulders and elbows, are replaced less often. The prosthetic usually lasts about 15 years.

    Elective joint replacement surgery may result in dramatically decreased pain and bleeding. You may also have increased mobility and improved quality of life once the joint is fully healed.

    Elective joint replacement surgery is a big decision. You must be committed to a tough rehab program after surgery. You must be very careful about preventing infection. The surgery requires admission to the hospital and is performed under general anesthesia. You may be in the hospital for 2 weeks or more.

    There is a chance of bleeding and infections. There is also potential for blood clots to form. Clotting factor will be given before, during, and after the procedure. Your hematologist will monitor you carefully for any sign of blood clots. It is important that you watch carefully for signs of bleeds and treat quickly if they occur.




      Elective total knee replacement surgery can relieve pain and help get your mobility back. It involves removing the damaged areas of the lower femur and upper tibia. These areas are replaced with metal and plastic parts called a prosthesis.

      The damaged portions of the thigh bone and cartilage are cut away. The end of the bone is reshaped so the replacement part can be attached.

      Next, the damaged portions of the lower leg bone and cartilage are cut away. The end of the bone is reshaped so the other prosthetic part can be attached to it.

      A plastic plate is attached to the lower leg bone component. The plate will support the body's weight and allow the thigh bone to move smoothly over the lower leg bone.

      Again, it is important to control bleeding through the whole process. This includes before, during, and after elective surgery. The recovery period is a critical time to control bleeding.

      Hemophilia Treatment Center at Orthopedic Hospital Los Angeles. Courtesy of James V Luck and Mauricio Silva
      Elective total hip replacement surgery replaces damaged parts of the hip joint. Surgeons use metal and plastic "ball and socket" prosthetic parts.

      The femur is separated from the pelvic bone socket joint.

      The damaged ball is cut off the thigh bone. The damaged cartilage and bone is removed from the hip socket. A metal shell is pressed into the socket of the pelvic bone and put in place.

      The surgeon will hollow out the end of the thigh bone. Then the metal implant is placed into it. A metal ball is then attached to the implant.
      Elective shoulder surgery can help improve your range of motion and reduce pain in the joint. During shoulder surgery, damaged bone and cartilage from the humerus and the glenoid are removed. They are replaced with a metal and plastic joint.

      The head of the upper arm bone is removed. The shoulder socket is smoothed and shaped. Then a plastic component is placed into the socket.

      The surgeon will then hollow out the upper arm bone. The metal stem of the prosthetic component is then placed into the bone. This acts like the upper arm bone's original head.
      Everyday tasks like shaving and carrying groceries are often simpler and less painful after elbow surgery. Although elective elbow replacement has been done, it is not as common as knee or hip replacement. There are limits on how much a person can lift after elbow replacement. Also, there are often problems after surgery.

      The elbow is a hinge joint consisting of 3 bones—the upper arm bone (humerus) and 2 forearm bones (radius and ulna).

      Elbow surgery in people with inhibitors involves removing the damaged end of the radius. This is called radial head excision. Often, synovectomy will be done at the same time to remove damaged tissue.

      This procedure usually results in good pain relief and improves forearm rotation. But, the amount you can bend your elbow will usually not change much.
      Joint fusion is performed to improve the ability to walk or bear weight. Called arthrodesis, joint fusion joins the bones to relieve pain. Two bones are joined together with screws, steel rods, or staples. The joint is no longer flexible, so this is usually done for joints like the ankle.

      During ankle joint fusion (arthrodesis), the main lower leg bone (tibia) is joined or fused to the ankle bone (talus). The surgery may be performed with an arthroscope or as an open procedure. After the operation, you may be able to go home after a few days to a week.

      Hemophilia Treatment Center at Orthopedic Hospital Los Angeles. Courtesy of James V Luck and Mauricio Silva