​ Joint Replacement and Adult Reconstruction Services

According to the National Institutes of Health (NIH), approximately 773,000 Americans have a hip or knee replaced each year.

If you have a joint condition, UPMC is enhancing this now-common surgery with:

• Evidence-driven treatment solutions
• Ongoing research
• An open-door policy that lets anyone see a joint replacement specialist without waiting months for an appointment

A Network of Support Services and Resources

Our joint replacement specialists have access to UPMC's incredible support services and resources, including:

• A complete operating room team
• A network of rehabilitation services
• An expert team of cardiologists, pulmonologists, physical therapists, anesthesiologists, and more

UPMC offers the kind of breadth and depth of experience that only a great team of experts can deliver.

Together, we are:

• Reducing infection
• Driving innovation
• Helping people move more and live more, with less recovery time

And, through the use of electronic medical records and a system that tracks patient success rates, we’re learning more each day while providing comprehensive orthopaedic care.

Leaders in Joint Replacement Surgery

As leaders in their field, joint replacement surgeons at UPMC are working to set the standards and protocol for joint replacement surgery.

And,  as a well-known research center, the University of Pittsburgh attracts some of the greatest minds in the field of medicine. They are heavily involved in research and teaching, and have access to some of the latest breakthroughs available.

Many people can benefit from joint replacement or one o f the many other alternative treatments available to alleviate symptoms or correct joint conditions.

Symptoms of Joint Conditions

Some common symptoms of joint problems include:

• Swelling around the joint
• Pain in the joint area, especially pain that keeps you awake at night
• Loss of joint function or movement

Joint Conditions We Treat

Joint specialists in the Department of Orthopaedic Surgery use joint replacement surgery to treat many conditions, including:

• Osteoarthritis — a condition associated with aging or abnormal wear of the joints that cause the cartilage to break down.
• Rheumatoid arthritis — an autoimmune disease in which the body’s immune system attacks cartilage in the joints.
• Arthritis due to trauma — fractured bones or injuries that damage the joint beyond repair.
• Bone cancer — certain bone cancers and some benign tumors that invade the joint bone.
• Developmental dysplasia of the hip
• Arthritis due to congenital and genetic disorders
• Developmental disorders leading to early arthritis
• Osteonecrosis — bone death due to a lack of blood supply.
  Some causes and risk factors for bone death include:
• Chemotherapy
• Radiation therapy
• Alcoholism
• Long-term steroid treatments or excessive steroid use
• Traumatic injuries, such as the dislocation or fracturing of a joint
• Lupus
• Sickle cell anemia

Anyone who has ongoing (chronic) pain or loss of function in a joint may be a candidate for joint replacement surgery.  

However, joint pain doesn’t usually require joint replacement surgery. Doctors usually try other measures, such as medical intervention, physical therapy, injections, or bracing before resorting to surgery.

Our joint replacement specialists at the Department of Orthopaedic Surgery are experts in a wide variety of treatments and surgical solutions, using the safest techniques available.

Partial and Total Joint Replacement Surgery

At UPMC, we’re experts in joint replacement and have experience with many techniques and prosthetic devices. Our operating rooms are supplied for any contingency for primary and revision joint replacement. We are familiar with the issues involving minimally invasive techniques ava ilable, navigation, and newer bearing surfaces.

In a joint replacement, our orthopaedic surgeons replace all or part of the joint with an artificial joint called a prosthesis.

• In hip replacement, surgeons replace the ball and the socket of the hip with various forms of metal, polyethylene, and ceramic tailors to the patient's needs.
• In a knee replacement, the arthritic surfaces are removed and the knee is resurfaced with a variety of metal and polyethylene components.
• A partial knee replacement does the same as a full knee replacement but for only one side of the joint. This can often provide a faster recovery, but it is limited to very specific patient situations.

The operation relieves pain and immobility for most people and is sometimes used in cases where bone is diseased or cancerous.

Most of the more modern artificial joints can be expected to last 15 years, and some longer than 20 years.

This surgery is ideal for older people. Younger, more active people have historically worn out parts of an artificial joint earlier. But more modern bearing surfaces appear to be providing longer lasting outcomes and may be appropriate for patients under 50 who require joint repla cement surgery.

Alternatives to Joint Replacement Surgery

To postpone or even avoid having to replace a joint, our doctors may choose another alternative treatment. It all depends on your situation and overall health.

Whenever possible, our orthopaedic surgeons will choose the treatment plan that gives you the most benefit with the least amount of invasive surgery.

Besides non-operative options, some surgical  treatment options may include any of the following listed below.

Knee Arthroscopy

Knee arthroscopy is minimally invasive, requiring only very small incisions.

It is not recommended for arthritis alone, but may be helpful for patients with arthritis complicated by:

• Meniscus tears
• Loose bodies
• Some types of joint lining problems

UPMC orthopaedic surgeons perform the surgery by inserting a tiny camera inside the knee at the source of the problem. They use the camera as a guide as they insert other instruments to repair the damaged area.

Core Decompression

Core decompression is a treatment for necrosis or osteonecrosis, where part of the bone has died due to lack of blood supp ly.

During a core decompression procedure, a surgeon relieves internal bone pressure by drilling a hole into the bone allowing for new blood vessels and cells to reach the area of the bone death.

• The success of the core depression procedure varies, although the greatest success rates occur at the early stages of bone death.
• Benefits to this treatment option are that it's a relatively simple procedure and doesn’t limit future surgeries if needed.

Osteotomy

An osteotomy can help relieve symptoms associated with arthritis when it iss being made worse by deformity. 

During this surgery, a UPMC surgeon makes a cut in one of the bones in the lower leg depending on where your pain originates and in the best place to correct the deformity.

When the surgery is on the:

• Shin bone, it's called a tibial osteotomy
• Thigh bone, it's called a femoral osteotomy

This surgery works by shifting the weight away from the damaged part of your knee to the other side of the knee.

An osteotomy can often delay the need for a knee replacement for up to 10 years, while still living an active life.