Joint Replacement Surgery and Services at UPMC

Joint Replacement Surgery, Services and Treatments

Joint replacement specialists at UPMC Orthopaedic Care are experts in a wide array of treatments and surgical solutions, using the safest methods available.

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 always require surgery.

Doctors will first try other treatments before turning to surgery, including:

• Medicine
• Physical therapy
• Injections
• Bracing

Partial and total joint replacement surgery

Joint replacement 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 provide longer lasting outcomes and may be an option for people under 50 who need joint replacement surgery.

In some cases, doctors may also use this surgery to replace diseased or cancerous bone.

At UPMC, we have experience with many surgical methods and prosthetic devices.

In a joint replacement, our orthopaedic surgeons replace all or part of the joint with an artificial joint called a prosthesis. Most of the more modern artificial joints last 15 years. Some even last longer than 20 years.

The operation relieves pain and immobility for most people.

Types of joint replacement surgery

• 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, surgeons remove arthritic surfaces and resurface the knee with 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 cases.

Alternatives to joint replacement surgery

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

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

Besides non-operative treatments, surgical options may include arthroscopy, core decompression, or osteotomy.

Knee arthroscopy

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

We do not recommend this surgery for arthritis alone, but it may be helpful for people 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 tools 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 supply.

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

The success of the procedure varies. The greatest success rates occur at the early stages of bone death.

Benefits of this treatment are that it:

• Is a relatively simple procedure.
• Doesn’t limit future surgeries if needed.

Osteotomy

An osteotomy can help relieve knee arthritis symptoms that become worse because of deformity.

This surgery works by shifting the weight away from the damaged part of your knee to the other side of the knee. It can often delay the need for a knee replacement for up to 10 years, while still living an active life.

During an osteotomy, 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.