Orthopedics & Orthopedic Surgery
Ankle, Hip, Knee & Shoulder Replacement in Mankato
When you have joint replacement surgery, a team of providers consisting of orthopedic surgeons, physical therapists and professional nursing staff will support you from your first appointment through recovery. You’ll benefit from having:
- Comprehensive education for you and your caregiver
- Family coaching tools
- Ongoing communication with you and the care team after you’re discharged from the hospital
- Group therapy and meals
By taking advantage of positive group dynamics, you’ll feel accountable to yourself as well as the others in your group. Drawing strength from the group environment provides an improved response to treatment with faster recovery times.
Learn about ankle, hip, shoulder and knee replacement surgery. We also offer robotic orthopedic surgery for hip and knee replacement that provides greater precision and quicker recovery.
Ankle replacement surgery
Ankle replacement surgery at Mayo Clinic Health System in Mankato is a complex procedure that is considered only after attempting other treatment options. Speak with your healthcare professional to determine if you are a good candidate for this surgery.
Nonsurgical options for ankle pain
Treatment for arthritis in the ankles often begins with pain medications, such as anti-inflammatory medications, as well as a brace or other support, and physical therapy to strengthen the muscles around the ankle joint. Additional treatment options, such as cortisone injections or lubrication injections, may offer relief.
The following graphic shows where ankle arthritis occurs:
Surgical options for ankle pain
If nonsurgical options do not reduce your ankle pain, surgery may be appropriate.
Two procedures frequently recommended for ankle pain are:
- Ankle fusion. Ankle fusion is more common than ankle replacement because it typically lasts longer and does not require as many long-term activity restrictions. Fusion usually is recommended for younger patients with more active lifestyles.
- Ankle replacement. Ankle replacement is recommended for patients older than 60 who do not participate in high-impact activities, such as running, and who are not overweight. Surgery may not be a good option if you have weakened ankle ligaments, misaligned ankle bones, or nerve damage from diabetes or other medical conditions.
Recovering from ankle replacement surgery
During ankle replacement surgery, the ends of the damaged bones are removed and replaced with a joint made of plastic and metal. This artificial joint helps the ankle retain more movement, so arthritis is less likely to develop in nearby joints.
Following your replacement surgery, your ankle will be in a splint, and you will need to use crutches. You will not be able to put any weight on your ankle for several weeks.
Eventually, most patients will begin physical therapy and slowly move to weight-bearing activities. Typically, patients recovering from ankle replacement will need some type of splint or brace on the ankle for at least three months.
It may take a year after ankle replacement surgery to resume normal activities.
Hip replacement surgery
Overview
Anterior surgical approach
The anterior (front) approach to total hip replacement involves the surgeon entering through the front of the upper thigh. Surgeons work between muscles, eliminating the need to detach muscles from the bone. Some in the field refer to this as a “muscle-sparing approach.” In addition, the anterior approach is performed with the patient supine (lying on his or her back), which facilitates use of X-ray guidance and increases placement accuracy of prosthetic hip components.
Typically, patients who undergo this procedure can expect slightly faster recovery, gait improvements and less need for walking aids. However, every patient is different, and recovery also depends on additional factors, such as body type and how the patient lives his or her life.
Patients who are active, in good physical shape and younger are often the best candidates for an anterior approach hip replacement.
Anterolateral (Watson-Jones)
The patient is typically lying on his or her side, and the hip is approached on the side and then around the front (anterior) portion of the hip. The hip is opened between the gluteus medius (muscle on the outside of the pelvis) and tensor fascia latae muscles (small muscle just in front of the hip joint). In most cases, at least a small portion of the gluteus medius muscle needs to be released to facilitate adequate exposure of the hip joint for hip replacement.
Posterior surgical approach
The posterior (back), or traditional, approach involves the surgeon entering just behind the side of the hip bone. It has been the most commonly used approach to hip replacement for the last few decades and thus one that most surgeons are familiar with. Additionally, it can easily be extended to provide greater exposure of the pelvic bone and femur (thigh bone). Because of this, the posterior approach is typically recommended over the anterior approach for revision surgeries.
Transgluteal
The patient again is side-lying, and the hip is approached through the side. The front portion of the hip abductor muscles (gluteus medius and gluteus minimus) are then removed from the greater trochanter to open up the hip joint. It’s considered an extensile approach that permits broader access to the pelvis bone around the hip socket and the femur (thigh bone).
This approach classically has the lowest risk of dislocation (ball coming out of the socket) but does carry the risk of a persistent limp from weakness of the hip abductor muscles.
Knee replacement surgery
Knee replacement surgery — also known as knee arthroplasty (ARTH-row-plas-tee) — can help relieve pain and restore function in severely diseased knee joints. The procedure involves cutting away damaged bone and cartilage from your thighbone, shinbone and kneecap and replacing it with an artificial joint (prosthesis) made of metal alloys, high-grade plastics and polymers.
In determining whether a knee replacement is right for you, an orthopedic surgeon assesses your knee's range of motion, stability and strength. X-rays help determine the extent of damage.
Your doctor can choose from a variety of knee replacement prostheses and surgical techniques, considering your age, weight, activity level, knee size and shape, and overall health.
The most common reason for knee replacement surgery is to relieve severe pain caused by osteoarthritis. People who need knee replacement surgery usually have problems walking, climbing stairs, and getting in and out of chairs. Some also have knee pain at rest.
Shoulder replacement surgery
Damage to your shoulder is painful and limiting. If a shoulder injury or condition is serious enough, a shoulder replacement may be the best option for regaining your mobility and independence. Some common reasons why you’d need a shoulder replacement include:
- Arthritis
- Broken shoulder bone
- Conditions causing bone or joint deterioration
- Torn rotator cuff
Types of shoulder surgery
Anatomical total shoulder replacement
This is the most common form of shoulder replacement and involves attaching a plastic lining to the socket to allow smooth movement. The surgeon removes the top of the arm bone and inserts a metal stem with a ball on the end.
Anatomical total shoulder replacements are often conducted when a patient suffers from osteoarthritis or rheumatoid arthritis in the shoulder.
Reverse total shoulder replacement
The rotator cuff is a group of muscles and tendons that hold the shoulder joint in place and allow you to move your arm and shoulder. Problems with the rotator cuff may cause weakness or pain and restrict movement. It may also cause damage to the shoulder joint.
Often, tendons can be repaired. However, if the tendons are severely damaged, an operation called reverse shoulder replacement may be a better way to improve the joint's function and reduce pain, especially if the joint is affected by arthritis.
This operation is also called reverse arthroplasty. "Arthro" means joint; "plasty" means to mold surgically.
In a reverse shoulder replacement, the normal ball-and-socket structure is reversed. An artificial ball is attached to the shoulder blade. An artificial socket is attached to the top of the arm bone. The large deltoid muscle that covers the shoulder is typically able to move the arm.
For more information, watch this video on reverse shoulder replacement.