Joint replacement for Arthritis

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One of the most rewarding surgical procedures that we can do is for painful arthritic joints. Over the past several years, new procedures have been developed to restore motion, eliminate pain, and re-align deformed arthritic joints of the foot. Also the development and refinement of joint replacement materials has taken quantum leaps in the past 10 years. These two developments have now made it possible for us to replace many of the "worn out" joints of the foot.

Over the past several years, research has been done to measure the amount of stress that we place on our feet with every step that we take. In reviewing this research, one comes away with a deep appreciation for what the foot does for us. It is indeed amazing that this part of our anatomy is able to take the abuse that we give it and just keep on working. There is a point, however, that the joints of the feet begin to become worn out and degenerative arthritis sets in. In figure 1 we see a normal joint, and in figure 2 a joint that is affected with a degenerative arthritis.

This form of arthritis generally first affects the great toe joint, but can be found in any of the joints of the foot. A person first becomes aware of this as the motion of the joint begins to diminish and it becomes increasingly more painful when the toe is bent. Ladies notice this first as they are unable to wear any kind of a high heel. As this progresses, motion becomes completely lost and the foot will then begin to compensate in order to continue walking. This will then cause knee and hip pain.

What can be done?

The goal of corrective surgery for these conditions is to restore function as best as can be done, to eliminate the pain, and to return the patient to normal shoes. When this procedure is done, the diseased portion of the joint is removed figure 3 and is replaced by a joint that is made of a material called Silastic figure 4. This is a material that is sturdy enough to withstand the stresses of walking and yet is flexible.

With this procedure, motion is restored to the joint immediately and very quickly the patient is able to return to a regular shoe and resume normal activity. In some case where the joints of the mid-foot and the rear-foot are involved, a fusion of the joint may be necessary. This also eliminates the pain of walking.