Frequently Asked Questions
What is a prosthesis?
The word "prosthesis" comes from the Greek prothesis (addition). Prostheses used in orthopedic surgery generally aim to replace (partially or totally) a worn and painful joint. The prosthesis is an artificial joint, composed of synthetic mechanical parts (prosthetic implants) of the same shape as the joint. It provides, as much as possible, the same services as a natural joint (flexibility, stability, etc.). The surgical procedure for joint replacement with a prosthesis is called "arthroplasty."
What is a total prosthesis?
A prosthesis is "total" when it replaces all components of the joint. It is called a total prosthesis as opposed to a partial prosthesis. It consists of several mechanical parts. For the hip, the total prosthesis will replace the two joint components forming the hip joint: the spherical femoral head and the hollow part of the pelvis in which it fits, called the acetabulum. In some cases (fracture of the upper end of the femur), only the femoral head is replaced. This is then called a partial prosthesis (femoral prosthesis). The acetabulum remains in place and is not modified.
Why do I need a prosthesis?
A prosthesis is proposed when you suffer "too much" from a very worn joint. No currently available method can repair a damaged joint. When the pain becomes too bothersome despite well-conducted medical treatment (medications, injections, rehabilitation), prosthetic replacement is the only solution.
Can a prosthesis be used to replace any worn joint?
Some prostheses are currently well-established, even if improvements are always possible. The hip prosthesis has the longest track record. The first prostheses were implanted in the 1960s. The knee prosthesis is also commonly performed. Only certain teams have the competence to place newer prostheses such as those for the ankle. Finally, other prostheses are offered exceptionally, and often within the framework of studies, such as prostheses for the discs located between the vertebrae.
Where should I have the surgery?
The competence of the surgeon and the experience of the center where you will be operated on are what matter most. The choice between "clinic or hospital," as well as the choice between "university hospital or non-university hospital" is not very important if the surgeon who will operate on you is specialized in bone surgery (orthopedic surgery is the official term) and has good experience in placing the prosthesis you need. As for the place of intervention, it must be well-equipped, have a competent medical-surgical team (anesthesiologists-intensivists, physiotherapists, nurses, etc.), and approved facilities (quality technical platform).
Should I see the surgeon several times before deciding?
It is not mandatory, but it is often a good idea. The explanations provided at the first consultation may be difficult to understand, or you may have forgotten to address certain details. Furthermore, if the disability is not very significant, it is advisable not to make your decision at the first contact and to plan a second consultation a few months later.
To replace a worn joint, is emergency surgery necessary?
Placing a prosthesis to replace a worn joint is never an emergency. Avoid any haste, choose the surgeon carefully, inform yourself about the expected benefits, potential risks of the intervention, means to control or reduce them, and practical organization (plan the duration of hospitalization, convalescence, rehabilitation, return home, return to work, etc.). Do not hesitate to ask your questions to the doctors and paramedical team, to discuss your hesitations or apprehensions to better plan the intervention with the surgeon.
Can I live normally with a prosthesis?
The answer to this question is mixed: yes and no. Yes, it is possible to live almost normally with a prosthesis if you have usual daily activities and reasonable sports activities, because the majority of prostheses restore a painless joint, good mobility, and overall, a function close to normal. However, there are limits: movements of too great amplitude on certain joints (hip, shoulder) risk dislocating the prosthesis and intensive physical activity will cause faster wear of the prosthesis. Moreover, some prostheses are probably more fragile (notably those of the elbow and fingers) and require more moderate physical activities (avoid carrying heavy loads, adapted sports activity, etc.). But we advise you to take certain precautions: Be careful, living normally does not mean wanting to live as before at all costs! It is preferable to reorganize your life, set new priorities, new goals, or new pleasures.
Have your oral-dental condition regularly monitored and have all treatments covered by appropriate antibiotic therapy. Foot care should be minimally aggressive and performed by a professional.
Avoid intramuscular or subcutaneous injections near the prosthesis (risk of abscess).
Consult your doctor quickly in case of infection: sore throat, bronchitis, urinary infection, sinusitis, etc., for an examination and possible antibiotic prescription.
Consult your surgeon quickly if the scar is warm, red, painful, if there is discharge from the scar, if you have a fever and pain in the operated joint.
No blind antibiotic treatment (without a sample to identify the germ that may be in your prosthesis).
This sampling is delicate and we advise you to have it done in a specialized surgery department with an experienced team. An antibiotic treatment prescribed too quickly, without prior identification of the microbe, risks inducing considerable therapeutic difficulties, because the microbe can no longer be identified. Finally, if you travel to a distant country with a rudimentary health system, consult your doctor at least one month beforehand to assess the situation and remember to take out insurance with medical repatriation.