On a musculoskeletal level, the human body can be deemed an exquisite machine that runs on a special blend of diet and exercise. But as high-performance vehicles go, new parts are sometimes required to keep us running, jumping and soaring. For many Americans, the most transformative form of bodily maintenance is a total joint replacement, be it of the hip, knee, shoulder or other.

Science and human ingenuity allow a majority of joint replacements to remain functional for over 20 years, and in the past this would have lasted the lifetime of most individuals. But as younger individuals undergo total joint replacements, a new level of maintenance must be stressed, especially as most of these individuals will often outlive the life expectancy of their own prostheses! To ensure such longevity, however, the most important mechanic in the body’s shop has to be the patient herself or himself.

The prostheses used in total joint replacements are themselves high-end pieces of engineering that require a particular form of maintenance. This doesn’t suggest daily upkeep, but vigilance in the short-term must be a part of any long-term strategy to keep one’s prosthesis in top condition.

Like any normal joint, a prosthesis will undergo wear and tear in its lifetime, and in a number of years the bearing surfaces which bears much of the load will have to be replaced. If left unchecked, the polyethylene, (plastic) will wear to the point where metal begins to rub on metal, causing severe discomfort which may require an operation to replace the prosthesis.  Replacing the load-bearing components is a routine and relatively simple step in the maintenance of a joint prosthesis.

As a patient, being aware of when you received your replacement and how physically active you are will factor into how long before the plastic bearing needs to be replaced. Normal wear becomes evident after an average of about 10 years, so it is prudent that patients get see their orthopedist at the 10, 15 and 20 year point to keep an eye on its long-term health.

Conversely, if a patient complains of pain and discomfort early on, this usually has little to do with wear and is often the result of loosening or infection.  This can occur due to biology or mechanical problems and should be attended to immediately.

Modern total joint replacements have very high rates of success and last longer than ever, but they can’t run forever without an individual’s sustained attentiveness. The best engineers know the secret of maintaining elite vehicles is how you care for what’s under the hood. When it comes to a new prosthesis, a set plan of long-term maintenance can lead to outsize benefits for the rest of your life.

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