Cost of major joint replacement or limb replantation by state

What is a major joint prosthesis?

“Major joint prosthesis” is a medical term that refers to the replacement of a large joint that is required to walk and care for one's self. This generally refers to the replacement of the hip or the knee. In rare cases, this may also refer to a joint replacement in the shoulder.

Is joint replacement major surgery?

Yes, joint replacement requires the surgeon to move all the muscles of your hip/knee/shoulder away from the joint, cut down to the area of the joint, saw off large areas of bone, and hammer in a metal replacement for that joint. This is made more complicated by the fact that many of the patients who require these surgeries are past the age of retirement and have multiple medical issues that can lead to serious health problems during and after surgery. 

While joint replacement can be a cure for severe pain and result in a dramatic increase in quality of life, it can also result in serious complications and health issues. Because of this, it is critical to discuss your health with your surgeon and how it may affect their plan for surgery.

What is the most common joint replacement?

The hips and the knees are the most common joints that require replacement. This is due to the fact that they hold up a large amount of the body's weight and have a larger range of motion than the joints in the ankle and legs. This increased movement and weight lead to wear and tear that breaks down the joint over the course of years.

What is the difference between arthroplasty and replacement?

Arthroplasty is the modification of the joint not the replacement of the joint. Arthroplasty is typically attempted prior to joint replacement in some patients. Patients that benefit from arthroplasty are typically younger, have joint pain due to an injury, and are otherwise in good health. Arthroplasty is used to repair damaged ligaments, alter the cartilage that cushions the joint, and diagnose infections within a joint.

How does limb replantation work?

Limb replantation is a procedure that can reattach an arm, leg, hand, or foot that is cut off due to a traumatic injury or accident. A limb replantation works by reattaching the bone, muscles, ligaments, blood vessels, and nerves surgically. This is a long procedure that requires multiple skilled surgeons with extremely specialized tools. 

Unfortunately, the complexity of limb replantation means that a lot of things must go right for it to be an option. Some of the most common requirements are:

• The cut must be “clean.” Limbs that are crushed, have explosion-related injuries, or a large amount of trauma to the cut ends make reattachment of blood vessels impossible. 
• The cut must be recent. Limbs cannot be reattached if they have lost blood flow for several hours.
• The patient must be relatively healthy. Reattaching a limb is a long and complex surgery that extremely sick patients may not survive.

How successful is limb reattachment?

Limb reattachment is an extremely individualized procedure and each case is different. A general rule is the more of the limb that needs to be reattached the less successful the procedure will be. There are also some limb functions that can never be restored. Unlike bones, muscles, blood vessels, and nerves do not always grow back together after surgery to reattach them. Because of this, the limb is often numb, weak, and may have limited to no movement. This again varies based on the severity and location of the injury.

How long does limb reattachment surgery take?

Limb reattachment surgery can take an extremely long time. Reattachment of a limb requires the surgeon to reattach complex muscular structures and extremely small blood vessels. These vessels are so small that microscopes and special surgical tools are required. These surgeries can take upwards of 12 hours, even with a skilled team of surgeons working on multiple areas of the limb at once.