- Orthopaedic & Neurosurgery Specialists PC (ONS)

Approximately 1.07 million joint replacement procedures are performed each year in America. Without the surgeries, most of these men and women would be severely impaired, dependent upon walkers, canes and wheelchairs to get around. Hip, knee and shoulder replacement procedures have had a profound impact on quality of life for millions of people.

Once performed primarily on patients over 65, today many surgeries are done in younger adults whose active lifestyles have promoted an early onset of arthritis symptoms. It is projected that by 2030, more than 570,000 primary total hip replacements and nearly 3.5 million primary total knee replacements will be performed annually in the United States.

The ONS joint replacement team are some of the most experienced and qualified physicians in the New York Metropolitan area:

ONS Hip and Knee Replacement Specialists
John Crowe, MD
Frank Ennis, MD
Brian Kavanagh, MD
David Nocek, MD 

ONS Shoulder Replacement Specialist
Seth Miller, MD

Knee Replacement Surgery

There are several different treatment options for knee arthritis. Each patient is unique and some will respond to certain treatments better than others. It is usually best to begin with the most conservative treatments.

If conservative treatments for arthritis pain stop being effective and simple activities such as walking or climbing stairs become difficult or impossible, total knee replacement may be an option. In this procedure, the cartilage and bone surface is removed and resurfaced with a metal and plastic implant.

New minimally invasive and smaller incision surgerical techniques are being used for total joint replacement. Because less tissue is cut, these techniques may allow for quicker, less painful recovery and a more rapid return to activities.

Computer-assisted surgery is the newest generation of technology available in joint replacement. With the aid of a highly precise computer-imaging system, the surgeon creates a visual map of the knee that allows his to see beyond what is possible with the naked eye. Every aspect of the operation is tracked by computer including the surgical instrumentation and the positioning of the implant, enabling the surgeon to achieve extremely accurate implant alignment.

Traditional open surgery for total joint replacement used to involve a 6- to 10-inch incision. Minimally invasive, or minimal incision surgery (MIS) uses a 3- to 4-inch incision. 

Smith & Nephew - Total Knee Replacement

DePuy - About Sigma Rotating Platform Knee

Total Knee Replacement overview by AAOS

Hip Replacement Surgery

Hip arthritis typically occurs in adults aged 45 and older, when the cartilage that cushions the joint breaks down and eventually wears away. Characterized by pain and stiffness, severe cases can be profoundly debilitating.

If conservative treatments for hip joint pain fail to bring relief; if pain is impacting normal daily functioning and the ability to get a good night's sleep, total hip replacement surgery (arthroplasty) may be recommended.

The surgery is most often performed under regional anesthesia. The surgeon removes damaged cartilage and bone, then positions new metal, plastic or ceramic joint surfaces to reconstruct the joint.

An artificial joint is comprised of two basic components: the ball (made of a highly polished strong metal or ceramic material) and the socket (a durable cup of plastic, ceramic or metal). Special surgical cement is frequently used to secure the artificial joint in place.

Sometimes in younger, more active patients, a non-cemented type of prosthesis is used. This prosthesis is designed so that the bone will grow into and integrates with the porous surface of the implant. In some cases, a combination of a cemented ball and a non-cemented socket is used. 

DePuy - What to expect  Before, During and After Hip Replacement

Total Hip Replacement overview by American Association of Orthopaedic Surgeons (AAOS)

Shoulder Replacement Surgery

For patients with severe arthritis of the shoulder who have not achieved pain relief from non-operative treatments, or who have had a severe fracture, a total shoulder replacement is often an option. The surgeon replaces the damaged or arthritic joint surfaces with a highly-polished metal ball attached to a stem, and a plastic socket. In cases where the ball is severely fractured and the socket is normal, the surgeon may replace only the ball.

As with any joint replacement surgery, a rehabilitation program that includes physical therapy and home exercises is key to a successful recovery.

Reverse Shoulder Replacement Surgery

In severe cases, where the rotator cuff tendons are degenerated or torn beyond repair and the patient has a drastic loss of mobility and severe pain, a reverse shoulder replacement may be an option.

While approved by the FDA for use in the United States in 2004, reverse shoulder replacement has been used successfully in Europe for over 20 years. The surgery uses a metal and plastic implant that works the opposite of a normal shoulder by placing the ball onto the shoulder blade and the socket onto the top of the upper arm bone. The reversed position of the ball and socket alters the mechanics of the shoulder. By changing the center of the shoulder’s rotation, the strength needed to move the arm is shifted away from the damaged rotator cuff muscles allowing the deltoid muscle to take over.

A rehabilitation program including physical therapy and home exercises is important in order to make a full recovery from a reverse shoulder replacement surgery.

Shoulder Replacement overview by AAOS

Reverse Shoulder Replacement 

With baby-boomers now in their 60’s, the demand for better and safer joint replacement is growing. Surgeons continually strive to make the procedures less invasive, safer, and durable over time.