Total Joint Replacement
What happens when healthy joints are no more?
Healthy joints are what keep our pet’s mobile. They help our pets stay active, comfortable and able to do what they love most: run, rest, run & repeat.
When a joint becomes diseased or abnormal, it can quickly become painful. This may occur as a result of arthritis, trauma, infection, tumour, congenital deformity or growth abnormalities. While the cause can vary, significant joint disease often begins once cartilage is damaged.
Cartilage plays an important role in helping joints move smoothly and comfortably. When cartilage is lost, pets can experience chronic pain, including limping and altered movement. Over time, this can lead to reduced mobility, reduced activity, weight gain and, in some cases, a shorter life span (Keeley JAVMA 1999).
What is a Joint Replacement?
A joint replacement is a surgical procedure that replaces part or all of a diseased joint with durable, long-lasting synthetic material. Joint replacements can be either partial or total, depending on the joint affected and the level of disease present.
These implants frequently comprise a titanium base with a bearing surface made from cobalt-chrome, stainless steel or ceramic, working against high molecular weight polyethylene. These materials are selected because they are strong, reliable and designed to move in a way that helps restore comfort and mobility.
The primary goal of joint replacement is to replace part or all of the diseased joint tissue with synthetic material that has similar properties to cartilage. By doing so, the procedure aims to reduce pain, improve movement and help pets return to a more comfortable, active life. These implants are designed to last a pet’s lifetime.
How do I know if my pet could benefit from a joint replacement?
Pets that have been diagnosed with an abnormal joint, such as arthritis, trauma, OCD or another joint condition, may be suitable candidates for joint replacement if they are showing signs of ongoing pain or reduced mobility. This may include reduced tolerance for exercise, being less inclined to exercise, intermittent or persistent limping, or an altered ability to jump onto furniture, climb stairs or get into the car. Some pets may limp in the morning, after rest or during activity, while others may hold a paw off the ground, lean away from a paw, or only toe touch when standing or walking.
Joint replacement may also be considered when a pet requires chronic use of medications, has a reducing response to medical management, or suffers adverse effects from medication. Pain medications, such as non-steroidal anti-inflammatories, also known as NSAIDs, or Gabapentin, can work wonders for painful joints, especially for short-term management. However, they are not a long-term solution and are not without risk of serious side effects, such as gastrointestinal ulceration, kidney disease and liver disease. Some patients also tolerate these medications poorly in the short term, with vomiting and diarrhoea developing, while others may develop significant behavioural problems while on these medications.
What factors influence joint replacement outcomes?
Joint replacement outcomes are influenced by both surgeon and patient factors. From a surgical perspective, experience, skill, training and, most importantly, case volume per annum are the key determinants of achieving successful outcomes in both animal and human joint replacements. GARS is the highest volume joint replacement & resurfacing centre in the country, meaning our team performs a significant number of joint replacement procedures.
Patient factors can also impact outcomes. Obesity can increase the risk of complications, while previous surgery may make some cases more difficult and increase the complication rate. If your pet has had prior surgery, this should be discussed with a GARS/MARS surgeon. Age is also considered, with joint replacement safely performed in patients from 6 months to 13 years old.
The surgical team also plays an important role. The surgeon team, including scrub assistants and nurses, must be experienced to help reduce complications. The specific joint being replaced and the underlying cause of the joint disease also influence the expected recovery and the likelihood of complications. These factors, along with other patient variables, help determine the most appropriate surgical approach and recovery plan.
Successful joint replacement requires a lead surgeon to have undertaken years of specialised training, years of high-volume joint replacement surgery, and to be supported by a truly exceptional and highly trained joint replacement team. You should not hesitate to ask about a surgeon’s experience, case volume and complication rate when considering joint replacement surgery for your pet.
What are GARS/MARS joint replacement outcomes?
GARS-MARS are extremely proud of our exceptionally low complication rate. We work tirelessly to maintain our average joint replacement success rate above 95%. This means that more than 95 out of every 100 joint replacements performed by our team will have a successful outcome.
Industry standards vary greatly across the globe and around the country, with success rates ranging between 70% and 95%. For comparison, the human Total Knee Replacement complication rate ranges from 1% to 5%, meaning 95 to 99 out of every 100 are successful (Gordon et al Arthroplasty 2022).
It is critically important that the right surgeon and surgical team is selected to maximise the chance of success. For joint replacement surgery, experience, case volume, training and team support all play a major role in achieving the best possible outcome for your pet.
Frequently Asked Questions
The youngest pet to undergo joint replacement with GARS/MARS surgeons was 5.5 months old, while the oldest was 13 years of age.
GARS/MARS offers one of Australia’s most advanced and experienced joint replacement surgical teams. We are Australia’s highest joint replacement case volume centre and one of the highest volume centres in the world. Our hospitals are the only hospitals in Australia to offer and perform total and partial joint replacements of the shoulder, elbow, hip, knee and ankle.
Our team was also the first in Australia to perform TATE3 Total Elbow Replacements and Total Ankle Replacements. We are known for an extremely low complication rate, which is industry leading, and our surgeons have conducted and published research on joint replacements. They have also undergone extensive further training and accreditation in joint replacement surgery and remain actively engaged in joint replacement research, technique refinement and improvement.
GARS/MARS surgeons have also mentored other joint replacement surgeons and surgical teams around the country to help improve outcomes. This combination of experience, case volume, research and ongoing surgical development is what makes the GARS-MARS joint replacement service one of the most established in Australia.
GARS/MARS is known as both a primary joint replacement centre, meaning we are often the first port of call, and a secondary or revision joint replacement centre. Other specialist teams commonly refer the most extreme and challenging cases to us, as well as failed replacement cases that require revision.
Achieving consistent success with the most complex and challenging replacements is a unique quality of our team and one of the key reasons pets are referred to GARS/MARS for joint replacement surgery.
We offer a second opinion service for all primary and revision, or secondary, joint replacements. If your pet has been to another specialist centre and you would like a second opinion for peace of mind, please don’t hesitate to contact us.
Most pets that undergo joint replacement, whether partial or total, are putting weight on the limb within 1 to 2 days. Elbow replacements are the exception and can take weeks before pets are putting consistent good weight through the leg.
By 6 weeks, implants are stable and patients generally return to normal, unrestricted activity from 6 to 8 weeks following surgery. We strongly recommend repeat radiographs at the 6 to 8 week mark to ensure everything is as it should be. This can be performed at your regular vet, who can send the radiographs to us, or it can be done with us.
Total Elbow and Total Ankle replacements have a soft padded bandage placed for 4 to 7 days following surgery. Hip, Knee and Shoulder replacements or resurfacing have a sticky dressing placed for 3 days, with no bandaging. All pets must wear a cone or inflatable collar for 2 weeks following surgery.
Post-operative medications usually include anti-inflammatories for 2 weeks, Gabapentin for 2 to 4 weeks, sedatives for 2 to 4 weeks and antibiotics for 1 week. Your pet’s medication plan will be discussed with you before they go home, so you know exactly what is required during recovery.
All cases must be walked on leash for 6 to 8 weeks following surgery. Strictly no off-leash activity is allowed for 6 weeks following surgery.
For Hip, Knee, Shoulder and Ankle replacements, pets usually start with 5-minute walks twice daily. Each week, 5 minutes can be added to the walk duration until they are doing 30-minute walks twice daily. For Elbow replacements, pets should have 5-minute walks three times daily for the first 3 weeks, then build by adding 5 minutes weekly.
Physiotherapy and hydrotherapy can be extremely beneficial following joint replacement or resurfacing and can commence from week 3 following surgery. We recommend it for all Total Elbow Joint Replacements and see it as an essential tool for these cases.
Other joint replacements or resurfacing procedures often don’t require physiotherapy or hydrotherapy, but we still support its use if you would like to include it in your pet’s recovery.
Partial joint replacements, Total Hip Replacements and Total Ankle Replacements usually require 1 night in hospital. Total Elbow Replacements usually require 1 to 2 nights in hospital.
We regularly have joint replacement patients travel from South Australia, Tasmania and New South Wales, with occasional patients from other states and territories. For interstate cases, and for any other patients where it is requested, we do offer longer hospitalisation for peace of mind and to help facilitate travel.
Time off work is typically not required. Pets usually stay in hospital for 1 night, or up to 2 nights for elbow replacements, which helps support their immediate post-operative recovery before they return home.
Confinement at home is critical following joint replacement surgery. This usually means a crate or small room with non-slip surfaces and nothing your pet can jump on. This helps protect the surgical site, supports implant stability and reduces the risk of complications during the early recovery period.
It is very common for pets to have both hips, both elbows or both ankles replaced. These are typically performed 6 or more weeks apart, with the average timing around 6 months following the first surgery.
