Nearly every major joint in the body can be replaced with an artificial implant. Hip and knee replacements are by far the most common, but surgeons also replace shoulders, elbows, wrists, ankles, fingers, toes, and even spinal discs. The specific implant design, materials, and expected lifespan vary significantly depending on which joint is involved.
Hips and Knees: The Most Common Replacements
Hip and knee replacements account for the vast majority of joint replacement surgeries performed worldwide. Both procedures are well-established, with decades of registry data tracking how long implants last. For total knee replacements, about 90% are still functioning at 20 years, and roughly 82% last 25 years. Partial knee replacements (which resurface only one side of the joint) have a shorter track record, with about 70% surviving to 25 years.
These procedures are typically performed for osteoarthritis that hasn’t responded to physical therapy, medications, or injections. There’s no single pain score or X-ray finding that automatically qualifies someone for surgery. An international initiative by osteoarthritis researchers found substantial overlap in symptom levels between patients who were and weren’t recommended for replacement, meaning the decision is individualized rather than based on a hard cutoff.
Modern hip implants use a titanium stem pressed into the thighbone, with a ceramic or metal ball that sits in a cup lined with either ceramic or a specialized plastic called highly cross-linked polyethylene. Ceramic-on-ceramic pairings produce less wear debris over time, which reduces the risk of the bone around the implant gradually breaking down. The tradeoff is that ceramic bearings can occasionally produce a squeaking sound and are slightly more prone to fracture than plastic liners.
Shoulder Replacements
Two fundamentally different shoulder replacements exist, and the choice between them depends on the condition of your rotator cuff. A standard (anatomic) shoulder replacement mimics the natural anatomy: a metal ball replaces the top of the upper arm bone, and a plastic socket replaces the shoulder blade’s socket. This works well for arthritis when the rotator cuff tendons are still intact.
A reverse shoulder replacement flips the anatomy, placing the ball on the shoulder blade and the socket on the upper arm bone. This clever redesign lets the deltoid muscle power arm movement without relying on the rotator cuff at all. It was originally developed for people with both arthritis and severe rotator cuff damage, but its use has expanded rapidly because it performs reliably in a wider range of patients.
Elbow Replacements
Total elbow replacement is far less common than hip or knee surgery and carries higher complication rates. It was originally developed for severe rheumatoid arthritis but is now also used for osteoarthritis, post-traumatic arthritis, and certain fractures near the elbow that can’t be repaired with screws and plates alone.
The results are respectable but noticeably less predictable than larger joint replacements. For rheumatoid arthritis patients, 10-year implant survival ranges from 85% to 92%. Complication rates across all types of elbow replacement run between 14% and 80% depending on the underlying condition, with loosening of the implant from the bone, infection, and nerve irritation being the most frequent issues. Osteoarthritis patients face particularly high complication rates (around 50% in one study of 18 patients), though the implant itself still lasted beyond 10 years in about 89% of cases.
Ankles, Wrists, Fingers, and Toes
Ankle replacement has gained ground as an alternative to ankle fusion, which eliminates the joint entirely by bolting the bones together. Replacement preserves more natural motion, which matters for walking gait and protecting the joints above and below the ankle. It works best in patients with arthritis confined to the ankle joint itself, without major deformity or instability.
Wrist replacement is one of the less frequently performed procedures, typically reserved for rheumatoid arthritis or severe post-traumatic arthritis when both sides of the wrist joint are damaged. Because we place heavy demands on our wrists (pushing, gripping, twisting), implant loosening remains a concern, and wrist fusion is still chosen more often.
Individual finger joints can be replaced, most commonly the large knuckle joints at the base of the fingers. These small implants help restore grip and reduce pain from arthritis, particularly in people with rheumatoid arthritis who develop significant joint destruction. In the foot, the big toe’s base joint (where the toe connects to the foot) is the toe joint replaced most frequently. This joint bears significant force during walking, and replacement can relieve the pain of severe arthritis while preserving the ability to push off during each step.
Spinal Disc Replacement
Artificial discs are a less well-known option. Rather than fusing two vertebrae together (which eliminates motion at that segment), disc replacement inserts a device that mimics the cushioning and movement of a natural disc. This is most commonly performed in the neck for disc disease causing nerve compression or spinal cord pressure that hasn’t improved with conservative treatment.
Not everyone qualifies. Good candidates have a disc space that’s still at least 3 mm tall, no significant spinal instability, and no severe arthritis in the small facet joints behind the spine. People with osteoporosis, active infections, or inflammatory spinal conditions are generally directed toward fusion instead, because weakened bone increases the risk of the implant sinking into the vertebra over time.
Robotic Assistance and Implant Precision
Robotic-assisted surgery has become increasingly common for knee replacements and is expanding into hips and other joints. These systems use preoperative imaging to create a 3D surgical plan, then guide the surgeon’s cuts with sub-millimeter precision. The practical benefits for patients include less postoperative pain, faster functional recovery, shorter hospital stays, and lower revision rates compared to conventional techniques. A 2020 national database study found that robotic-assisted knee replacements also required less opioid pain medication afterward.
How Long Replacements Last
Implant lifespan depends on the joint, the patient’s activity level, body weight, and the materials used. Hips and knees have the longest track records and the best survival data. Smaller and more complex joints like elbows, wrists, and fingers tend to have shorter lifespans and higher revision rates, partly because the implants are smaller and the mechanical demands can be unpredictable.
Age at the time of surgery matters. Younger, more active patients put more cycles of stress through an implant over their lifetime, which increases wear. That said, implant materials have improved substantially. Modern highly cross-linked polyethylene and fourth-generation ceramic bearings produce far less wear debris than materials used even 15 or 20 years ago, which means today’s implants may outperform the survival numbers from older registry data.
If an implant does eventually wear out or loosen, revision surgery (replacing the original implant with a new one) is possible for most joints. Recovery from revision surgery is generally similar to the original procedure, with most people returning to work and daily activities within three to six months for hips and knees.