arthroplasty/ joint replacement

Question 1

joint replacement

Answer 1

involves wither replacement or part of the joint (hemiarthoplasty) or the whole joint (total joint replacement)

Question 2

most common joint replacements

Answer 2

are off the hip and the knee

Question 3

other joint replacements exist

Answer 3

for the shoulder, elbow, ankle, 1st metatarsophlayngeal joint of great toe (although arthrodesis preferred for ankle and 1st MTP joint of great toe), MCP joints of hand

Question 4

why are metal on metal replacements never carried out

Answer 4

they cause an inflammatory granuloma known as a psuedotumour which causes bone and muscle necrosis

Question 5

complications of joint replacements

Answer 5

• deep infection
• recurrent dislocation
• neuromuscular injury
• pulmonary embolism
• medical complications

Question 6

deep infections management

Answer 6

if diagnosed within first 2-3 weeks the joint is attempted to be salvaged if diagnosed after 3 weeks the joint is non-salvagagble

Question 7

deep infection diagnosed within first 2-3 weeks of joint replacement surgery

Answer 7

surgical washout, debridement and 6 weeks of IV antibiotics

Question 8

success rate of attempting to salvage joint

Answer 8

is only 50%

Question 9

deep infections diagnosed after 3 weeks of joint replacement

Answer 9

are not salvageable and the joint is removed and the person is let without a joint for 6 weeks while they are given IV antibiotics, after this point a revision joint replacement is carried out but has a much poorer functional outcome