Joint Replacement

Question 1

Types of joint replacements available for hip?

Answer 1

Total hip replacement (THR)- the ball (femoral head) & socket (acetabulum) are replaced w/ an artificial joint.

Hemiarthroplasty - where the femoral head & neck is removed & replaced w/ a prothesis.
- often used for intra-capsular fractures in someone who already has reduced mobility.

NOTE: view images on notes

Question 2

Types of joint replacement available for knee

Answer 2

Total knee replacement (TKR) – where both sides of knee joint are replaced (lateral and medial part of patella).

Partial knee replacement - where only one side of knee joint is replaced either lateral or medial.

NOTE- VIEW IMAGE

Question 3

Types of joint replacement available for shoulder

Answer 3

Anatomical total shoulder replacement - where the ball & socket are replaced, & the implant resembles natural shape of bones.

Reverse total shoulder replacement - where both the ball & the socket are replaced, but the implants are reversed.
- The ball is attached to the shoulder blade & the socket is attached to the upper arm bone.

Partial shoulder replacement is when only the head (ball) of the joint is replaced.

NOTE- view image on notes

Question 4

What other types of joint surgery available?

Answer 4

Joint debridement- osteophyte removed- allows more movement

Arthroscopy- key hole surgery- used for stabilisation or rotator cuff repair

Joint excision- held w/ temporary wire & space fills w/ fibrous tissue

Joint arthrodesis (fusion)

NOTE- view images on notes

Question 5

What are the reasons (indications) for getting a joint replacement?

Answer 5

1. Severe pain
2. Lack of mobility - stiffness & swelling
3. Radiological changes e.g. loss of cartilage.
4. Interferes w/ daily life - reduced quality of life.
5. Symptoms are not adequately alleviated by non-surgical treatments.
6. Trauma & severe injury

Question 6

What are contraindications in joint replacement?

Answer 6

1. Infection - an existing infection or prone to infection.
2. Nicotine - smokers face a higher rate of medical complications & a higher need for revision surgery.
3. Severe osteoporosis - brittle bones cannot support & adhere to a new joint prothesis.
4. Unable to follow pre or post surgical instructions e.g. dementia or alcoholism = falls.

Question 7

Hemiarthroplasty vs total arthroplasty

Answer 7

Hemiarthroplasty can be better than total arthroplasty because:

• The operation will be quicker.
• Less chance of infection/blood loss
• Less chance of dislocation and fractures.
• Beneficial to elderly patients who come w/ hip fractures. The acetabulum (socket) can be still function properly even w. a little arthritis hence THR is not needed for elderly.

The benefits of having total arthroplasty are:
- Good for young, more active individuals.
- Allows normal mobility.

If younger individuals use THR & TKH they are more likely to:
- Have less severe pain
- Better long-term function
- Better overall mobility