Other: Arthritic Joint Replacements

Question 1

Which material which can be used in a joint replacement may shatter with fatigue due to its brittleness?

Answer 1

Ceramic

Question 2

Name three indications for arthrodesis

Answer 2

End stage ankle arthritis, wrist arthritis and hallux rigidus

Question 3

What is an osteotomy?

Answer 3

Surgical realignment of a bone which can be used for deformity correction or to redistribute load across an arthritic joint and shift load onto an undiseased part

Question 4

When might a total elbow replacement be indicated?

Answer 4

An elbow severely affected by RA or OA at the humero‐ulnar joint which isn’t satisfactorily treated with conservative management

Question 5

What is a unicompartmental knee replacement?

Answer 5

Only the worn area of the knee is replaced

Question 6

When would a total knee replacement be indicated?

Answer 6

Only for older, medically fit appropriate patient with end stage arthritis and severe pain refractory to chronic management

Question 7

When would an knee osteotomy be indicated?

Answer 7

Early arthritis in very active patients who would damage or loosen a joint replacement

Question 8

What is a disadvantage of a unicompartmental knee replacement?

Answer 8

Progression of OA in unreplaced knee - reoperation rate significantly higher than TKR

Question 9

Which material which can be used in a joint replacement may cause an inflammatory granuloma (pseudotumour), leading to muscle and bone necrosis?

Answer 9

Metal particles

Question 10

What is arthrodesis?

Answer 10

Surgical stiffening or fusion of a joint in a position of function

Question 11

When might cartilage regeneration surgery be indicated?

Answer 11

Small localised area of articular cartilage damage of the knee with persistent pain

Question 12

Which material which can be used in a joint replacement may cause an inflammatory response in bone with subsequent bone resorption (osteolysis), resulting in loosening?

Answer 12

Polyethylene

Question 13

What is an excision/resection arthroplasty?

Answer 13

Involves the removal of bone and cartilage of one or both sides of the joint, effective for smaller joints e.g. 1st CMC joint in foot for hallux valgus

Question 14

What is the principle indication for a total hip replacement?

Answer 14

Pain

Question 15

When would a reverse polarity shoulder replacement be performed instead of an anatomic shoulder replacement?

Answer 15

In shoulder OA secondary to rotator cuff tear

Question 16

Why is a total elbow replacement not good for young/active patients?

Answer 16

Limited life span and come with a lifting restriction of 2.5 kg posteriorly post op

Question 17

When would a hip osteotomy be indicated?

Answer 17

Early arthritis in very active patients who would damage or loosen a joint replacement