Week 3 Artificial Joint Replacements

Question 1

What are the indictions for arthritis surgery?

Answer 1

1. pain unrelieved by meds and other non operative measures
2. interrupts sleep
3. hinders ability to perform activities of daily living
4. reduces quality of life

Question 2

What are four categories of surgical treatment of arthritis?

Answer 2

1. Osteotomy-cut and realign bone, corrects joint malalignment and spares joints
2. debridement-historically used, for RA, remove inflamed synovium and smooth irregular articular surfaces
3. Arthrodesis-fusion of bones to *eliminate motion throughout that joint
4. arthroplasty-changing joint surfaces

Question 3

When would you use debridement as a surgical treatment for joints?

Answer 3

• best in young active patients, results may be short lived

* better if there are specific lesions that are addressed, i.e. degenerative meniscal tears, loose bodies in knees

Question 4

What must be avoided after a total joint arthroplasty?

Answer 4

Avoid impact activities such as running, jumping, contact sports

Question 5

What are contraindications to total joint replacement?

Answer 5

ABSOLUTE
-active infection!!! in the joint being replaced
-also if there is no arthritis in the joint: need to check for referred pain
RELATIVE
*morbid obesity
*neuropathic joints
*young age <45, due to wear and tear
-also progressive neuro disease, hx of IV drug use, non-compliance, non ambulatory

Question 6

What are the complications of total hip arthroplasty and total knee arthroplasty?

Answer 6

Hip
-infection!
-DVT
Knee
-infection and DVT also
Knee recovery is longer than hip recovery, more difficult rehab
-functioning extensor mechanism is required for good function
-incidence of both is increasing

Question 7

What is hip surface replacement?

Answer 7

• only replace surface of joint
• big head- has less risk of dislocation
• also has metal/metal articulation, leaching of metal ions
• risk: femoral neck fracture, esp. women