Arthroplasty
Arthroplasty
Arthroplasty
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ARTHROPLASTY
Types
1. Excision arthroplasty
Sufficient bone is excised to create a
gap which allows movement
(eg. Girdlestone)
2. Partial Replacement
One surface only is replaced
3. Total Joint Replacement
Convex component usually metal
bears on a concave component which
is usually polyethylene
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ARTHROPLASTY -indications
Disabling pain
Functional limitations
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ARTHROPLASTY-indications.
• Oteoarthritis or arthritis, which causes joint pain
that has failed to respond to conservative therapy
(NSAID medication for 6 months or more).
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ARTHROPLASTY-indications.
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JOINT REPLACEMENT- HISTORY - PAIN
Site
Radiation
Limiting activity
Disturbing sleep
Analgesics
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JOINT REPLACEMENT- HISTORY -
FUNCTION
Walking distance
Walking aids
Low chairs
Foot care
Stairs
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JOINT REPLACEMENT- EXAMINATION
Gait
Limb alignment
Range of movement
Stability
Peripheral circulation
Skin condition
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JOINT REPLACEMENT- INVESTIGATION
X-ray - alignment
- deformity
- previous fractures and implants
- AVN
- osteophytes
- bone loss
CT, MRI, bone scan - rarely
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JOINT REPLACEMENT
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JOINT REPLACEMENT
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JOINT REPLACEMENT
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JOINT REPLACEMENT- IDEAL
Painless joint
Full range of movement
Stable
Permanent
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JOINT REPLACEMENT- IDEAL
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ARTHRITIS : Knee arthroplasty
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JOINT REPLACEMENT -
HIP COMPLICATIONS
Dislocation - 1%
Loosening >90% 10y survival
DVT / PE
Infection - 1%
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JOINT REPLACEMENT-
KNEE COMPLICATIONS
Limited ROM
Patellar instability 3-5%
Loosening > 90% 10y survival
DVT / PE
Infection - 2%
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JOINT REPLACEMENT-
WHAT TO DO OR NOT TO DO
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