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Arthroplasty PowerPoint Presentation

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Description : Arthroplasty or joint replacement surgery, is a procedure of Orthopaedic surgery in which an arthritic or dysfunctional joint surface is replaced with an orthopedic prosthesis.

Tags : Joint Replacement, Types of Joint Replacement

Published on : Jun 10, 2020 | Views : 5150 | Downloads : 27

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ARTHROPLASTY PRESENTED BY: AAKANKSHA BAJPAI
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REPLACEMENT Arthroplasty or joint replacement surgery, is a procedure of orthopaedic surgery in which an arthritic or dysfunctional joint surface is replaced with an orthopedic prosthesis. It is often indicated for various joint diseases, including OA & RA. Arthroplasty removes damaged or diseased parts of a jt and replaces them with new parts. Arthroplasty can reduce pain and help you move and feel better. Hips and knees are replaced most often. Other joints that can be replaced include the shoulders, fingers, ankles, and elbows.
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Joint arthroplasty is performed most frequently to replace hip joints and knee joints. Involves the complete removal of the damaged joint and tissues to be replaced with an artificial prosthesis. The goal of the procedure is to relieve pain and restore a sense of normal function and mobility into the damaged joint. Arthroplasty are often recommended for patients experiencing severe pain and disability as a result of progressive arthritis.
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HIP REPLACEMENT Hip replacement (total hip arthroplasty) is surgery to replace a worn out or damaged hip joint. The surgeon replaces the old joint with an artificial joint (prosthesis). This surgery may be a choice after a hip fracture or for severe pain because of arthritis.
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TYPES OF HIP ARTHROPLASTY Replacement arthroplasty Excisional arthroplasty (girdle stone arthroplasty) Replacement arthroplasty is further divided into:- Hemireplacement (only head of femur is replaced) Total replacement (head & acetabulum are replaced)
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hemireplacement In hemireplacement one articular surface of joint (head of femur) is surgically removed & replaced with metal prosthesis. Two most commonly used prosthesis for hemireplacement arthroplasty are: Austin’s moore prosthesis Thompson prosthesis The stem of prosthesis is inserted into the bone through a drilling hole made in the proximal shaft of femur.
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The position of stem is secured by bone cement or by screw fixation around the prosthesis. The metal head is inserted in acetabulum & restores the function of hip joint.
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Total replacement In this arthroplasty both surfaces (head of femur & acetabulum) are removed. The femoral surface is replaced same as hemireplacement & the acetabulum is replaced by high quality polyethylene plastic cup.
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Excisional arthroplasty / girdle stone In this surgical procedure the head & neck of femur are removed surgically from the base of greater trochanter & this procedure creates a gap between acetabulum & femur. It is indicated in conditions where hip joint becomes extremely stiff & painful and no other treatment is possible. This procedure results in painfree joint on the cost of stability.
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Complications of arthroplasty Immediate complications. Delayed complications. Late complications. Immediate complications Nerve injury Vascular injury Immediate dislocation of prosthesis Prosthetic fracture (seen in osteoporotic cases)
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Delayed complications Infections Avascular necrosis Dislocation of prosthesis Late complications Degeneration of prosthesis New bone formation around the prosthesis Loosening of prosthesis
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Various types of arthritis and AVN may affect the hip joint: Osteoarthritis - This is a degenerative joint disease that affects mostly middle-aged and older adults. It may cause the breakdown of joint cartilage and adjacent bone in the hips. Rheumatoid arthritis - This type of arthritis causes inflammation of the synovial lining of the joint. It causes extra synovial fluid. It may lead to severe pain and stiffness. Traumatic arthritis - This is arthritis is caused by an injury. It may also damage the hip cartilage. Avascular Necrosis.
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TOTAL KNEE REPLACEMENT A total knee replacement is a surgical procedure whereby the diseased knee joint is replaced with artificial material. During a total knee replacement, the end of the femur bone is removed and replaced with a metal shell. The end of the lower leg bone (tibia) is also removed and replaced with a channeled plastic piece with a metal stem. Depending on the condition of the kneecap portion of the knee joint, a plastic "button" may also be added under the kneecap surface. The artificial components of a total knee replacement are referred to as the prosthesis.
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The posterior cruciate ligament is a tissue that normally stabilizes each side of the knee joint so that the lower leg cannot slide backward in relation to the thighbone. In total knee arthroplasty, this ligament is either retained, sacrificed, or substituted by a polyethylene post. Each of these various designs of total knee replacement has its own particular benefits and risks. The most common cause of chronic knee pain and disability is arthritis.
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Types of knee arthroplasty Partial or unicompartmental Total or bicompartmental Tricompartmental
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Partial/ unicompartmental The tibial articular surface is removed surgically & being replaced by metal prosthesis known as tibial component. some other name include ‘mcintosh’ or ‘sledge’ prosthesis can used.
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Total / bicompatmental Femoral & tibial condyles are replaced surgically & being replaced by tibial & femoral component.
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tricompartmental Both tibial & femoral componenet are removed & patellar component is also removed by patellar button.
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complications Development of infection Loss of stability of knee joint DVT Dislocation of prosthesis Compartmental syndrome Stiff knee joint
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Although there are many types of arthritis, most knee pain is caused by just three types: osteoarthritis, rheumatoid arthritis and, post-traumatic arthritis. Osteoarthritis- This is an age-related "wear and tear" type of arthritis. usually occurs in people 50 years of age and older, but may occur in younger people, too. The cartilage that cushions the bones of the knee softens and wears away. The bones then rub against one another, causing knee pain and stiffness.
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Rheumatoid arthritis- This is a disease in which the synovial membrane that surrounds the joint becomes inflamed and thickened. This chronic inflammation can damage the cartilage and eventually cause cartilage loss, pain, and stiffness. It is also termed as "inflammatory arthritis”. Post-traumatic arthritis- This can follow a serious knee injury. Fractures of the bones surrounding the knee or tears of the knee ligaments may damage the articular cartilage over time, causing knee pain and limiting knee function.
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TOTAL ANKLE REPLACEMENT Ankle arthroplasty is when the ankle joint (Talocrural Joint) is replace with prosthetic components comprised of polyethylene and metal and is preferred to ankle arthrodesis (fusion) as range of movement and function an not compromised. Main objectives of the arthroplasty are to Replicate ROM of the talocrural joint Function well under weight bearing Be wear resistent Maintain alignment and stability
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Generally here are common indications for arthroplasty: Primary or post-traumatic osteoarthritis Severe rheumatoid arthritis Rejected arthrodesis
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TOTAL SHOULDER JOINT ARTHROPLASTY Total shoulder arthroplasty, or TSA, is a procedure used to replace the diseased or damaged ball and socket joint of the shoulder with a prosthesis made of polyethylene and metal components. A reverse total shoulder arthroplasty, or rTSA, refers to a similar procedure in which the prosthetic ball and socket that make up the joint are reversed to treat certain complex shoulder problems. Several conditions can cause shoulder pain and disability, and lead patients to consider shoulder joint replacement surgery like rotator cuff arthropathy, osteonecrosis, severe fractures etc.
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Rotator Cuff Tear Arthropathy A patient with a very large, long-standing rotator cuff tear may develop cuff tear arthropathy. In this condition, the changes in the shoulder joint due to the rotator cuff tear may lead to arthritis and destruction of the joint cartilage.
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Avascular Necrosis (Osteonecrosis) Avascular necrosis is a painful condition that occurs when the blood supply to the bone is disrupted. Because bone cells die without a blood supply, osteonecrosis can ultimately cause destruction of the shoulder joint and lead to arthritis. Chronic steroid use, deep sea diving, severe fracture of the shoulder, sickle cell disease, and heavy alcohol use are risk factors for avascular necrosis.
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Severe Fractures A severe fracture of the shoulder is another common reason people have shoulder arthroplasty. When the head of the upper arm bone is shattered, it may be very difficult for a doctor to put the pieces of bone back in place. In addition, the blood supply to the bone pieces can be interrupted. In this case, a surgeon may recommend a shoulder replacement. Older patients with osteoporosis are most at risk for severe shoulder fractures.
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