Arthroplasty
| Arthroplasty | |
|---|---|
| Intervention | |
| MeSH | D019643 |
Arthroplasty (literally "[re-]forming of joint") is an orthopedic surgical procedure where the articular surface of a musculoskeletal joint is replaced, remodeled, or realigned by osteotomy or some other procedure. It is an elective procedure that is done to relieve pain and restore function to the joint after damage by arthritis or some other type of trauma.
Background
Previously, a popular form of arthroplasty was interpositional arthroplasty with interposition of some other tissue like skin, muscle or tendon to keep inflammatory surfaces apart or excisional arthroplasty in which the joint surface and bone was removed leaving scar tissue to fill in the gap. Other forms of arthroplasty include resection(al) arthroplasty, resurfacing arthroplasty, mold arthroplasty, cup arthroplasty, silicone replacement arthroplasty, etc. Osteotomy to restore or modify joint congruity is also an arthroplasty.
For the last 45 years the most successful and common form of arthroplasty is the surgical replacement of arthritic or destructive or necrotic joint or joint surface with prosthesis. For example a hip joint that is affected by osteoarthritis may be replaced entirely (total hip arthroplasty) with a prosthetic hip. This would involve replacing both the acetabulum (hip socket) and the head and neck of the femur. The purpose of this procedure is to relieve pain, to restore range of motion and to improve walking ability, thus leading to the improvement of muscle strength.
Complications and Improvements:
Arthroplasty presents various and continuous challenges to the engineer and surgeon. The prosthetic selected must be nontoxic yet resistant, compatible and durable. Meeting all these criteria usually means that the prosthetic will not last 10–20 years. 75% of artificial knees will last 20 years and 90% will last 10 years.[1]
In recent years the technology has been improved with porous-coated prosthesis which allows for stronger bonding to the bonding, but an even more notable improvements have derived from the recent explosion in computer-assisted design and manufacturing (CAD/CAM). Using X-rays and other scans of the patient as well as modern 3D printing, personally tailored prosthesis are a reality for more and more individuals.[2]
1 Saladin, Kenneth S. New York: McGraw Hill, 2012. Print. Pgs 307-208.
2 "NIH 3D Print Exchange | A Collection of Biomedical 3D Printable Files and 3D Printing Resources Supported by the National Institutes of Health (NIH)." U.S National Library of Medicine. U.S. National Library of Medicine, n.d. Web. 22 Nov. 2016.
Indications
- osteoarthritis (OA)
- rheumatoid arthritis (RA)
- avascular necrosis (AVN) or osteonecrosis (ON)
- congenital dislocation of the hip joint (CDH) Hip dysplasia (human)
- acetabular dysplasia (shallow hip socket)
- frozen shoulder, loose shoulder
- traumatized and malaligned joint
- joint stiffness
Complications
- Infection
- Bleeding
- Periprosthetic fracture
- Loosening
- Mechanical wear
- Failure