7/28/2019 Artificial Joint Replacements

1/2

A. Four categories of Surgical Treatment for Arthritisa. Osteotomy

i. Cut bone and realign: good for joint misalignment that abnormally distributesforces

ii. Corrects joint misalignmentiii. Joint sparing: its not replacing the joint, which is good for younger patients

who; essentially delay or prevent joint replacement

b. Debridementi. remove inflamed synovium; smooth irregular articular surfaces (cleaning out a

joint or inflammation; improves healing potential of remaining healthy tissue

c. Arthrodesis (fusion)i. Eliminates motion at the joint (thus eliminating pain); most commonly done on

wrist, spine, ankle (hip and knee arthodesis are uncommon now; with knee=loss

of extensor mechanism)

d. Arthroplasty (joint replacement)i. Best option for pain relief, function and motion

ii. Has potential for wear, loosening, infection (not ideal for young, active,patients)

iii. Absolute contraindication: ACTIVE INFECTION IN THE JOINT, no arthritis (joint isnot the main pain generator, so there is no need to replace it)

iv. Relative contraindications: Obesity, Progressive neuromuscular (Parkinsons),Young age (e.g.

7/28/2019 Artificial Joint Replacements

2/2

Hip surface replacement uses a smaller approach: false Hip surface replacement has a greater risk of dislocation: false

What is an absolute total contraindication of THA? InfectionCan you do joint replacement:

On patients with Parkinsons? Yes. Less than 45 y.o? yes Obese? Yes

Which statement is true?

TKA/THA will need revision in 10 years Hips recover slower than knees DVT is a potential complication (TRUE)

What can be damaged in the carpal canal? Median Nerve

Is periarticular bone erosion part of RA? No, osteoarthris

What involves cutting bone to correct misalignment? Osteotomy

Which of the following is not a contraindication for THA?

a. obesity

b. Parkinsons

c. A and B.

d. active infection

B. In Slides:a. 4 signs of OA on X-ray: joint space narrowing, subchrondal sclerosis (layer of bone below

the cartlidgeincreased blood flow and pressure; increased bone density or thickening

in the subchondral layer, abnormally white (dense) bone along joint line), osteophytes

(bone spurs), cysts