Arthroplasty

• Interpositional arthroplasty, previously a popular form of arthroplasty, with interposition of some other
  tissue like skin, muscle or tendon to keep inflammatory
  surfaces apart
• Excisional or resection(al) arthroplasty in which joint surface and bone is removed. The remaining ends are attached, or left to give time for
  metacarpal bone to the remaining phalanx.^[1]
• Resurfacing arthroplasty, where one or both bone surfaces are trimmed and replaced with a smooth metal covering.[2]
• Mold arthroplasty,
• Silicone replacement arthroplasty
• Osteotomy to restore or modify joint congruity

Complications and improvements

Arthroplasty presents various and continuous challenges to the engineer and surgeon. The prosthesis selected must be nontoxic yet resistant, compatible and durable. Meeting all these criteria usually means that the prosthesis will not last 10–20 years. 75% of artificial knees will last 20 years and 90% will last 10 years.^[3]

In recent years the technology has been improved with a porous-coated prosthesis which allows for stronger bonding to the body, but 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 prostheses are a reality for more and more individuals.^[4]

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

• Blot clots or deep vein thrombosis
• Infection
• Bleeding
• Periprosthetic fracture
• Loosening
• Mechanical wear
• Failure

See also

• Rheumasurgery
• Hip replacement
• Knee replacement
• Wrist osteoarthritis

References