Arthroplasty is the operative procedure for construction of a new movable joint. It is a surgical procedure to restore the integrity and function of a joint. A joint can be restored by resurfacing the bones. An artificial joint also known as prosthesis may also be used. Various types of arthritis may affect the joints. Osteoarthritis a degenerative joint disease results in a loss of the cartilage or cushion in a joint and is the most common reason for arthroplasty. It is not applicable to all joints it is used in the diseases affecting shoulder, elbow, hip, knee, certain joints in the hand, and the metatarso-phalangeal joints in the foot. Osteotomy to restore or modify joint congruity is also an arthroplasty.

 

Arthroplasty is the operative procedure for construction of a new movable joint. It is a surgical procedure to restore the integrity and function of a joint. A joint can be restored by resurfacing the bones. An artificial joint also known as prosthesis may also be used. Various types of arthritis may affect the joints. Osteoarthritis a degenerative joint disease results in a loss of the cartilage or cushion in a joint and is the most common reason for arthroplasty. It is not applicable to all joints it is used in the diseases affecting shoulder, elbow, hip, knee, certain joints in the hand, and the metatarso-phalangeal joints in the foot. Osteotomy to restore or modify joint congruity is also an arthroplasty.

 

Types of Arthroplasty 

Most successful and common form of arthroplasty is the surgical replacement of arthritic or destructive or necrotic joint or joint surface with prosthesis. If a hip joint is affected by osteoarthritis it may be replaced entirely with a prosthetic hip and the procedure is known as total hip arthroplasty. This would involve replacing both the acetabulum or hip socket and the head and neck of the femur. This is done to relieve pain and to restore range of motion to improve walking ability, thus leading to the improvement of muscle strength.

• Interpositional Arthroplasty – It involves placing of some other tissue like skin, muscle or tendon to keep inflammatory surfaces apart
• Excisional arthroplasty – In this procedure the joint surface and bone creating the problem is removed from the joint so that the scar tissue can grow and fill the joint space.
• Resection Arthroplasty
• Resurfacing Arthroplasty
• Mold Arthroplasty
• Cup Arthroplasty
• Silicone Replacement Arthroplasty

Indications for Arthroplasty

• Osteoarthritis – when it leads to disabling pain commonly involving shoulder, elbow, hip, hand and metatarso-phalangeal joints
• Rheumatoid arthritis – It can cause severe pain which cannot be controlled by medical measures requiring Arthroplasty
• Avascular necrosis or osteonecrosis
• Congenital dislocation of the hip joint Hip dysplasia
• Acetabular dysplasia
• Frozen shoulder, loose shoulder
• Traumatized and malaligned joint
• Joint stiffness
• Arthroplasty is used for the correction of certain types of deformity like hallux valgus
• In certain cases of Quiescent tuberculous arthritis especially of the elbow or hip Arthroplasty may be the only solution
•  In certain ununited fractures of the neck of the femur. It can work in several of these conditions as an alternative to arthrodesis.

Complications

• Bleeding
• Infection
• Blood clots in the legs or lungs
• Loosening of prosthetic parts

 

When Arthroplasty Is Required

 

 Arthroplasty may be used when medical treatments no longer provide adequate relief from joint pain and or disability. Some medical treatments for osteoarthritis that may be used prior to arthroplasty are -

• Anti-inflammatory medications
• Pain medications
• Limiting painful activities
• Assistive devices for walking
• Physical therapy
• Cortisone injections into a knee joint
• Weight loss
• Glucosamine and chondroitin sulfate
• Exercise and conditioning