Arthroplasty (literally " e-orming 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.

Types

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 a

prosthesis In medicine, a prosthesis (plural: prostheses; from grc, πρόσθεσις, prósthesis, addition, application, attachment), or a prosthetic implant, is an artificial device that replaces a missing body part, which may be lost through trau ...

. For example, a hip joint that is affected by osteoarthritis may be replaced entirely (

total hip arthroplasty Hip replacement is a surgical procedure in which the hip joint is replaced by a prosthetic implant, that is, a hip prosthesis. Hip replacement surgery can be performed as a total replacement or a hemi (half) replacement. Such joint replacement ...

) 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.

Other types of arthroplasty

* Interpositional arthroplasty, previously a popular form of arthroplasty, with interposition of some other tissue like skin,

muscle Skeletal muscles (commonly referred to as muscles) are organs of the vertebrate muscular system and typically are attached by tendons to bones of a skeleton. The muscle cells of skeletal muscles are much longer than in the other types of muscl ...

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 scar tissue to fill in the gap. One variant of is the ''Stainsby procedure'' which consists of excision of part of a

proximal phalanx The phalanges (singular: ''phalanx'' ) are digital bones in the hands and feet of most vertebrates. In primates, the thumbs and big toes have two phalanges while the other digits have three phalanges. The phalanges are classed as long bones. ...

in a metatarsophalangeal joint, reduction of the plantar plate and

kirschner wire Kirschner wires or K-wires or pins are sterilized, sharpened, smooth stainless steel pins. Introduced in 1909 by Martin Kirschner, the wires are now widely used in orthopedics and other types of medical and veterinary surgery. They come in differ ...

fixation of the metacarpal bone to the remaining phalanx. * Resurfacing arthroplasty, where one or both bone surfaces are trimmed and replaced with a smooth metal covering. * 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. 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.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 Avascular necrosis (AVN), also called osteonecrosis or bone infarction, is death of bone tissue due to interruption of the blood supply. Early on, there may be no symptoms. Gradually joint pain may develop which may limit the ability to move. Co ...

(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 Fracture is the separation of an object or material into two or more pieces under the action of stress. The fracture of a solid usually occurs due to the development of certain displacement discontinuity surfaces within the solid. If a displa ...

* Loosening * Mechanical wear * Failure

References