Orthopaedic Surgery/Arthroplasty:General Principles

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Central to the practice of orthopaedic surgery is the idea that painful and poorly functioning joints are surgically treatable entities. In the past century, surgeons have attempted to replace the surfaces of joints to relieve pain and preserve function. The replacement of joint surfaces with artificial or alternative surfaces is called arthroplasty.

Arthroplasty can be performed successfully using a variety of substances including autogenous tissue. Typically, joint surfaces are exposed and the diseased joint is removed to provide a surface capable of accepting the arthroplasty material. One common result of this is that arthroplasty surgery is rarely a trivial affair as entire exposure of and replacement of the joint is a standard goal.

The standard elements of joint arthroplasty will be discussed. It should be noted that there is a common trend in both literature and practice to refer to arthroplasty as "adult reconstructive" surgery. This owes to the fact that the majority of arthroplasties are performed in patients suffering from osteoarthrosis which is a degradative process common in the joints of the elderly. Osteoarthrosis itself is most commonly referred to as "osteoarthritis" which signifies a wear-and-tear process in a joint. Although the term adult reconstruction is commonly used, it can be a type of misnomer because it suggests osteoarthrosis as the disease for which arthroplasty is the cure. On the contrary, arthroplasty is a surgical solution for many types of destructive joint disorders including the inflammatory arthropathies and neuroarthropathy.

With these concepts in mind, a discussion of the elements of arthroplasty can begin.