Principles of Joint Surgery Kuo-An Lai Orthopaedic Department National Cheng Kung University Medical Center.

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Presentation transcript:

Principles of Joint Surgery Kuo-An Lai Orthopaedic Department National Cheng Kung University Medical Center

Joint Disorders Degenerative joint disorders — OA Noninfectious inflammatory disorders-RA etc. Systemic and local metabolic disorders-Gout, AVN etc. Trauma and sequels Congenital and developmental disorders Infection and sequels Neoplasm Miscellaneous

Surgery of the Joint Extra-articular Intra-articular Combined Mini-invasive Arthroscope aided Computer aided

Osteotomy To change the load of the joint

High tibial osteotomy For OA, varus deformity of the knee

Valgus osteotomy of the proximal femur Nonunion of the femoral neck fracture

Supracodylar osteotomy of the femur For valgus deformity of the knee

Innominate bone osteotomy For dysplasia of the hip

Realignment of the soft tissue To change the track of the joint during motion

Habitual dislocation of the patella Proximal and distal realignment

Synovectomy and/or debridement To remove the diseased synovium and/or diseased tissue from the joint Rheumatoid arthritis Pigmented villonodular synovitis etc.

Resectional arthroplasty To remove the diseased joint surface Ulnar head Metatarsal heads Metacarpal heads Radial head

Interpositional arthroplasty To reconstruct the joint surface with either soft tissue membrane or artificial spacer Soft tissue interposition of the elbow Silastic rubber interposition of the MP joint in hand with RA

Artificial joint arthroplasty Hemiarthroplasty Partial arthroplasty Total joint arthroplasty

Hemiarthroplasty Hip Femoral head prosthesis Bipolar prosthesis Shoulder Humeral head prosthesis

Femoral head prosthesis

Bipolar prosthesis

Humeral head prosthesis

Partial arthroplasty Unicompartment knee prosthesis

Total joint arthroplasty Total hip arthroplasty Total knee arthroplasty Total elbow arthroplasty Total shoulder arthroplasty Total ankle arthroplasty Wrist etc

Total hip arthroplasty

Total knee arthroplasty

Total elbow arthroplasty

Total shoulder arthroplasty

Arthrodesis To create solid fusion of the joint to prevent its motion For active infection, salvage of failed total joint arthroplasty, severe neuromascular disorders, severe trauma and some tumors Functional position

Arthrodesis of the hip

Arthrodesis of the knee

Arthrodesis of the ankle

Arthrodesis of the wrist