Surgical Principles

Gulraj Matharu, 2009

There are a number of surgical procedures an orthopaedic surgeon can perform to treat diseases of the bones and joints.  

ARTHROSCOPY

= having a look inside a joint with a small camera

Performed under general anaesthetic

Camera inserted through small incision

Joints commonly arthroscoped = KNEE, SHOULDER, ANKLE, HIP, WRIST

Arthroscopy can either be diagnostic or therapeutic

Operations that can be performed with arthroscopy include:

Anterior cruciate ligament repair (KNEE)
Rotator cuff repair (SHOULDER)

ARTHROPLASTY

= surgical replacement of a joint

Nearly all joints can be replaced

Common joints replaced = HIP, KNEE, SHOULDER, ELBOW

Implants can last more than 10 years, but survival depends on:

The patient - young, active patients more likely to wear out implanted joint
The prosthesis - some implants last longer than others
 
N.B. Excisional arthroplasty = excision of arthritic joint

Rarely performed now due to joint replacement

E.g. MTP joint in foot excised for arthritis which subsequently heals by fibrosis  

ARTHRODESIS

= fusion of a joint

Fuse two bones together in fixed position

Improves pain but loss of joint mobility

Common joints fused = ANKLE, WRIST, JOINTS IN HANDS + FEET

DEBRIDEMENT

= 'cleaning'  the diseased joint

Can be done by arthoscopy, e.g.

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