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

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Presentation on theme: "Principles of Joint Surgery Kuo-An Lai Orthopaedic Department National Cheng Kung University Medical Center."— Presentation transcript:

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

2 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

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

4 Osteotomy To change the load of the joint

5 High tibial osteotomy For OA, varus deformity of the knee

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

7 Supracodylar osteotomy of the femur For valgus deformity of the knee

8 Innominate bone osteotomy For dysplasia of the hip

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

10 Habitual dislocation of the patella Proximal and distal realignment

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

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

13 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

14 Artificial joint arthroplasty Hemiarthroplasty Partial arthroplasty Total joint arthroplasty

15 Hemiarthroplasty Hip Femoral head prosthesis Bipolar prosthesis Shoulder Humeral head prosthesis

16 Femoral head prosthesis

17 Bipolar prosthesis

18 Humeral head prosthesis

19 Partial arthroplasty Unicompartment knee prosthesis

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

21 Total hip arthroplasty

22 Total knee arthroplasty

23 Total elbow arthroplasty

24 Total shoulder arthroplasty

25 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

26 Arthrodesis of the hip

27 Arthrodesis of the knee

28 Arthrodesis of the ankle

29 Arthrodesis of the wrist


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