1. REPLACEMENT ARTHROPLASTY FOCUSED ON THE KNEE Katherine Noonan BME 281 10/16/12

2. Joints Types: Hinge- knee and elbow Pivot- neck Ball and socket-shoulder, hip Replacement joints Need to be sturdy Provide support Titanium, stainless steel, chrome, or cobalt alloy Parts made from polyethylene plastic

3. Procedure Reasons for procedure : Severe arthritis pain Cant sleep through the night with the pain Pain limits daily activity i.e. cleaning, bathing, cooking etc. Unable to walk and take care of self Other treatments have failed Procedure is usually performed on individuals 60 years or older

4. Procedure continued Surgeon makes a cut 8 to 10 inches long Moves the patella out of the way and cuts the femur and tibia Fastens prosthesis to bones-femur prosthesis is usually made of metal alloy, tibia prosthesis is made from strong plastic, patella prosthesis is made from strong plastic. Attached with special bone cement

5. History 1860s- Fergusson performed a resection arthroplasty of the knee for arthritis 1940s- first artificial implants were tried as molds fitted to the femoral condyles following similar designs in the hip 1950s- tibial replacement was also attempted, but both designs had problems with loosening and persistent pain, then both tibial and femoral implants were tried together 1971- Gunston created a polycentric knee replacement which glided on femoral condyles and had early success with its improved kinematics over hinged implants

6. History continued 1973- The total condylar prosthesis was designed by Insall at the Hospital for Special Surgery- concentrated on mechanics and didn’t try to reproduce normal knee kinematics 1993- Ranawat et al reported a survivorship of 94% at 15 years of follow up Current- cemented total knee replacements

7. Limitations Serious risk due to surgery Infection Blood clots Nerve damage Knee flexion is never fully restored Recovery is anytime between 6 weeks and 3 months Prosthesis don’t last forever, about 10-15 years

8. Future Shorter recovery time More flexibility restored to the patient Less invasiveness of surgery

9. Citations Staff, Mayo Clinic. "Definition." Mayo Clinic. Mayo Foundation for Medical Education and Research, 15 May 2010. Web. 13 Oct. 2012.. "Types of Replacement Parts." Arthritis Foundation. Web. 13 Oct. 2012.. Palmer, Simon H. Total Knee Arthroplasty. 24 Feb. 2012. Web. 13 Oct. 2012.. "Oral Thrombin Inhibitor Dabigatran Etexilate vs North American Enoxaparin Regimen for Prevention of Venous Thromboembolism After Knee Arthroplasty Surgery." The Journal of Arthroplasty 24.1 (2009): 1-9. Print. Cartier, P., J. Sanouiller, and R. Grelsamer. "Unicompartmental Knee Arthroplasty Surgery10-Year Minimum Follow-up Period." The Journal of Arthroplasty 11.7 (1996): 782-88. Print.