arthroplasty

Indications

Indications

Osteoarthritis

Rheumatoid arthritis

Avascular necrosis

History

First generation (late 70s early 80s) 

Results

Definition 

Disorder of immune system 

- antigen-antibody complexes

- stimulate release of proteolytic enzymes

- leading to vasculitis, synovitis and cartilage destruction

Characterised

Articular Effects

- synovitis

- ligamentous and capsular laxity

- cartilage destruction

- osseous erosion

Vasculitis

- rheumatoid nodules

Epidemiology

Extremely common

- 90% by 10 years have wrist problems

Principles

Landsmeer 1961

- treat wrist at same time as treat fingers or will recur

Frequently combine procedures

- synovectomy

- tendon transfer

- ulna procedure