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Arthritis surgery
Great advances have been made in the surgical treatment of rheumatoid arthritis
- Synovactomy: A synovactomy means removal of the synovium of the joint; this is practiced on the hands, feet and knees.
- Osteotomy: Is the division of the bone to correct weight bearing and relieve pain. Examples are found in the knee and the hip. It is more successful for osteoarthritis than for rheumatoid arthritis. By dividing the bone distilled to the joint and then letting it unite the weight bearing of the joint is realigned. An example is found in an osteotomy of the hip joint. In severe cases of ankylosing spondylitis spinal osteotomy maybe necessary.
- Arthroplasty: This means a new joint. This maybe a total hip replacement with metal to metal as in a McKee-Farroer or metal to plastic as in a Charnley. Other examples of new joint replacements are found in the (a Waldius or freeman- sawnson) and in the hand Calnan- Nicolle. This is also useful; for the weight bearing joints such as the hip and knee. Originally a simple cup arthroplasty was used to protect the damaged and painful femoral head, so that it could reform. Later on prosthesis was inserted into the femur to replace the worn femoral head. However the pain wasn't always relieved and the femoral component eroded. Now however the mechanism of arthroplasty has been improvised.
- Another method of arthroplasty is the Girdle stone. This however is less commonly used.
- Arthrodesis: means fixation of the joint. It is used in osteoarthritis. A rigid fixation of the joint is used for painful osteoarthritis of the hip joint in young people. It is important that there is good movement pf the spine and knee