1. In principle, elderly people over 60 years of age with severe bone destruction on knee x-ray, significant pain, standing or walking dysfunction due to deformity and/or twinning of the joint, instability, are surgical indications for artificial knee replacement.
2. The purpose of surgery is, firstly, to relieve pain and, secondly, to improve the stability and mobility of the knee joint. Determine the indications for surgery according to the patient’s condition, age, occupation, weight, and mental status; Yang Yong, Department of Orthopedic Surgery, Xinxiang First People’s Hospital.
3, primary osteoarthropathy, rheumatoid arthritis, traumatic arthritis and some other non-septic arthropathies in the late stages.
4, male osteoarthritis patients aged 40-60 years old, if they must engage in physical labor, are suitable for osteotomy or joint fusion. Patients of the same age with osteoarthritis, who have impaired mobility due to pain and deformity, are also surgical indications for artificial knee replacement in order to improve quality of life.
5. For patients with bone tumors in the distal femur or proximal tibia who are in a position to preserve their limbs, artificial knee arthroplasty with special prosthesis can be performed after resection of the tumor segment.
When choosing total hip arthroplasty, the following should be considered
1. general health status: the presence of complications of the heart, lung and brain systems and whether they can withstand the surgery.
2, age: there is a trend to relax the age of surgery.
3.Occupation: for people with strong physical labor. Preferably not artificial total hip arthroplasty.
4, patient requirements: in principle, the purpose is to relieve pain, correct deformity and improve function.
5.Bone quality of the hip.
Indications: firstly, to relieve hip pain, secondly, to improve hip function.
1, old femoral neck fracture: both head and socket have been destroyed and painful, affecting the function
2, ischemic necrosis of the femoral head: including traumatic, idiopathic, cortisone alcoholism-induced ischemic necrosis of the femoral head; Ⅰ, Ⅱ stage is feasible, such as head and neck drilling and decompression, rotational osteotomy in the rough area, for Ⅲ, Ⅳ stage ischemic necrosis of the femoral head, the femoral head has collapsed, deformation, acetabulum has been destroyed, feasible total hip arthroplasty.
3, degenerative osteoarthritis: mostly seen in the elderly, for osteoarthritis with severe pain, artificial femoral head replacement is not effective, artificial total hip arthroplasty should be performed.
4, rheumatoid arthritis and ankylosing spondylitis: mostly seen in younger patients, due to.
(1) intolerable hip pain or severely limited activity due to ankylosis.
(2) deformities of the hip joint often causing concurrent deformities of other joints.
(3) small range of joint movement due to contracture and fibrosis of soft tissues such as hip capsule and muscles. Although the patient is young, his physiological age aging should relax the age limit for early total artificial hip replacement.
5, hip joint ankylosis: hip pain is the most important surgical indication. Unilateral hip joint ankylosis in physiological position without pain is not an indication for surgery; artificial total hip arthroplasty is feasible for hip joints with incomplete bony ankylosis but with pain and deformity.
6, chronic hip dislocation: mainly including congenital hip dislocation, acetabular dysplasia and old dislocation due to trauma and infection; hip subluxation with hip traumatic arthritis, patient pain or loss of function, patients over 45 years old can be considered for artificial total hip arthroplasty.
7. Failed cases: failed arthroplasty cases, including post-osteotomy, post-head and neck resection and post-dual cup artificial femoral head and total hip arthroplasty cases.
The main indications for resurfacing surgery are hip pain, poor joint mobility or in order to adjust the length of the limb is not an indication for surgery, and the indications for performing resurfacing surgery are
(1) Hip pain caused by loosening of the prosthesis.
(2) Fracture of the stem of the prosthesis.
(3) dislocation of the prosthesis and failure of manipulative repositioning
(4) those with painful central dislocation caused by wear and tear of the acetabulum due to the prosthesis; those whose prosthesis stem penetrates the femoral stem due to surgery, such as those without pain are relative indications for surgery.
8, bone tumor: low-grade malignant tumor located in the femoral head neck or acetabulum, such as: giant cell tumor of bone, chondrosarcoma, can be considered for artificial total hip arthroplasty, such as the lesion and large thick ridge, the application of special artificial hip joint.