Article

Osteoarthritis is a process largely associated with aging, and Americans today
are living longer than ever before, with the most recent data from the Centers
for Disease Control and Prevention showing an average life expectancy of 78.2
years. With an increasingly older society, there will be an increased need for
medical and surgical treatment of osteoarthritis. At the same time, a decline in
the number of surgeons performing total joint arthroplasty is anticipated, by as
much as 30% in some studies. Due to this anticipated shortage, nonoperative
physicians will play a more prominent role in patient care and should become
better educated in maximizing nonoperative care, recognizing appropriate surgical
indications, and educating their patients on surgical outcomes. Total joint
arthroplasty offers pain relief and potential functional improvement.
Unfortunately, the outcomes for joint replacement differ significantly by the
joint being replaced. The best examples of positive outcome for both pain relief
and functional improvement are total hip arthroplasty and total knee
arthroplasty. Shoulder arthroplasty has demonstrated encouraging outcomes but the
outcome data is not yet as robust as the data for hip and knee arthroplasty.
Elbow arthroplasty provides good pain relief but functional outcomes are not
nearly as good, and significant potential complications exist. Lastly, ankle
arthroplasty has not demonstrated outcomes that are as positive as the other
major joints, and the criterion standard treatment continues to be ankle fusion.
In this article, surgical options for arthroplasty will be reviewed for each of
the major joints, including the joint-specific indications and outcomes for each
procedure.
CI - Copyright (c) 2012 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS