Arthroplasty

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Humeral head prosthesis "Epoca Shoulder Arthroplasty System" made by Synthes

Arthroplasty (from the Greek ἄρθρον = joint and πλάττειν = to shape, to form) is a surgical procedure that aims to secure or restore joint function.

Arthroplasty comes e.g. B. for stiffened, restricted in their mobility or severely painful joints. The defective articular cartilage is usually removed. Then fatty tissue, fascia or the like is deposited between the bone surfaces to absorb the friction. If a reconstruction or treatment is no longer possible using only the body's own materials, artificial joints can also be used.

The first successful arthroplasty was carried out in 1826 by the Pennsylvania surgeon John Rhea Barton (1794–1871), when he separated the rolled hillocks on the femoral neck of a patient with a stiff hip .

Arthroplasty subgroups (overview)

• Alloarthroplasty : The replacement of one, several or all joint surfaces with allogeneic ( i.e. non-biological, non-biological) material. Usually the name for the joint endoprosthesis .

• Resection arthroplasty: Here the diseased joint or the affected bone is completely removed, whereby the pain is eliminated but the function of the body part is severely restricted. In the case of a treatment of the thumb saddle joint , the name Epping plastic is common.

• Chondroplasty: The smoothing or freshening of degeneratively changed articular cartilage. Also the attempt to create scar cartilage in the defect area by drilling into the subchondral bone (so-called Pridie drilling).

• Transplant arthroplasty:
  • Cartilage bone transplantation: The removal of one or more cartilage-bone cylinders from healthy marginal areas of the joint and transplantation into the defect area, from which the corresponding receiving cylinders were previously punched. The auto-transplants must be slightly larger in diameter than the receptacle so that the transplants anchor themselves using the press-fit technique . The current term for this procedure is OATS (osteochondral autologeal transplant system).
  • Cartilage cell transplantation: (ACT: Autologous Chondrocyte Transplantation) is the most modern procedure for restoring articular surfaces in the case of circumscribed defects. Cartilage cells are taken from healthy joint areas and grown on a special nutrient matrix. The resulting healthy cartilage can then be transplanted back into the joint.
  • Joint transplantation : The first allogeneic transplantation of a knee joint in humans was carried out by Gunther O. Hofmann's team in 1996
• Joint toilet and synovialectomy: The extensive, mostly arthroscopic flushing and "cleaning" of the joint with the removal of degenerated and / or inflammatory tissue. During a synovialectomy, the inflamed joint mucous membrane ( synovia ) is selectively removed.

Individual evidence

1. ↑ Barbara I. Tshisuaka: Barton, John Rhea. In: Werner E. Gerabek , Bernhard D. Haage, Gundolf Keil , Wolfgang Wegner (eds.): Enzyklopädie Medizingeschichte. De Gruyter, Berlin / New York 2005, ISBN 3-11-015714-4 , p. 151 f.
2. ↑ Gunther O. Hofmann: Bone and Joint Transplantation in: Transplantation Medicine: A Guide for Practitioners, de Gruyter, Berlin 2006, ISBN 978-3-11-018927-8 , accessed on January 5, 2012

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