Dr. Pete Rose
Surgical Treatment
Surgical Treatment
• Fusion
• Arthroscopy
• Realignment / reshaping
• Joint replacement
Fusion
• Traditional treatment for arthritis in the young– “No motion, no pain”
• Not for patients with multiple joint involvement– Spine, ankle, wrist
possible exceptions
Arthroscopy
Arthroscopy
• Low morbidity outpatient procedure• Doesn’t “burn” bridges
– Effective against well defined targets• Focally torn cartilage
– Not effective for generalized joint pain or arthritis
Realignment Procedures - Knee
• Surgically change alignment to “offload” worn area
• Delay need for joint replacement
Operative Plan
• Combined femoral and proximal tibial osteotomies.– Femoral side correction of varus bow.– Tibial side correction of apex anterior bowing
and down slope of the articular surface.
Realignment Procedures - Hip
Impinging bump on the edge ofa malformed femoral head (ball)
But…
• Relatively few patients are good candidates for these procedures– Treat a local problem when the true pathology
is global– Usually small “window” between when things
start to hurt until the whole joint is damaged