‘À La Carte’ Joint Replacement

Excerpt

Hip and knee arthroplasties are life-changing procedures, reducing pain and restoring function after end-stage arthrosis. Almost 90% of patients who have undergone hip arthroplasty, and 82% after knee arthroplasty, report improvement in quality of life after surgery [1]; this leaves a significant number of dissatisfied patients. The modern surgeon can make decisions regarding surgical approach, implant design and component orientation. However, it is challenging to gain proficiency in a wide variety of surgical configurations. A smaller repertoire is technically and economically more feasible, and thus a one-size-fits-all approach is commonplace. Hip and knee arthroplasties are forgiving procedures, most frequently performed in older patients without high functional demands. The future arthroplasty surgeon is faced with new challenges—patients with higher demand, expectations and longer life expectancy, in addition to an increasing burden of revision surgery. Here, we discuss ‘a la carte’ joint replacement, which is both patient specific and bone/soft tissue conservative. It may improve overall satisfaction while conserving bone stock in the event of future revision surgery.