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