OKOJ, Volume 14, No. 6

The Biologic Response to Bearing Materials

Total joint arthroplasty (TJA) is a common and highly successful orthopaedic procedure for which surgeons can use different bearing materials. The materials used for TJA must be both biocompatible to minimize adverse local tissue reactions and robust enough to support weight bearing during common daily activities. Modern bearing materials for TJA are made from metals and their alloys, polymers, and ceramics. The orthopaedic surgeon should be knowledgeable about the biologic response to the different bearing materials used for TJA, as well as the wear by-products generated.

    • Keywords:
    • orthopaedic bearing materials

    • biocompatibility

    • foreign body response

    • inflammation

    • hypersensitivity

    • Subspecialty:
    • Adult Reconstruction

    • Basic Science

Bicompartmental Knee Arthroplasty

Knee arthritis is one of the leading causes of disability and functional limitations in the United States and worldwide. Total knee arthroplasty results in good functional outcomes and high survival rates in patients who have tricompartmental arthritis. Bicompartmental knee arthroplasty is being used more often in patients who have arthritis that is isolated in two compartments: the patellofemoral compartment and either the medial or the lateral compartment. Bicompartmental knee arthroplasty preserves the kinematics, ligaments, and bone stock of the knee and is a good option for younger, active, high-demand patients who wish to return to their previous levels of activity.

    • Keywords:
    • arthroplasty

    • bicompartmental arthroplasty

    • knee

    • patellofemoral arthroplasty

    • unicompartmental arthroplasty

    • Subspecialty:
    • Adult Reconstruction

Outpatient Total Knee Arthroplasty

Total knee arthroplasty (TKA) is one of the most successful and frequently performed procedures by all orthopaedic surgeons. As with all joint arthroplasties, this procedure has evolved, and so has the arena in which these procedures are performed. As arthroplasty has progressed to the outpatient setting, the goal remains to provide patients with a durable, well-functioning joint while minimizing complications. Thorough patient selection and preoperative education is of paramount importance. Also, developing protocols with the medical and anesthesia teams regarding perioperative pain management is as critical as all intraoperative aspects of the procedure. Blood management and postoperative care should also be conducted carefully to decrease any complications and readmissions. These steps are necessary to make surgery in the outpatient setting feasible and reduce the risk to the patient. Outpatient TKA likely will continue to increase; however, not all patients who would benefit from TKA are candidates for outpatient arthroplasty. Providers, with the help of independent medical staff, need to be diligent in patient selection when moving patients from an inpatient to an outpatient setting.

    • Keywords:
    • total knee arthroplasty

    • outpatient TKA

    • outpatient arthroplasty

    • TKA

    • Subspecialty:
    • Adult Reconstruction