Joint Replacement
Joint replacement procedures have become a preferred method among the American medical community of rectifying severe pain caused by arthritic or dysfunctional joints. In fact, these procedures are becoming common practice among orthopedic surgeons worldwide. The medical term replacement 'arthroplasty' literally means 'surgical repair of joint,' and it is an elective procedure that is done to relieve severe pain that is caused by such conditions as osteoarthritis and rheumatoid arthritis in order to restore joint function. In these procedures, malfunctioning joint surfaces are replaced with artificial materials in order to realign and reconstruct the joint restoring a patient's range of motion. Millions of Americans are having these procedures done every year, which can be performed on the joints of knees, hips, shoulders, and ankles. So what are the different procedures used in arthroplasty and the regulations governing this method of joint restoration?
History
Arthroplasty is a medical procedure that goes back as far as the 19th century. In 1821, Dr. Anthony White of Westminster Hospital, performed what is recorded as the very first arthroplasty. In the years following, Dr. Vitezlav Chlumsky, a Czech surgeon, experimented with various types of materials for joint replacements, but these were most unsuccessful. By 1891, Dr. Themistocles Gluck, a Berlin professor, designed a method of arthroplasty using an ivory ball and socket affixed by nickel plated screws. The very first successful arthroplasty in the United States was performed in 1893 by Dr. Jules Pean, and by mid-century, New York City orthopedic surgeon Stephen Hudack began testing artificial joints on animal subjects. From there, with funding from the Office of Naval Research, Dr. Hudack was replacing human hip joints while performing research at the New York Orthopedic Hospital. By this time, the method of using artificial materials for joint replacement became an accepted method in several countries around the world for relieving severe joint pain due to trauma or medical conditions such as arthritis.
Different types of procedures
There are several types of joint arthroplasty currently performed in the United States and worldwide, with not all procedures totally replacing a joint. Several types of materials are used in these procedures. Some of the different types of arthroplasty include resection arthroplasty, interpositional arthroplasty, and surgical replacement arthroplasty. Some of the materials used in the varied arthroplastic procedures are ceramic, metal, polyethylene, zirconium, and silicone.
Resection: In resection arthroplasty, an incision is made and excess bone is removed in order to improve stability and range of motion of the joint. This procedure was made popular in the early 1900s primarily for resection of bunions, but since 1967 silicone implants were included in order to relieve pain and maintain greater joint stability.
Interpositional: This type of arthroplasty involves the reshaping of joint bones by placing a piece or pieces of artificial materials between the joints. This additional material is designed to keep bones from rubbing together, relieving pain and improving joint range of motion as well as stability.
Surgical replacement: In modern medicine, one of the most common forms of arthroplasty is surgical replacement. In this type of procedure, an entire joint that has been affected by trauma or other medical condition such as osteoarthritis is replaced with a prosthetic joint, again, in order to relieve pain and restore range of motion and stability.
Pharmaceutical regulations
Of course, one of the main methods used by the U.S. Federal Government to regulate all medical procedures and practices is by requiring licenses to practice and board certifications. Currently, joint replacements programs are certified under the standards for disease-specific care programs, with stringent certification requirements including compliance with national standards, effective and consistent use of appropriate guidelines for knee, shoulder, or hip replacement patient populations, and collection as well as analysis of a minimum of four performance measures specific to each of these areas of joint replacement patient population. With many patients recently experiencing pain and dysfunction of arthroplastic surgeries and lawsuits ensuing, the Federal Drug Administration (FDA) has begun changing and enhancing regulations on manufacturers selling all-metal hip replacement materials. The FDA recently announced that, under new regulations, manufacturers will have 90 days in which to file applications that include the results of clinical trials and other scientific evidence showing these hip replacement materials are safe and effective. Any manufacturers who are unable to prove the safety and effectiveness of their products will no longer be permitted to sell them in the United States at all.
History
Arthroplasty is a medical procedure that goes back as far as the 19th century. In 1821, Dr. Anthony White of Westminster Hospital, performed what is recorded as the very first arthroplasty. In the years following, Dr. Vitezlav Chlumsky, a Czech surgeon, experimented with various types of materials for joint replacements, but these were most unsuccessful. By 1891, Dr. Themistocles Gluck, a Berlin professor, designed a method of arthroplasty using an ivory ball and socket affixed by nickel plated screws. The very first successful arthroplasty in the United States was performed in 1893 by Dr. Jules Pean, and by mid-century, New York City orthopedic surgeon Stephen Hudack began testing artificial joints on animal subjects. From there, with funding from the Office of Naval Research, Dr. Hudack was replacing human hip joints while performing research at the New York Orthopedic Hospital. By this time, the method of using artificial materials for joint replacement became an accepted method in several countries around the world for relieving severe joint pain due to trauma or medical conditions such as arthritis.
Different types of procedures
There are several types of joint arthroplasty currently performed in the United States and worldwide, with not all procedures totally replacing a joint. Several types of materials are used in these procedures. Some of the different types of arthroplasty include resection arthroplasty, interpositional arthroplasty, and surgical replacement arthroplasty. Some of the materials used in the varied arthroplastic procedures are ceramic, metal, polyethylene, zirconium, and silicone.
Resection: In resection arthroplasty, an incision is made and excess bone is removed in order to improve stability and range of motion of the joint. This procedure was made popular in the early 1900s primarily for resection of bunions, but since 1967 silicone implants were included in order to relieve pain and maintain greater joint stability.
Interpositional: This type of arthroplasty involves the reshaping of joint bones by placing a piece or pieces of artificial materials between the joints. This additional material is designed to keep bones from rubbing together, relieving pain and improving joint range of motion as well as stability.
Surgical replacement: In modern medicine, one of the most common forms of arthroplasty is surgical replacement. In this type of procedure, an entire joint that has been affected by trauma or other medical condition such as osteoarthritis is replaced with a prosthetic joint, again, in order to relieve pain and restore range of motion and stability.
Pharmaceutical regulations
Of course, one of the main methods used by the U.S. Federal Government to regulate all medical procedures and practices is by requiring licenses to practice and board certifications. Currently, joint replacements programs are certified under the standards for disease-specific care programs, with stringent certification requirements including compliance with national standards, effective and consistent use of appropriate guidelines for knee, shoulder, or hip replacement patient populations, and collection as well as analysis of a minimum of four performance measures specific to each of these areas of joint replacement patient population. With many patients recently experiencing pain and dysfunction of arthroplastic surgeries and lawsuits ensuing, the Federal Drug Administration (FDA) has begun changing and enhancing regulations on manufacturers selling all-metal hip replacement materials. The FDA recently announced that, under new regulations, manufacturers will have 90 days in which to file applications that include the results of clinical trials and other scientific evidence showing these hip replacement materials are safe and effective. Any manufacturers who are unable to prove the safety and effectiveness of their products will no longer be permitted to sell them in the United States at all.