Surgery

Abstract

There has been a major revolution in the field of elective orthopaedic surgery in the past 20 years to the extent that today this field offers the intervention modality most likely to alter radically the life-style of a patient with chronic arthritis. The most important aspect of this topic for the physician is the need to be aware of the importance of patient selection. Results are most gratifying in conditions such as osteoarthritis or adult haemophilia where the patient is well controlled in all respects with the clamant exception of a single surgically accessible joint. In this situation the outlook of the patient may truly be transformed. When, in polyarticular disease such as rheumatoid arthritis, the disease process remains active, advancing and aggressive, caution remains the watchword and the need for sound assessment becomes doubly important.