Adult Reconstruction

In this issue of Orthopedic Clinics of North America, we focus on two interesting topics. In the first article, on juvenile idiopathic arthritis (JIA), Figgie and Abdel discuss the epidemiology and coordination of care, including medical and surgical management for patients with JIA undergoing total hip arthroplasty (THA) and total knee arthroplasty. This select group of patients has persistent arthritis in one or more joints occurring before the age of 16 years. Although medical management can be effective, approximately 10% have end-stage arthritis requiring joint arthroplasty. The surgical management of these patients requires a multidisciplinary team approach and the authors clearly describe the challenges that may be present.

In the second article, Hepinstall reports the recent advances in robotic total hip arthroplasty. It has been well established that component position in total hip arthroplasty influences the functional outcome, durability of the implant, and risk of complications. With the introduction of robots into the surgical arena, the author suggests that surgeons may be able to optimize the accuracy and precision of THA. This well-written review article describes the utility of robots in the surgical workflow with optimization of surgical precision without increasing this surgical complexity.

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