Overview
  
A core group of interested surgeons have started performing total joint replacement surgeries and
related clinical researches in the Department since 1984. Not until 1999, a formal subspecialty
team, Adult Joint Reconstruction Team, was established. The Team manages all adult patients with
non-infective arthritis problems. The Team also plays a leading role in adult joint reconstruction
in the New Territories East cluster. Cluster based revision total joint replacement surgery, ward
round, journal club and clinical research have started in 2001 till 2009.
Clinical Service
The total number of hip and knee replacements increased from 12 in 1984 to 175 in 2012. Most
of the hip replacements were performed on patients with avascular necrosis of the femoral heads,
acetabular dysplasia and inflammatory diseases while degenerative osteoarthritis, followed by
rheumatoid arthritis, were the leading causes for total knee replacements. With aging of the Hong
Kong population, degeneration becomes a more major health issue. This can be reflected by the
fact that total knee replacements outnumber total hip replacements since year 2000. Besides hip
and knee replacements, the Team also performs joint realignment procedures for selected cases.
The Team performed the first computer-aided total knee replacement in 2002. With the advance
computer-aided technique, complicated cases of total joint replacement were managed with great
success.
Training
The Team has been organizing bioskill workshop in total joint replacement since 1999. The first
workshop in 1999 actually marked the opening of the Orthopaedic Learning Centre. Since 2002 we
had also run workshops in computer-aided total joint replacement for local and Asia-pacific orthopaedic
surgeons. The one in 2002 was the first navigation workshop in total joint replacement in Hong Kong.
Up till 2013, the Team organized more than 20 workshops in total joint reconstruction.
 Twin City Workshop
Research
The Team actively conducting clinical research related to joint replacement surgery. Presentations
have been made in the Hong Kong Orthopaedic Association Annual Congress and other local
and international meetings. Moreover, we have published our research results related to joint
replacements in both local and international journals. In 1997, based on our clinical data, we had
developed the Asian size implants for the Exeter Total Hip Replacement System.
In order to set up a more systematic way to assess and document all our patients undergoing total
joint replacements, we have upgraded and computerised the PWH total joint replacement registry.
The database contains all preoperative and postoperative information related to the assessment
of patients undergoing total joint replacements. The database helps us in the assessment of
our patients and the retrieval of all these data for analysis and scientific presentations and
publications.
 Computer-aided Total Knee Replacement  Asian size Exeter Stem 30mm and 33mm offset as
compared to 35.5mm and 37.5mm offset
Future Development
With the increase in demand for service in adult joint reconstruction in Hong Kong, and in the New
Territories East cluster, a cluster joint replacement center has been planned to meet this challenge
and continue to provide high quality clinical service and research.
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