# Prosthetic arthroplasty of joint

<mark style="color:$danger;">**This Editorial Guide is used for Education Purposes Only. It is used in the Authoring Courses and Certifications. It is based on the January 2026 Editorial Guide.**</mark>

<< 1288025000 | Prosthetic arthroplasty of joint (procedure)|

Prosthetic arthroplasties refer to the partial or total replacement of bones of a joint with a prosthetic device. All prosthetic arthroplasty concepts must be modeled with a *Repair* role group to ensure they classify under 442095009 |Repair of joint (procedure)|, along with an *Implantation* role group for the prosthetic device.

## Total joint replacement

Total joint procedures are modeled by repair and implantation role groups. The repair group must have the 405813007 | Procedure site - Direct (attribute)| value of the entire joint. In the implantation role group, as the prostheses are applied to all of the bones in a joint, the generic *joint prosthesis* and *joint structure* concepts should be used in modeling to subsume hybrid total arthroplasties.

<figure><img src="https://3063935683-files.gitbook.io/~/files/v0/b/gitbook-x-prod.appspot.com/o/spaces%2FSZh4aZdgpviXMYp37bCy%2Fuploads%2Fgit-blob-ad0a1a4963abd8a3b57729dfb682e80e27f21935%2Fimage%20(222).png?alt=media" alt=""><figcaption><p>Stated view of 609588000 |Prosthetic total arthroplasty of knee joint (procedure)|</p></figcaption></figure>

<figure><img src="https://github.com/SNOMED-Documents/snomed-editorial-guide/blob/main/authoring/procedure/images/232391031.png" alt=""><figcaption></figcaption></figure>

## Cemented total arthroplasty

The use of bone cement should only be included in the implantation role group. The entire joint in the repair group represents the totality of arthroplasty, as does the total joint prosthesis in the implantation role group.

<figure><img src="https://3063935683-files.gitbook.io/~/files/v0/b/gitbook-x-prod.appspot.com/o/spaces%2FSZh4aZdgpviXMYp37bCy%2Fuploads%2Fgit-blob-3821a5ea8884deccfe70c08e60cd62a322b36b8c%2Fimage%20(223).png?alt=media" alt=""><figcaption><p>Stated view of 265170009 |Cemented prosthetic total arthroplasty of knee joint (procedure)|</p></figcaption></figure>

## Hybrid total arthroplasty

Bone cement is only applied to one bone in a joint, leaving the other bone uncemented. Hence, a hybrid total arthroplasty should not be a subconcept of a cemented total arthroplasty.

If the cemented component is unspecified, the single implementation role group follows the model of total joint replacements with an additional substance of bone cement.

<figure><img src="https://3063935683-files.gitbook.io/~/files/v0/b/gitbook-x-prod.appspot.com/o/spaces%2FSZh4aZdgpviXMYp37bCy%2Fuploads%2Fgit-blob-decae48402f73c31d29b00ef39ad0b90cbad522e%2Fimage%20(224).png?alt=media" alt=""><figcaption><p>Stated view of 1287945008 |Prosthetic hybrid total knee replacement (procedure)|</p></figcaption></figure>

<figure><img src="https://github.com/SNOMED-Documents/snomed-editorial-guide/blob/main/authoring/procedure/images/232391029.png" alt=""><figcaption></figcaption></figure>

If the cemented component is known, multiple implantation role groups should be created to represent the prosthesis component of each bone.

<figure><img src="https://3063935683-files.gitbook.io/~/files/v0/b/gitbook-x-prod.appspot.com/o/spaces%2FSZh4aZdgpviXMYp37bCy%2Fuploads%2Fgit-blob-5623bc5ac2b0d29e50ab0462e453119155fea0f5%2Fimage%20(225).png?alt=media" alt=""><figcaption><p>Stated view of 427560001 |Prosthetic hybrid replacement of shoulder joint using cemented humeral component (procedure)|</p></figcaption></figure>

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