7] Total Joint Arthroplasty

Question 1

What’s TJA fixation

Answer 1

Cemented use in older population b/c it allows for higher load after surgery

Question 2

Mechanical causes

Answer 2

Wear and stress

Question 3

Biological causes of TJA failures

Answer 3

Infection
Bone restoration
Aseptic loosening

Question 4

Surgical reasons for TJA failure

Answer 4

Poor fit

Dislocation

Question 5

TJAs last? And for who?

Answer 5

They last 10-15 years so better for ppl over 70 years old.

Less than 55 years 3x more likely to do it again.

Question 6

Indications for TJA surgery

Answer 6

Hip pain
Stiffness
Failure of conservative txt

Question 7

3 types of surgical procedures

Answer 7

Anterolateral approach
Posterolateral approach
Anterior approach (minimally invasive)

Question 8

Anterolateral approach

Answer 8

C shaped cut on back of greater trochanter

Question 9

Space for anterolateral approach

Answer 9

Between glute med and TFL

Question 10

Posterolateral approach

Answer 10

Skin cut over greater troch with distal straight limb and prox limb curved posteriorly

Question 11

Access space for posterolateral approach

Answer 11

Between glute max and med

Question 12

Anterior approach

Answer 12

Special table to do rotation and traction.

Incision made distal and slightly lateral to ASIS

Question 13

Space for anterior approach

Answer 13

Between TFL, sartorius and rectus femoris

Question 14

What’s opened and compromised in anterior approach?

Answer 14

Anterior capsule is opened.

No muscles are compromised.

Question 15

Complications of TJA

Answer 15

Nerve injury
DVT
Dislocation
Leg length discrepancy

Question 16

Hip precautions

Answer 16

No flex past 90
No ADD past midline
No IR

Question 17

Dislocation risk factors

Answer 17

Female
Anything that you got TJA for besides OA
Weak hip abd
Previous hip surgery
Impaired mental status

Question 18

How to measure performance in acute stage

Answer 18

TUG

Gait speed