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MI1 > Arthroplasty > Flashcards

Arthroplasty Flashcards

1
Q

What are the goals of a hip arthroplasty?

A
  • Pain relief
  • Restoration of structure within joint
  • Mobility
  • QOL
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2
Q

What are the different types of hip arthroplasty?

A
  • Hybrid cemented THA
  • Resurfacing arthroplasty for avascular necrosis (head of femur)
  • Noncemented modular THA
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3
Q

What are the indications for hip arthroplasty?

A
  • OA
  • Avascular necrosis
  • Inflammatory arthritis (RA, AS, JCA)
  • Non union of neck of femur #
  • TB
  • Tumour
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4
Q

What does a physio need to be concerned with following arthroplasty?

A
  • Weight bearing status

- What structures were cut during the surgery (i.e. need rehab)

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5
Q

What structures are cut during a hip arthroplasty?

A
  • Skin
  • Fascia
  • Glutes split
  • Sciatic nerve retracted
  • Short external rotators divided
  • Capsule exposed & opened
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6
Q

What are the complications of hip arthroplasty?

A
  • Blood loos & shock, anaemia, confusion
  • Thromboembolism
  • Dislocation
  • Femur/acetabular #
  • Infection
  • Loosening
  • Wear
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7
Q

What does appropriate rehabilitation need to recognise and address?

A
  • Patient’s home & environment
  • Pre op history & impairments
  • Surgical history & technique
  • Surgeon’s assessment of the tissue status upon finalisation of the surgery
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8
Q

What are the common restrictions following hip arthroplasty?

A
  • Active/passive ROM
  • ROM limits
  • Weight bearing status
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9
Q

What are some of the common issue around the hip when people have chronic dysfunction?

A
  • OA
  • Tendinopathy
  • Bursitis
  • Core strength
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10
Q

What are some of the things that should be taught to the patient before a THR (phase 1)?

A
  • Ankle pumps
  • Quadriceps sets
  • Gluteal sets
  • Active hip & knee flexion (heel slides)
  • Isometric hip abduction
  • Active hip abduction
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11
Q

What are the typical THR goals for the first 5 days post op?

A

Day 1:

  • Sit out of bed
  • Knee & hip exercises
  • Chest physio
  • Abduction pillow

Day 2:

  • Assisted walking
  • Lots of exercises

Day 5:

  • Home
  • PT at home (stairs, step)
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12
Q

What movements typically should be avoided post THR?

A
  • Internal rotation
  • Adduction
  • Hip flexion past 90 deg
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13
Q

What are the precautions post hip arthroplasty?

A
  • Prevent DVT
  • Prevent dislocation (avoid FADIR - low chairs, roll in bed)
  • Prevent infection
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14
Q

What are the general principles for post op stage 1 for arthroplasty?

A
  • Treatment & exercise
  • Mobility
  • Comfort
  • Hygiene
  • Clothing/dressing
  • Safety education
  • Other joints health
  • Education re future progression
  • Discharge planning
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15
Q

What are the typical goals for phase 2a of a THR (1-2 days post op)?

A
  • Prevent complications
  • Increase muscle contraction
  • Improve control of affected leg
  • Help patient sit up for 30 mins
  • Reinforce THR precautions
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16
Q

What are the typical goals for phase 2b of a THR (3-7 days post op)?

A
  • Promote transfer & gait independence
  • Reinforce THR precautions
  • Discharge
17
Q

What are the typical goals for phase 3 of a THR (1-6 weeks post op)?

A
  • Evaluate safety of the home
  • Assure patient independence
  • Plant patient’s return to work
18
Q

What are the essential components of discharge?

A
  • Home exercises
  • Understanding of progressions & restrictions
  • Team (OT, nurse, GP)
  • Appointment for follow-up with physio
19
Q

What are the indications for knee arthroplasty?

A
  • OA
  • RA
  • Post-traumatic arthritis
  • When joint dysfunction is causing a loss in QOL
20
Q

What are the surgery goals for knee arthroplasty?

A
  • Restore QOL
  • Relieve pain
  • Provide motion with stability
  • Correct deformity (e.g. valgus/varus)
21
Q

What are the different designs of knee arthroplasty?

A
  • Unicompartmental (medial/lateral)
  • Unconstrained (dep on ligament integrity)
  • Semi constrained (most common)
  • Fully constrained (rotating hinges)
22
Q

What are the complications of knee arthroplasty?

A
  • Thromboembolism
  • Poor wound healing
  • Infection
  • Joint instability
  • Fractures
  • Patella tendon rupture
  • Peroneal nerve injuries
  • Component loosening
  • Wear
23
Q

What are the typical knee arthroplasty goals for the first 5 days post op?

A

Day 1:

  • Sit out of bed
  • Continuous passive motion
  • Knee exercises
  • Chest physio

Day 2:

  • Assisted walking
  • CPM, exercises

Day 5
- Home, PT at home

24
Q

What are the precautions for knee arthroplasty?

A
  • Wound care
  • Prevention of DVTs
  • Early motion is essential
25
Q

What are the indications for shoulder arthroplasty?

A
  • OA
  • Rotator cuff arthropathy
  • Fracture/disclocation
  • RA
  • Avascular necrosis
  • Other inflammatory arthritis
  • Instability
  • Tumour
26
Q

What are the complications of shoulder arthroplasty?

A
  • Infection
  • Dislocation
  • Loosening of a component
  • Periprosthetic humeral & glenoid fractures
  • Nerve injuries
  • Fractures of prosthetic component
  • Heterotrophic ossification
27
Q

What are the typical rehab protocols for shoulder arthroplasty?

A
  • Abduction pillow 1-6 weeks
  • Or sling & swathe bandage

Neer program

  • Day 5: assisted ROM
  • Day 7: active assisted
  • Day 14: active assisted exercises sitting & standing
  • Day 21: isometric & active progression of exercises
28
Q

What are the precautions for shoulder arthroplasty?

A
  • Prevent tear of rotator cuff suturing

- Prevent dislocation (horizontal abduction not permitted until flexion at 140 deg)

MI1 (18 decks)

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