case study 6 - Total Hip Replacement Flashcards

1
Q

what type of joint is the hip joint

A

ball and socket

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2
Q

what is the hip joint comprised of

A
  • femoral head
  • acetabulum (socket)
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3
Q

what muscles surround the hip joint

A
  • rectus femoris
  • psoas major
  • iliacus
  • gluteus minimus
  • quadratus femoris
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4
Q

what is osteoarthritis

A

joint disease where tissues in the joint break down
- articular cartilage breaks down, overtime causing friction

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5
Q

describe the structure of a joint

A
  • cartilage
  • synovial membrane
  • fibrous capsule
  • joint capsule containing synovial fluid
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6
Q

what are clinical presentations of oseoarthritis?

A
  • swelling around joint
  • pain around joint
  • stiffness
  • inflammation
  • restricted ROM
  • ## crepitation sounds
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7
Q

what are the different hip surgeries/incisions

A
  • anterolateral
  • posteralateral
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8
Q

name for low blood pressure

A

hypotension

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9
Q

what is the normal degree of hip flexion

A

80-140

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10
Q

what is the normal degree of hip extension

A

5-40

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11
Q

what are the precautions of THR

A
  • don’t go past 90 degree hip flexion due to risk of dislocation
  • pain
  • wound infection
  • limited weight bearing
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12
Q

what is capillary refill time?

A

assesses peripheral perfusion quickly, must last less then 2 seconds

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13
Q

if capillary refill time is more then 2 what does this mean

A

could be caused by
- dehydration
- shock
- hypothermia

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14
Q

what is oxycodone

A
  • opioid painkiller.
  • slow release tablets
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15
Q

why is it important to know he is taking oxycodone

A
  • ## side effects could affect the treatment
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16
Q

what are side effects of oxycodone

A
  • arrythmias
  • confusion
  • dizziness
  • headache
17
Q

how would you asses decrease ROM in right hip

A
  • test unaffected first actively to compare
  • test affected hip active assisted
  • compare both sides and state findings
18
Q

how would you treat decreased rom in right hip

A
  • get patient to perfrom:
  • ankle pumps
  • glute queezes
  • quad squeezes
  • patient to SOEOB and transfer to standing with WZF
  • perform abduction, flexion, extension exercises
19
Q

what evidence is there showing treatment for decreased rom in right hip

A
  • NICE guidelines 2020 suggest early mobilisation for total hip replacements
  • Kepp 2023 systematic review showed that early mobilisation reduced length of stay, increased walking mobility and reduced further joint complications
20
Q

how would you assess decreased mobilisation doing transfers with WZF

A
  • assess ROM of left compared to right hip
  • assess strength whilst doing this
21
Q

how would you treat decreased mobilisation doing transfers with WZF

A
  • prior to mobilising, prescribe exercises such as:
  • foot pumps
  • glute squeezes
  • quad squeezes
  • get patient to stand and perform abduction, flexion, extension exercises
  • progress to teaching how to transfer appropriately and walking with WZF
  • get back to basleine
22
Q

What evidence is there to treat decreased mobilisation doing transfers with WZF

A
  • NICE guidelines 2020 suggest early mobilisation for total hip replacements
  • Kepp 2023 systematic review showed that early mobilisation reduced length of stay, increased walking mobility and reduced further joint complications
23
Q

how would you assess decreased strength right hip

A
  • assess ROM + strength 3/5
24
Q

how would you treat decreased strength right hip

A

start by prescribing
- ankle pumps
- glute squeezes
- quad squeezes
get patient to SOEOB and transfer to standing with WZF
perform abduction, flexion + extension exercises
progress to walking

25
Q

what evidence is there to show treatment for decreased strength right hip

A
  • NICE guidelines 2020 suggest early mobilisation for total hip replacements
  • Kepp 2023 systematic review showed that early mobilisation reduced length of stay, increased walking mobility and reduced further joint complications
26
Q

3 phases of bone healing

A

inflammatory
reperative
remodelling