Common Orthopaedic Procedures Flashcards
Describe the process of THR
Spinal anaesthetic
Postero-lateral incision
Dislocation of hip joint
Femoral head cut off, acetabulum grinded/ reshaped
Acetabular cup in socket, liner in cup
Prosthetic femoral stem in shaft of femur
What is a hemiarthroplasty
Replaces femoral head only
What is hip resurfacing
Replaces joint surface
Head of femur not removed
Reshaped to allow metal cap to be fitted on
Describe the process of a Total Knee Replacement
Spinal anaesthetic
Incision down front of knee
Knee cap moved to side
Distal femur and proximal tibia cut away, using guides to shape
Distal femur replaced with curved metal prosthesis, plastic spacer in between two components
What is the post-op physio for hip/knee replacements
Most FWB after surgery Mobilise on Day 0 ROM/strength Hip precautions? Glut med/min may be affected
What are the possible complications of hip/knee replacement
Post-op infection
DVT
Malfunction of prosthesis
Nerve injury
What is the process of a traditional shoulder replacement
For severe arthritis but intact tendons GHJ accessed anteriorly Deltoid/ pecs separated Subscapularis cut Arthritic areas removed Implants inserted
What is added onto the normal process for a reverse shoulder replacement
Humerus must be prepared for new socket (humeral cup) and glenoid prepared for ball shaped prosthesis
Humeral stem inserted, humeral cup and glenosphere attached - cement or press fit
What is the post op physio for shoulder replacement
Early - sling for 2/52, ROM as allowed (not ER), ADLS
Wk 2-6 - wean out of sling, progress ROM, isometrics
What is the process for RC repair?
Normally done arthroscopically but can be done open for large tear
Joint/ tendon debrided
Sub-acromial depression may be needed
RC tendon attached using anchor/sutures
What is the test for achilles rupture?
Thompson test - squeeze bulk of calf, should see slight plantar flexion
What is a discectomy and decompression and when may they be required?
Discectomy - removing disc material extruding into spinal canal
Decompression - removal of osteophytes, laminectomy, removal of thickened ligament, foraminotomy, facetectomy
What is the post op physio for discectomy/ decompression?
Sitting often restricted to 30 min for 1-2/52
Gentle ROM and isometrics initially
Walking encouraged immediately
When might spinal fusion be indicated?
Elective or trauma - some cases of nerve root compression, unstable spondylolisthesis, unstable fractures, scoliolis
What is a dynamic hip screw?
Indicated in NOF fracture
Allows some movement of the femoral head in the direction of the screw
Two bony surfaces can impact on WB, helping healing
