Elective surgery Flashcards
What are the four surgical strategies for treating OA?
Arthroplasty
Excision arthroplasty
Arthrodesis
Osteotomy
What is arthroplasty?
Joint replacement.
Can be full or hemi
What materials are often used in joint replacement?
Stainless steel Cobalt chrome TItanium Polyethene Ceramics
How are arthroplasties attached?
EIther cemented or uncemented (bone grows into them)
What are some of the problems associated with arthroplasty?
Muscle and bone necrosis and bone lysis from metal particles. Infection Recurrent dislocation Neurovascular injury PE
What is an excision/resection arthroplasty?
Removal of bone or cartilage from one or both sides of joint.
What joints are excision arthroplasties good for?
Small joints
Sometimes used for failed hip to shoulder replacements
What is arthrodesis?
Fusion of a joint in position of function
How is a arthrodesis performed?
Remove diseased bone and cartilage then let it heal together.
What are the benefits and problems of arthrodesis?
Good for alleviating pain
Increases pressure on surrounding joints
What joint are often arthrodesed?
End stage ankle, wrist and MTP arthritis.
What is an osteotomy?
Surgical realignment of bone
What are osteotomies used for?
To correct deformities or redistribute load- move load from diseased part to undiseased.
Give some examples of soft tissue problems
Tendonitis Enthesopathies Cartilage tears Labrum tears Bursitis Capsulitis Non-infectious fasciitis
What are the eight options for treatment of soft tissue injuries?
Rest Steroid injection Debridement Decompression Synovectomy Splinting Surgical repair Tendon transfer
What is the best treatment for soft tissue injury?
Rest, analgesia and anti-inflammatories
When should steroid injections be and not be used?
Use: Rotator cuff and lateral epicondylitis
Do NOT use: Achilles
What is debridement?
Removal of diseased tissue
What is decompression
Making more space
What is a synovectomy?
Removal of synovial membrane
When is splintage used for soft tissue injuries?
Large tendons like Achilles
What is joint instability?
Abnormal motion of a joint resulting in dislocation
In what joints is instability common?
Knee and shoulder
What is conservative management for joint instability?
Physio and splints etc
