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MSK2 > Hip Arthroplasty > Flashcards

Hip Arthroplasty Flashcards

1
Q

indications for an arthroplasty

A

hip OA, RA, some fx, osteonecrosis, tumors

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2
Q

what is the difference between a cemented and non-cemented arthroplasty

A

cemented is porous and can be loose in the clinic, more of a mirror image of bone

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3
Q

what is a primary THA

A

replacement of femoral stem and acetabulum

- acetabular cup, head & neck of femur

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4
Q

hemiarthroplasty

A
  • replacement of femoral stem

- typically used when ORIF is not possible or likely to be successful

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5
Q

components of hemiarthroplasty

A
  • head & neck of femur

- bipolar vs unipolar

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6
Q

hip resurfacing arthroplasty

A
  • RA, osteoarthropy
  • replacement of acetabulum and articular surface of femoral head
  • typically used for young, active patients
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7
Q

components of hip resurfacing arthroplasty

A

acetabular cap or femoral cap

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8
Q

revision arthroplasty

A
  • replacement of pre-existing components

- indicated with complications of initial procedure (recurrent dislocations, infxn, fixation loss, etc.)

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9
Q

who is more likely to get a revision arthroplasty

A

males 3x more

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10
Q

hip precautions for revision

A

typically global precautions - anterior and posterior

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11
Q

surgical approach for posterior hip replacement

A
  • incision posterior to greater trochanter

- TFL incised, glute max split, short ER detached

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12
Q

what is the advantage of posterior hip approach

A

hip abductors are not disrupted

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13
Q

disadvantage for posterior hip approach

A

higher risk of dislocation

post-op precautions limiting for ADLs

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14
Q

posterior hip approach dislocation precautions

A

no flexion >90 deg
no adduction past neutral
no IR past neutral

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15
Q

direct lateral surgical approach

A

incision along greater trochanter

release of anterior glute med and min

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16
Q

advantaages for direct lateral approach

A

decreased risk for dislocation

17
Q

disadvantages for direct lateral approach

A

prolonged hip abductor weakness

greater risk for HO

18
Q

direct lateral dislocation precautions

A

varies

avoid active hip abduction

19
Q

anteriolateral procedure approach

A

accessed btw TFL & glut med

20
Q

direct anterior procedure approach

A

accessed btw TFL & rectus femoris/sartorius tendons

21
Q

advantages of anterior & anteriolateral

A

ADLs less affected by dislocation precautions

decreased risk for dislocation

22
Q

disadvantages for anterior & anteriolateral

A

prolonged hip abd weakness if anterior glut med released for access

23
Q

post op precautions for anterior & anteriolateral

A

no hyperextension

no ER past neutral

24
Q

transtrochanteric surgical procedure

A

lateral incision

osteotomy of greater trochanter

25
Q

advantages of transtrochanteric

A

preserves attachment of hip abd

26
Q

disadvantages of transtrochanteric

A

WB limitations until bony union
risk for non-union
prolonged hip abd weakness

27
Q

post-op precautions for transtrochanteric

A 
no active hip abd
WB restrictions (TDWB or PWB)
28
Q

what is a potential post-op complication for THA

A

DVT

PE

29
Q

Well’s criteria for DVT

A
  • predict extremity for DVT
30
Q

values for Well’s criteria for DVT

A

/= 3: high probability of DVT

31
Q

potential post-op complications

A

infection, dislocation, hardware failure, mechanical loosening, fx, nerve injury, vascular injury, leg length, discrepancy

32
Q

what are some outcome predictors that increases prognosis

A
  • lower pre-op WOMAC scores
  • pre-op knee extensor strength
  • TUG score <10 at 14 wks post-op
  • younger age
  • male sex
33
Q

what are some outcome predictors that decreases prognosis

A
  • greater number of comorbidities
  • higher BMI
  • increased age
  • female sex
34
Q

predictors for long term use of AD

A
  • greater age >69yrs
  • female sex
  • high BMI
  • depression

MSK2 (2 decks)

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