hip replacements

Question 1

Lower Extremity Replacements

Answer 1

restoration of joint motion
 Indicated for clients with
 Osteoarthritis/DJD (degenerative joint disease)

Question 2

Dysplasia

Answer 2

congenital malformation of joints

Question 3

Lupus, cancer, use of corticosteroids

Answer 3

Compromise blood flow to hip and result in avascular necrosis

Question 4

Hip

Answer 4

 Cartilage lost centrally; osteophytes develop; pain arises
 Hip movement causes pain
 Movement restricted
 Muscles shorten from disuse
 Hip may assume flexed, adducted and internally rotated position

Question 5

Knee

Answer 5

 Cartilage lost on joint surface
 Pain and limping during activities; difficulty bending knee

Question 6

 Total Hip Replacement

Answer 6

 Arthroplasty Goals
-Alleviate Pain
- Restore joint motion
 Two components
- Polyethylene socket is fitted into the acetabulum
-Metal prosthesis replaces femoral neck and head

Question 7

Surgical Approaches
 Anterior/Anterolatera

Answer 7

 Client will be unstable in external rotation, adduction and extension
 Must observe precautions to these movements for 6-12 weeks

Question 8

TKA goals

Answer 8

 Alleviate pain
 Restore motion
 Maintain alignment and stability of knee joint

Question 9

TKA

Answer 9

 Components
- Cut away damage bone (as little as possible)
- Attach prosthesis
 Prosthesis
-Cemented
- Noncemented
 Knee Immobilizer
 No rotation for 12 weeks postop

Question 10

OT practitioners assist with pain management

Answer 10

 Positioning of comfort
 Superficial cold modality
 Provide support to LE during transfers and movement transitions

Question 11

Rehab focus is on:

Answer 11

 Maintaining and regaining joint ROM
 Strengthen surrounding muscles
 Decrease swelling
 Increase ADLs and IADLs
 OT usually provides education on adaptive techniques for ADLs and IADLs

Question 12

Role of OT in hip and knee replacement

Answer 12

-Occupational profile
-Evaluate occupational performance, performance skills and body functions/structure
 Observing for pain/fear
 OT goal is to return client to their home performing ADLs and IADLs

Question 13

Bed Mobility

Answer 13

 Leg abduction; sleep on surgical side
 Avoid adduction past midline
 Getting out of bed; nonoperated side first initially
 Use of leg lifter

Question 14

Special Equipment

Answer 14

 Hemovac – drainage tube from surgical site
 Abduction Wedge
 Balanced suspension – set up by PT/Physician
 Reclining wheelchair – opens the seat to back angle so hip does not flex past 90
 Commode chairs