Joint Replacements (THR/TKR)

Question 1

Indications for Arthroplasty

Answer 1

Pain relief caused by arthritis

Trauma, hip fracture, tumor

Severe progressive deformity

FAILED CONSERVATIVE TREATMENT (NSAIDs, injections, activity mod, assistive ambulation devices)

Question 2

Pre-Op Interventions for TJA

Answer 2

Teach isometrics

Fit for assistive device for ambulation

Gait training with assistive device on the level and on stairs

Diaphragmatic breathing & coughing
For hip replacement, teach hip precautions

Question 3

Early Post-Op Interventions

Answer 3

Patient education, precautions
Bed mobility
Transfer training
Exercise

Question 4

Transfer training protocol for TJA

Answer 4

Progress to standing & gait training with AD

Progress to stairs (day 3-4)

Question 5

Exercise for Post-Op TJA

Answer 5

Isometrics
AROM on non-involved side
AAROM &/or AROM on involved side
Ankle pumping
Deep breathing exercises, coughing

Question 6

Sub-Acute Interventions

Answer 6

Progressive resistive exercises

Cardiopulmonary endurance training

Balance and functional training (IADLs/car transfers)

Question 7

Outpatient Interventions

Answer 7

Progress WB status & assistive device if appropriate

PREs, determine RM

Progressive gait training for all surfaces, elevations and gait pattern

Muscular, cardiopulmonary endurance and balance training

Return to work & recreation

Question 8

Weight bearing restrictions for cemented THR

Answer 8

FWB

Question 9

Weight bearing restrictions for uncemented THR

Answer 9

Restricted WB

Question 10

Posteriolateral WB and Precautions

Answer 10

FWB

Flexion >90, adduction, IR

SitStand, don/doff shoes

Question 11

Anteriolateral WB and Precautions

Answer 11

PWB 6 weeks

Extension, adduction, ER

Turning away from hip

Question 12

Transtrochanteric WB and Precautions

Answer 12

PWB in 6 weeks

Extension, adduction, ER

Turning away from hip