Lecture 18 - arthroplasty Flashcards
What are treatment options for arthritis
What are the top 3 reasons for both hip and knee revvisions?
- Infection
- Aseptic loosening
- Instability
Are we increasing same day discharge for TKA and THA surgeries?
Yes to reduce wait time due to more patient volume and decrease hospital costs
What is the role of physiotherapy in same day discharges?
Should a neurologic assessment be done prior to mobilizations after replacement surgeries?
YES
PACU -> post anaesthetic care unit
-Usually get epidurals for arthroplasties so they cannot feel from the waist down or they could sometimes, but rarely get anaesthesia so need to make sure they are neurologically ok before mobilization
-Will perform a myotome assessment
-Need to look at orthostatic blood pressures (cannot get up if greater than 20% drop to prevent fainting)
What are components of a physiotherapy assessment with day surgery
For a TKA what is the patient selection
What are the types of patients that are requesting TKA’s
What are 3 types of TKA’s
Key factors of TKA’s
Have 6-8 weeks to get to a certain range or the joint or it will become stuck in limited ROM and they will have to have it surgically mobilized
What are the methods of anesthesia during TKA or THA’s
TKA or THA complciations
What is the role of physio in acute care post TKA
-Lots of patients are mobilized on the same day
-No pillow underneath the knee after TKA
What are some initial exercises after a TKA
What are types of THA surgeries
What is hip resurfacing surgery?
What are 3 key factors of THA’s
Hip anatomy
Direct anterior approach THA
Lateral approach THA
THA posterior approach
LHSC standard hip precautions
What are some modifications for THA restrictions
What are some equipment needs following a THA
Role of physio in acute care post THA
Initial exercises following a THA
NOTE:
Not forcing ROM -> only gentle to get things moving so they are not stiff
->no passive knee extension as they will get that with walking
What are some factors of instability immediately post-op THA
What are some stabilities for the hip in terms of anterior, posterior, and dynamic movement
NOTE: Iliofemoral and ischiofemoral ligaments provide the stability for anterior hip
What is important to note about THA’s in terms of dislocation and the mechanisms of dislocation
Posterior approach = posterior instability
Anterior approach = anterior instability
Lateral approach = lateral instability
THA or TKA revision surgery reasons
What are some key factors of a THA or TKA revision surgery?
What are long term restrictions post-arthroplasty?
What are some recommended and not-recommended activities and sports after a TKA
NOTE:
Want patients to do 30 mins a day of cardiovascular activity and lift 2-3 times a week
Key factors for long term post arthroplasty
Shoulder anatomy
Advantages of hemiarthroplasty
Disadvantages of hemiarthroplasty
Advantages of total shoulder arthroplasty?
Disadvantages of total shoulder arthroplasty
How is a TSA performed
Describe 2 key factors of the rotator cuff in terms of TSA
