lower limb Flashcards
where might hip pain be felt and why/
Hip pathology typically produces pain in the groin which may radiate to the knee (due to the obturator nerve supplying both joints and referred pain).
what is a first sign of hip pain?
Examination may reveal a reduced range of motion with loss of internal rotation usually the first sign.
early local complications of hip arthroplasty
Early local complications include infection, dislocation, nerve injury (sciatic nerve) and leg length discrepancy.
early general complications from hip arthroplasty
Early general complications include medical complications from surgery (MI, chest infection, UTI, blood loss & hypovolaemia) as well as deep vein thrombosis and pulmonary embolism
late local complications of hip arthroplasty
Late local complications include early loosening, late infection (haematogenous spread from a distant site) and late dislocation (due to component wear).
implications of performing THR in young patient
There are implications of performing THR in younger patients as they have a higher risk of requiring revision surgery later in life as they will put more demand on their prosthetic hip than an elderly patient and they have a longer life expectancy. This is the rationale behind delaying surgery for as long as possible however if the patient’s pain and disability is severe, hip replacement in the younger patient may be justified.
has first or second hip replacement got more risks
When a hip replacement has failed, it can be re‐done (known as a revision hip replacement) however this involves bigger and more complex surgery than a first time (primary) procedure with often substantial blood loss, around twice the complication rates and often poorer functional outcome. Additionally, revision hip replacements tend not to last as long as primary hip replacements.
what does the knee joint consist of?
The knee joint consists of the medial and lateral compartments of the tibiofemoral joint and the patellofemoral joint. Although these “joints” are often considered separately, they all communicate with each other as one synovial “knee” joint. The surfaces are covered with hyaline cartilage with the retropatellar surface having the thickest hyaline cartilage in the body (a reflection of the load placed on the patella; especially when descending stairs.
where are the menisci contained?
The tibiofemoral joint contains the fibrocartilaginous menisci which ensure congruence between the concave femoral condyles and the flattish tibial plateau. The menisci are important “shock absorbers” and act to distribute load evenly.
what are the four main ligaments in the knee and their functions?
The four main ligaments include the anterior cruciate ligament (ACL), the posterior cruciate ligament (PCL) and the two collateral ligaments – the medial (MCL) and lateral (LCL) collateral ligaments.
The principal role of the ACL is to prevent abnormal internal rotation of the tibia (although it is clinically tested by assessing anterior translation of the tibia). The PCL prevents hyperextension and anterior translation of the femur (although it is tested by assessing posterior translation of the tibia). The MCL resists valgus force whilst the LCL resists varus force and abnormal external rotation of the tibia.
