MSK

Question 1

TKA
WB status
precautions
protocol
OMs

Answer 1

WBAT usually after surgery
No precautions usually
protocol - AROM and strengthening begin immediately – 0 to 90 knee ex/fl
OMs- FGA or DGI

Question 2

THA
WB status
Precautions - ant and post
Protocol

Answer 2

Most often WBAT
Precautions
a)	Posterolateral approach: no hip flex past 90, no adduction past midline, no IR past neutral
b)	Anterolateral and 2-incision approaches: limit hip ext especially with ER
c)	Avoid sleeping on surgical side
d)	Avoid sitting on low surfaces
Post protocol
a)	ABD wedge
b)	Possible Knee immob
c)	Prescribe appropriate AD
d)	AROM – strength
i)	submax on surgery site 
ii)	avoid SLR – strain on surgery site
e)	functional mobility
i)	avoid pivoting on surgical LE – turn toward surgical side

Question 3

TSA
shoulder access
most common type
complications

Answer 3

access - deltopectoral most common - lesser tubercle osteotomy more common

most common type - unconstrained

complications - RC tear GH instability

Question 4

TSA
Precautions
Pt Edu
Post OP

Answer 4

Common precautions
a) Avoid shoulder active range of motion
b) No lifting, pushing, or pulling objects with involved upper extremity
c) No excessive shoulder motion behind back, especially into internal rotation
d) No excessive stretching, especially into external rotation
e) No supporting body weight by hand on involved side
f) No driving for 3 weeks
Pt edu
a) Ice for pain and inflammation
b) Avoid lying on involved shoulder
c) Towel under elbow in supine
d) HEP
e) Squeeze ball or sponge
f) AROM of distal extremities
Post OP
a) Supine PROM FL w/ elbow FL
b) Supine PROM ER with arm at side elbow FL no more than 30
c) Pendulum

Question 5

rTSA

approach does what

Answer 5

deltopectoral - allows AROM on day 1

deltoid splinting - PROM FL and ER AAROM in 2-3 wks

Question 6

spinal decompression

Answer 6

remove posterior elements

Question 7

spinal fusion

Answer 7

stabilizes hypermobile joints

Question 8

spinal precautions

Answer 8

a) Log-rolling technique for getting in/OOB
b) Avoid excessive trunk flexion while seated
c) Limit extended periods of sitting
d) Lifting restrictions to < 5-10 pounds (may vary depending on protocol)
e) There are no LE WB restrictions