Orthapaedics Flashcards

1
Q

Indications for joint replacement

A

Degenerative disease
Inflammatory disease
Trauma
Tumour
Vascular disease
Revision of previous replacement

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2
Q

3 types of hip replacement

A

Cemented
Hybrid
Uncemented

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3
Q

Difference between cemented and uncemented hip replacement

A

Cemented uses bone cement to fix implant to bone
Uncemented relies on bone in growth onto implant

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4
Q

What substance is used as cement in cemented joint replacements

A

Poly(methyl methacrylate) - acrylic polymer

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5
Q

How are Uncemented joint implants designed to increase bone ingrowth

A

Porous or hydroxyapetite covering

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6
Q

How can cement cause damage to tissue

A

Cause burns as it sets

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7
Q

Which materials for joint replacements have the lowest wear rate

A

Ceramic on ceramic

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8
Q

Are intra operational fractures more common in cemented or Uncemented joint replacements and why

A

Uncemented
Forcing prosthesis into too small hole

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9
Q

How long before a pt can bear weight on a cemented or Uncemented hip replacement

A

Cemented - immediately
Uncemented - 4-6wks

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10
Q

Spinal fusion

A

2+ vertebrae joined together with screws and bone graft to stabilise vertebral column

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11
Q

Indications for spinal decompression surgery

A

Spinal stenosis
Damaged IVD
fractured vertebrae
Tumours

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12
Q

3 types of spinal decompression surgery

A

Spinal fusion - vertebrae are joined together to stabilise and strengthen the spine
Laminectomy - area of bone from vertebrae is removed to relieve nerve pressure
Discectomy - section of damaged disc is removed to relieve nerve pressure

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13
Q

Vertebroplasty

A

injection of bone cement into the vertebral body in order to relieve pain and / or stabilise the fractured vertebra

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14
Q

Soft tissue orthopaedic procedures

A

Tendon repair
Tendon transfer
Tendon lengthening
Ligament repair
Ligament replacement
Free muscle transfer

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15
Q

Free muscle transfer

A

Replacing damaged or destroyed muscle with other skeletal muscle (+ often overlying skin) from elsewhere in body

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16
Q

Which muscles are most commonly used for free muscle transfer

A

Gracilis
Rectus femoris

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17
Q

Which tendons are most commonly used for ACK reconstruction

A

Semitendinous tendon
Gracilis tendon

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18
Q

What procedure can improve toe walking

A

Achilles tendon lengthening

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19
Q

Tendon lengthening

A

surgically cutting part, or all, of a tendon to create a longer, more functional tendon

20
Q

Types of poor fracture healing

A

Delayed
Mal union
Non union

21
Q

Delayed fracture healing

A

Failure to consolidate within 1.5x expected time

22
Q

Fracture Non union

A

Failure to consolidate within 2x expected time

23
Q

Fracture Mal union

A

Misalignment of proximal and distal fragments

24
Q

Types of fracture Mal union

A

Rotation
Angulation
Shortening
Translation

25
Q

2 types of fracture non union

A

Atrophic
Hypertrophic

26
Q

Difference between Atrophic and hypertrophic non union

A

Atrophic - no Blood supply
Hypertrophic - has blood supply

27
Q

What causes Atrophic non union

A

Lack of blood supply to bone ends or metabolic conditions

28
Q

What causes hypertrophic non union

A

Inadequate fracture stability - bone ends move too much

29
Q

What type of poor fracture healing leads to ‘elephant foot’ or ‘horse hoof’ appearance

A

Hypertrophic non union

30
Q

Osteotomy

A

Surgical cutting of a bone usually for realignment

31
Q

Distraction osteogenesis

A

Bone lengthening
cutting and slowly separating bone using a distractor and allowing the bone healing process to fill in the gap

32
Q

Reconstructive orthopaedic procedures

A

Osteotomy
Distraction osteogenesis

33
Q

4 sources/types of bone graft

A

Autograft
Allograft
Xenograft
Alloplast

34
Q

Autograft, allograft, xenograft, and alloplast sources

A

Auto - pts own tissue
Allo - tissue from another person
Zeno - tissue from an animal
Allo - synthetic material, eg hydroxyapetite

35
Q

4 processes involved in bone grafting

A

Osteogenesis
Osteoconduction
Osteoinduction
Osteopromotion

36
Q

Osteogenesis

A

Formation/development of new bone cells from graft

37
Q

Osteoconduction

A

Physical effect where matrix of graft forms a scaffold which favours outside cells to penetrate the graft and form new bone
(Bone growing on a surface)

38
Q

Osteoinduction

A

Chemical process where molecules in graft converts neighbouring cells into osteoblasts

39
Q

Osteopromotion

A

Grafted material enhances Osteoinduction

40
Q

Aseptic loosening

A

failure of the fixation of a prosthetic component in the absence of infection

41
Q

Difference between wear and corrosion of a prosthetic

A

Wear - mechanical process from changes in load distribution and micro motion
Corrosion - electrochemical process of metal degradation

42
Q

Which areas of bone are most commonly affected by cancer metastases

A

Spine
Pelvis
Proximal femur
Proximal humerus

43
Q

Effects of cancer metastasising into bone

A

Severe pain
Decr mobility
Pathological fractures

44
Q

Treatment of cancer metastases lesions in bones

A

Surgical resection
Joint reconstruction w bone graft

45
Q

Lytic bone metastases

A

distant tumour deposits of a primary tumour within bone characterised by a loss of bone with the destruction of the bone matrix