orthopaedics: elective surgery Flashcards
what is an arthroplasty
reshaping/ joint replacement/ removal of diseased joint
what is a hemiarthroplasty
replacing 1 part of joint
what are common arthroplasty sites
hip, knee, shoulder, elbow, ankle, 1 MTPJ
what materials are joint replacements usually made of
stainless steel, cobalt chrome, titanium, polyethylene, ceramic
what can metal particles caue in muscle and bone
pseudotumour –> muscle and bone necrosis
what can polyethylene cause
osteolysis
what are early complications of a joint replacement
infection, dislocation, instability, fracture, nerve injury, ischaemia, DVT bleeding
what is a deep infection of arthroplasty
biofilm form on new joint
how do you treat deep infections of arthroplasties
if early detection joint surgically washed out and debrided to save it, if after 3 weeks needs to be removed and then replaced 6 weeks later
what early complications are there of arthroplasty
hypovolaemia, shock, MI, acute renal failure, urine infection, ARDS,PE
what are late complications are there of arthroplasty
infection (haematogenous spread), loosening, fracture, break, pseudotumour
when is excision or resection of a bone used
usually in small joints, (remove bone and cartilage of joint), occasionally in failed shoulder replacement
what is surgical arthrodesis
surgical stiffening or fusion of a joint into position
what are pros and cons of arthrodesis
alleviates pain but can have limited function (esp larger joints), increases pressure in surrounding joints –> OA
which joitns is arthrodesis normally used
end stage ankle, wrists, 1st MTPJ arthritis
what is osteotomy
surgical realignment of a bone by taking a bit out
when is osteotomy used
deformity correction or share load of arthritic joint (knee or hip)
what non-surgical treatment can be given in soft tissue problems
rest, anaglesia, anti-inflamm, steroid injections around tendon (not achilles)
what surgical treatment can be given in soft tissue problems (6)
debridement and decompression, synovectomy (wrists and tibialis posterior tendon), splint (achilles), surgical repair (quadriceps/ patellar), tendon transfer, arthroscopic removal (meniscal tear)
how can you surgically manage joint instability
ligament tightening, ligament reconstruction, soft tissue reattachment
