Orthopedic Surgical Procedures

Question 1

List soft tissue orthopedic surgeries

Answer 1

1. Ligament reconstruction
2. Tendon surgery
3. Rotator cuff Repair

Question 2

Ligament reconstruction is commonly performed at which 3 joints?

Answer 2

1. Knee (ACL, PCL, MCL)
2. Ankle (ATFL, CFL)
3. Elbow (UCL)

Question 3

What grafts are typically used for ligament reconstruction?

Answer 3

1. Autograft

2. Allograft

Question 4

As a physical therapist, when treating a patient who recently underwent ligament reconstruction, what factors does therapist need to know regarding the patients surgery.

Answer 4

1. Graft material
2. Fixation
3. Quality of tissue
4. Status of joint surfaces
5. Comorbidities
6. Associated injuries frequently impact rehabilitation

Question 5

A patient underwent PCL reconstruction surgery the therapists would expect the LE to immobilized in what position?

Answer 5

Immobilized in full extension for 6 weeks

Question 6

A patient underwent a lateral ankle reconstruction. The patient should expect to immobilized for how many weeks?

Answer 6

4-6 weeks in a combination of cast and/or rigid walking blood

Question 7

The goal post lateral ankle reconstruction for therapy is to ?

Answer 7

Regain ROM after immobilization

Question 8

Tendon surgery is commonly performed on what structures?

Answer 8

1. Hand
2. Rotator cuff
3. Achilles
4. Patellar Tendons

Question 9

List the tendon repairs of the hand?

Answer 9

1. Flexor tendon repairs
2. Distal repairs
3. Proximal repairs

Question 10

How long is a flexor tendon repair immobilized for?

Answer 10

3-4 weeks with wrist and digits FLEXED

Question 11

When may a therapist initiate AROM with a flexor tendon repair?

Answer 11

May initiate AROM at 4 weeks

Question 12

How long are distal repairs immobilized for?

Answer 12

1. Immobilized in neutral for 6-8 weeks

Question 13

When can a therapist initiate AROM with distal repairs?

Answer 13

6 weeks with PIP in neutral

Active extension initiated first, followed by flexion

Question 14

How long is a proximal repair immobilized for?

Answer 14

Immobilized with wrist and digital joints in extension for 4 weeks

Question 15

A therapist may initiated ROM when with a proximal tendon repair?

Answer 15

Early AROM/PROM in flexion with MCP joints in extension

Full AROM initial into flexion/extension at 6 weeks

Question 16

How long are rotator cuffs typically immobilized for?

Answer 16

Immobilized for 4-6 weeks

no active shoulder motion and NWB during this weeks

Question 17

A therapist may initiate isometrics at what week with a rotator cuff repair?

Answer 17

Initiate isometrics at 6 weeks

Question 18

Meniscal and labral repairs and debridement are commonly performed at what structures?

Answer 18

1. Knee (meniscus)

2. Hip (labrum)

Question 19

True or False: debridement requires less early protection than repair

Answer 19

True

Question 20

What provocative position should be avoided with a knee meniscal repair?

Answer 20

Weight-bearing with flexion

Question 21

What provocative position should be avoided with a hip labrum repair?

Answer 21

Passive unilateral hip extension, excessive hip flexion, abduction, and ER

Question 22

List the procedures that restore and preserve articular cartilage

Answer 22

1. Osteochondral autograft transplantation (OAT)

2. Autologous chondrocyte Implantation (ACI)

Question 23

Describe the OAT procedure.

Answer 23

Transfers articular cartilage from areas of low-loading to ares of high-loading

Question 24

Describe the ACI procedure.

Answer 24

Health articular cartilage is harvested from patient and injected under a periosteal flap closed with additional sutures and fibrin glue

Question 25

True or False: Early NWB followed by progressive WBing for OAT and ACI. High level activities may be introduced at 6+ months.

Answer 25

True

Question 26

Describe an osteotomoy.

Answer 26

Surgical cutting of bone to correct bony alignment.

Commonl perfored at the knee to correct excessive Genu varum/valgum.

Question 27

What procedure is commonly performed at the knee to correct excessive genu varum/valgum.

Answer 27

Osteotomy

Question 28

For Total Joint Arthroplasty cement or noncemented procedures are more stress for the bones?

Answer 28

Noncemented procedures therefore typically performed on younger and/or more active individuals

Question 29

For Total joint replacements which technique (cemented vs noncemented) can tolerate FWB?

Answer 29

Cemented can tolerate FWB immediately after surgery

Question 30

True or False: Cement may crack with aging, causing a loosening of prosthesis

Answer 30

True

Question 31

What is the foundation of lumbar and cervical procedures?

Answer 31

Walking programs

Question 32

Describe spinal fusion procedures.

Answer 32

Adjacent joints compensate to restore mobility, possibly creating pain above or below fusion.

Question 33

Muscles must be retrained to adapt to a new movement patter, what exercises should a therapist incorporate into a patient’s POC for lumbar and cervical fusions?

Answer 33

Lumbar: core stabilization exercises
Cervical: deep neck flexor strengthening and stabilization exercises

Question 34

A patient just underwent a Harrington rod placement of idiopathic scoliosis what should the therapist focus on for the first week.

Answer 34

Early Mobilization in bed and effective coughing

Begin ambulation on 4th and 7th post-op days

Question 35

What are the precautions for Harrington rod for idiopathic scoliosis procedure.

Answer 35

BLT—bending, lifting, twisting in all directions