Osteoarthritis Flashcards
Osteoarthritis is the …..
Loss of cartilage
Causes of osteoarthritis (primary, secondary)
Primary-
Aging and genetics
Secondary: Joint injury, obesity, trauma, overuse, diseases
Assessment of OA
- Chronic joint pain and stiffness that diminishes after rest but worsens with activity
- ROM: May be limited, crepitus, pain
- Enlarged, hardened joints
- Seconday synovitis
- Heberden’s nodes
- Bouchard’s nodes
- Joint effusions
- Atrophy of skeletal muscles
- Limp
Diagnostics for OA
- Based on H&P exam
- XRs may be degenerative changes
- MRI and CT for vertebral and knees
- Erythrocyte sedimentation rate and c-reactive protein
Interventions for OA
-Management of pain: tylenol (first), lidoderm patches, other topical medications, NSAIDs, Topical Nsaids, muscle relaxants, opioids (try to avoid)
Non pharm interventions of OA
- Exercise and rest balance
- Hot/cold therapy (focus on heat)
- Weight control
- Supplements (glucosamine and chondritin)
- Position
- Shoes
- Surgery
- PT/OT
- Swimming/walking/ cycling/ aerobics
- Home adjustments
- Beware of curative remedies
Joint arthroplasty
surgical creation of joint
- knees and hips are more common
- only recommended when QOL can’t be maintained
- Majority are over >60
- Contraindications: infection, (not absolute) advanced osteoporosis, severe inflammation, severe DM, dialysis
Pre op Joint
- Acquire equipment
- Clean entire body with antibiotic soap
- blood transfusions
- Pre-op antibiotic
- NPO
- Education (dental work and antibiotics) (positioning/ restrictions)
Peri op joint
- Minimally invasive versus traditional
HIP: acetabular and femoral component - may be press fitted and cemented
Knee: femoral and tibial component
Post-op
Hip:
- dislocation ( shortening of leg, leg rotation)
- See hip precautions: weight bearing versus non weight bearing (cement vs press fit)
- DVT/ PE
- Infection
- Bleeding
- Neurovascular Compromise (Assess -> compromise)
Do not have people do what after operation
- bend knees, cross legs
Abduction pillow only for
- confused elderly
- post side
Cement
- things are being held together like glue
- can bear weight immediatley
Press fitted
- take awhile for things to heal
- can not due weight bearing
Post op Knee
- Continuous passive motion machine
- ICe
- Pressure dressing
- Prevention of adduction is not necessary
- keep in neutral position
- risk of DV/ PE, bleeding, infection, NV compromise
Expected outcomes for OA
Client will be able to maintain level of mobility that allows independent function
- client able to maintain activities of daily living independently
Posterior approach worry and rotation for
about adduction!!
rotation for hips and knee
