Pathology 12 - MSK Flashcards
THA - what leads to this
OA
RA
development dysplasia
tumor
failed reconstruction
AVA
traumatic
nonunion fx
any hip conditions that produce pain and disability
THA - when is a hemiarthoplasty preformed
when there are only degen changes in the femoral head and not the ACE
THA - population
normally
> 55
experienced consistant pain that has not improved with conservative methods
THA - imaging
c\xray
CT scan
MRI
all can be used to view integrity of the joint
THA - contraindication
active infections
severe obesity
art insuffiency
neuromuscular disease
certain mental illness
capillary refill test used for
arterial insuffiency
THA - how long does it last for
20 years
THA - what pt are hip hemiarthroplasty used for
limited life expectancy
hip fx
THA - AL approach where
interval between the TFL and glute medius
small portion of the hip abd are released
THA - AL precautions
extension
ER
add
THA - direct lateral approach where
leaves post portion of glute med attahced, releases the anterior portion
long division of the TFL and vastus lateralis
posterior tissue and capulse left intact
THA - direct lateral approach precautions
flexion > 90
ext of hip
ER
add
if glute med repaired: avoid activity or resisted hip abd for 6-8 weeks
THA - PL approach where
splits the glute max muscle
short external rot are released
hip abd are retraction anterioly
maintain the glute med and vastus lateralis
THA - PL hip precaution
no hip flexion past 90-deg
IR
add
what is the most common apparach for THA
Posterolateral approach
results in a higher post surgical disloaction
THA - when does cement used in surgery achieve max fixation
15 mins
THA - turing
turn toward uninvolved side
TKA - what are we removing
the proximal and distal joint surfaces of the knee and replacing them with a implant
TKA - unicompartmental
only the medial of lateral joint surface needs to be replaced
TKA - bicompartmental
the entire surface of the feumr and the tibia were replaced
TKA - tricompartmental
replacement of the tibia, femur and the patella
TKA - what design offers the most support
most to least
fully constrained design
semicontrained - the most common
unconstrianed
TKA - how long does it last
15-20 years
TKA - what is most common type of fixation
cement
TKA - complication following include
DVT
infection
PE
fibular nerve plasy
reduced ROM
periprothesitic fractures
what are periprosthetic fractures
a bone fracture that occurs around or near an orthopedic implant, like a joint replacemen
TKA - how much knee ROM do we need for ADL’s
90
TKA - how much knee ROM do we need to rise from sitting
105-deg
TKA - can we perform high intensity strengthing activities with these pt’s
yes
TKA - what should the pt avoid when resting
placing the knee in 30-60 of flexion - we want to avoid contractures
TKA - do we like CPM machine
nope
Osteophyte formation is often seen with what
OA - due to bone and bone contact
what is oscillopsia
a vision problem that makes objects appear to move when they are actually still
what is hemothorax
a serious condition that occurs when blood pools in the pleural cavity, the space between the lungs and chest wall
TKA - imaging
XRAY, MRI, CT
used to look at the deteration of the joint
TKA - contraindications
active infection of kee
severe obesity
genu recurvatum
art insufficiency
neuropathic joint
certain mental illnesses
what is genu recurvatum
a knee deformity that causes the knee to bend backward
what is a neuropathic joint
severely damaged joint that occurs when a nerve that sends pain signals to the brain is damaged
TKA - post op complications
infection
vascular damage
patellofemoral instability
fx surronding the prothesis
PE
nerve damage
arthrofibrosis
what is arthrofibrosis
a condition that causes excessive scar tissue to form in a joint, leading to pain and reduced joint movement
TKA - phram
anticoagulants
pain meds
TKA - noncements vs cemented WB precautions
non: toe touch
cement : WBAT
TKA - knee ROM prior to hospital discharge
normally 90-0
patellectomy - what is it
surgical removal of your patella
patellectomy - when is it indicated
when there is comminuted fracture of the pattella that cannot be fixed with internal fixation
patellectomy - what part of the patella is removed
entire patella
just inferior or superior pole
patellectomy - what exercises are introduced at start of PT
ROM
closed chained exercises
