Post Surgery Flashcards
Post op SLAP repair:
- when can athlete return to athletic play?
12 months post op
What nerve is at risk after a SLAP repair?
Suprascapular Nerve
- atrophy of the intraspinatus & supraspinatus
What are the EBP exercises to decrease imbalances btwn the mid, lower and upper trap?
- sidelying ER
- sidelying forward flexion
- prone horizontal ABD w/ ER
- prone extension
Post UCL repair:
- when can a baseball pitcher return to throwing?
- plyometric exercise can begin btwn 3-4 months
- begin return to throwing program at 4 months
- hitting program at 5 months
- long toss
- throwing off the mound 9 months
Putti-Putti Shoulder Surgery
This procedure divides the subscapularis tendon, overlaps it, and repositions it to achieve anterior capsular stability.
*This is not performed in throwers due to the risk for range of motion loss
5 weeks post op ACL w/ BTB: what would be an inappropriate exercise?
OKC extension btwn 60 and 30 deg
Post op ACL w/ a significant loss of ROM - most likely due to?
Surgical error
- anterior placement of the femoral tunnel
ACL allografts use have been?
Decreased:
- b/c of high re-injury rate
- especially in young patients & females
- more expensive
A double bundle ACL repair has been shown to be?
Theoretically better than single bundle in rotational control via cadaver studies
6 months post ACL rehab:
- what % of the quads typically show a deficit
15-25% compared to non-surgical leg
What timeframe of returning to sport do ACL’s habe the highest graft re-rupture rate?
Returning to sport during the first 12 months following ACL-R have the highest re-rupture rate
- very high > 30% early re-injury or contralateral injuries with allografts
After a partial meniscectomy - what is the increase in articular cartilage contact pressure?
removal of 20% of medial meniscus, creates 350% increase in articular cartilage pressure
In a mensical repair: what is the most common suture?
Stacked suture
ACL-R: What is the safe range of OKC exercises in post op ACL?
90-70 degrees
- anything greater than 70 degrees increases stress through the patella, can lead to increase anterior shear of the patella
3 weeks post op microfracture - what is the recommended WB status?
toe touch weight bearing
Should OKC exercises be used in post op ACL-R?
yes!
Using OKC exercises in combination with CKC exercises because it is shown that they can be incorporate safely and result in an improved outcome
Safe range: 90-70 deg
What % of post op isolated mensical repairs return to sport?
80% of elite athletes were able to return to sport
What is the rational of using a contra-lateral PT graft in ALC-R?
Shelbourne popularized this approach.
This process may allow greater equality R to L during rehabilitation
The use of contra-lateral PT for graft allows a dual rehabilitation program. You work a donor site program on the graft limb and then ACL protocol on the reconstructed limb, along with additional attention to ROM in this case.
What characteristics are associated with improved patient reported outcomes following a surgical cartilage procedure?
- Less than 2 cm defect size
- Preoperative duration of sx less than 18 months
- No prior surgical treatment
- Younger patient age
- Higher levels of activity (pre and post surgery)
What kind of shoes would you recommend to a golfer 20 weeks s/p TKA?
Spikeless shoes
Golf spikes create torque about the knee
What kind of tennis is recommended after a THA?
Doubles tennis
What kind of sports are not recommended after a THA or TKA?
High-impact aerobics
Jogging
Singles tennis
What grade Lisfranc injury requires surgery?
Grade III
Diastasis greater than 2 mm seen on AP radiographs
Most important risk factor in developing OA after a meniscal repair?
BMI classified as overweight >25
Revascularization of the bone patellar tendon bone ACL autograft occurs most rapidly at which portion of the graft?
Mid-substance
What position is contraindicated s/p PCL surgery?
Gravity assisted extension
ie. propping heel up on towel rolls for quad sets
