S/P Hip & Knee Arthroplasty & Spinal Surgery Flashcards
Mahle Chapter 22 PowerPoint: orthopedic conditions: spine, pelvis, hip, knee
posterior hip precautions (3)
- no hip FLEXion (90+)
- no hip internal rotation
- no hip ADDuction beyond neutral (no crossing legs)
anterior hip precautions (3)
- ho hip EXTENSion
- no hip external rotation beyond neutral
- no hip ABDuction
back precautions
- no bending
- no twisting
- specific limits on how much they can lift
- stand smart
- sit smart
- lift smart
weight-bearing precautions
- FWB – 100% weight
- NWB – 0% weight
- PWB – 1-50% weight
- TDWB – foot touch 0%
weight - TTWB – toe touch 0%
weight - WBAT – to client pain
tolerance or strength
TLSO means:
thoracolumbosacral orthosis
spinal fusion
surgery to join, or fuse, two or more vertebrae so there is no movement between them
laminectomy
decompression surgery that enlarges the spinal canal to relieve pressure on the spinal cord or nerves (by removing the lamina)
foraminotomy
decompression surgery that is performed to enlarge the foramen
discectomy
removal of herniated disc material that is pressing on a nerve root or the spinal cord
artificial disc replacement
intervertebral disc in the spine is replaced with a mechanical device; helps to restore motion to the spine; newer procedure
interlaminar implant
u-shaped implant that fits between the spinous processes located in the lumbar region of the spine; maintains a fixed distance between the spinous processes to support and stabilize without a reduction in the ROM
kyphoplasty
procedure used to treat compression fractures of the spine; space is created in a compressed or collapsed vertebrae with a balloon-type device; once fractured bone pieces are in more of a normal position, cement is injected to restore the damaged vertebrae height with goal to relieve pain
common hip problems
- osteoarthritis
- rheumatoid arthritis
- avascular necrosis
- fractures
common knee problems
- osteoarthritis
- rheumatoid arthritis
- post-traumatic arthritis
general orthopedic considerations
- post-surgical complications (DVT, infection)
- safety (low hemoglobin, orthostatic hypotension)
- fall prevention
- debility
- pain
- cognition (temporary, underlying confusion)
- psychosocial impact
- occupational performance
main goal for S/P knee surgery
keep the knee moving!!
- consider weight-bearing status
- knee rotation avoided for up to 12 weeks
- may use a knee immobilizer for bed mobility and ambulation to support the knee
- bilateral knee replacements complicate rehab process
causes of back pain
- bone spurs
- herniated/ degenerative discs
- arthritis/ ankylosing spondylitis
- fractures
- facet joint problems
- osteomyelitis
- spinal stenosis
- spondylolisthesis
- herniated/ ruptured disc
- disc degeneration
neurological symptoms of back pain
- radiculopathy
- sciatica
spine (pelvis) interventions
main focus: education & adaptation
- back precautions
- body mechanics
- log rolling techniques
- donning/ doffing TLSO
- sit on higher surfaces with arms
- raised toilet seat
- shower chair
- other AE
hip surgery facts to know
- ORIF (open reduction internal fixation)
- THA (posterior, anterior, lateral)
- hemiarthroplasty
- revision surgery
back pain classification
- acute
- subacute
- chronic
knee surgery facts to know
- TKR/TKA
- partial knee replacement
- knee resurfacing
knee surgery interventions
- keep moving joint
- ADLs
- functional mobility
- AE (may be limited by MD to encourage ROM)
aquatic therapy can be used to increase or decrease the demand on muscles:
- muscle strength
- muscle tone
- weight-bearing
- joint pain
- joint flexibility
- balance
- healing
- sensory-perceptual
