Shoulder Arthroplasty - 3

Question 1

What have pain with resisted isometrics (2)

Answer 1

1. Rotator cuff tendinitis

2. Impingement syndrome

Question 2

What describes what is going on at a cellular/tissue level

Answer 2

Pathologies

Question 3

What is usually impinged in the shoulder

Answer 3

Supraspinatus

Question 4

What is bicipital tendinitis

Answer 4

Degeneration of the biceps tendon and inflammation

Question 5

Someone with a complete tear will be graded what during resisted isometrics

Answer 5

Weak and painless

Question 6

What is adhesive capsulitis classified

Answer 6

Dysfunction and noncontractile

Question 7

What are the indications for shoulder arthroplasty (7)

Answer 7

1. Osteoarthritis
2. Rheumatoid arthritis
3. Traumatic arthritis
4. Osteonecrosis
5. Rotator cuff arthropathy
6. Capsulorrhaphy arthritis
7. Proximal humeral fracture

Question 8

What causes osteonecrosis

Answer 8

Infections

Question 9

What can cause rotator cuff arthropathy

Answer 9

Over/under compensation and guarding

Question 10

How do you distinguish between hypermobility and instability

Answer 10

Willingness to move actively

Question 11

What is capsulorrhaphy arthritis

Answer 11

The capsule is too tight

Question 12

Too much PROM equals what

Answer 12

Hypermobility

Question 13

How do you work on stabilization

Answer 13

Working in the range that is stable at mid range

Question 14

Does the joint have to be in neutral for stabilization

Answer 14

True

Question 15

What can cause subluxation

Answer 15

Lax ligaments or trauma

Question 16

Who performed the first shoulder arthropathy and when

Answer 16

Jules Emile Pean in 1893

Question 17

How was the first arthropathy done

Answer 17

Rubber humeral head boiled in parffin wax and attached via metal wire to a platinum shaft

Question 18

Who performed a shoulder arthropathy with and anatomic design and when

Answer 18

Krueger in 1950

Question 19

Who performed the first hemiarthroplasty and when

Answer 19

Neer in 1953

Question 20

Why did Neer perform a hemiarthoplasty

Answer 20

To treat a complex proximal humeral fracture

Question 21

When was the reversed ball and socket first introduced

Answer 21

1960s

Question 22

What was reversed ball and socket invented to treat

Answer 22

Shoulder OA and massive rotator cuff tear

Question 23

What are the benefits of reversed ball and socket

Answer 23

requires less recruitment of muscle

Question 24

What are other reasons to do reversed ball and socket arthroplasty

Answer 24

Deltoid the is weak or not working or weak rotator cuff muscles

Question 25

What has caused an increase in shoulder arthoplasty

Answer 25

The baby boomers aging

Question 26

In the early 1990s how many total shoulder arthoplasty (TSA) occurred

Answer 26

5,000

Question 27

How many TSA occurred in 2003

Answer 27

28,743

Question 28

Between 1997 and 2005 how much did the amount of TSA increase

Answer 28

145%

Question 29

What number most common arthroplasty is TSA

Answer 29

3rd behind hip and knee

Question 30

What does overstuffed mean

Answer 30

Humeral head is too bog for glenoid fossa

Question 31

What are all 4 rotator cuff muscles responsible for when lifting arm up

Answer 31

Bringing head of humerus down

Question 32

What does an overstuffed joint cause

Answer 32

decreased ROM and increased strain on the subscapularis

Question 33

What is the distance between the lateral base of the coracoid to the lateral margin of the greater tuberosity

Answer 33

Lateral humeral offset

Question 34

What determines the moment arm of the deltoid and rotator cuff muscles

Answer 34

Lateral humeral offset

Question 35

What does success of the TSA depend on (6)

Answer 35

1. Anatomic design 2. Biomechanical functon 3. Adequate fixation 4. Component durability 5. Soft tissue balance restoration 6. Surgical skill

Question 36

What shape is the arthritic glenoid

Answer 36

Oval

Question 37

What is the normal shape of the glenoid

Answer 37

Pear

Question 38

What is the glenoid component made of

Answer 38

Polyethylene or polyethylene with a metal backed base

Question 39

What degree of retroversion is the humeral component placed in

Answer 39

30 degrees

Question 40

What are the 2 ways the humeral component can be put in place

Answer 40

1. Cementing | 2. Press fit technique

Question 41

How is the glenoid component placed in respect to the scapula

Answer 41

Neutral position

Question 42

What is the most common component that fails

Answer 42

Glenoid component

Question 43

Which way is the center of rotation moved to increase the moment arm of the deltoid in the reverse method

Answer 43

More medial and move distally

Question 44

What does a PT look at during the physical exam post TSA surgery (4)

Answer 44

1. Inspection 2. ROM and strength 3. Outcome measures 4. Imaging studies

Question 45

What do you look for during inspection (3)

Answer 45

1. Purulent 2. Oozing 3. Infectect

Question 46

What is hemiarthroplasty

Answer 46

One component is changed

Question 47

What is total shoulder arthroplasy

Answer 47

Humeral component is convex

Question 48

What is reverse shoulder arthroplasty

Answer 48

Humeral component is concave

Question 49

What is the most common hemiarthroplasty approach

Answer 49

Deltopectoral

Question 50

Where is the incision made in the deltopectoral approach

Answer 50

Just lateral to coracoid process obliquely along the deltopectoral inverval down to lateral border of biceps

Question 51

What are attached directly off or 2 cm medial to the lesser tuberosity

Answer 51

Subscapularis and anterior capsule

Question 52

What degree is the arthritic humeral head cut at

Answer 52

45 degrees from inclination of humerus and 30 degree of retroversion