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pt clin med > Shoulder Arthroplasty - 3 > Flashcards

Shoulder Arthroplasty - 3 Flashcards

1
Q

What have pain with resisted isometrics (2)

A
  1. Rotator cuff tendinitis

2. Impingement syndrome

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2
Q

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

A

Pathologies

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3
Q

What is usually impinged in the shoulder

A

Supraspinatus

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4
Q

What is bicipital tendinitis

A

Degeneration of the biceps tendon and inflammation

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5
Q

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

A

Weak and painless

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6
Q

What is adhesive capsulitis classified

A

Dysfunction and noncontractile

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7
Q

What are the indications for shoulder arthroplasty (7)

A
  1. Osteoarthritis
  2. Rheumatoid arthritis
  3. Traumatic arthritis
  4. Osteonecrosis
  5. Rotator cuff arthropathy
  6. Capsulorrhaphy arthritis
  7. Proximal humeral fracture
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8
Q

What causes osteonecrosis

A

Infections

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9
Q

What can cause rotator cuff arthropathy

A

Over/under compensation and guarding

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10
Q

How do you distinguish between hypermobility and instability

A

Willingness to move actively

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11
Q

What is capsulorrhaphy arthritis

A

The capsule is too tight

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12
Q

Too much PROM equals what

A

Hypermobility

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13
Q

How do you work on stabilization

A

Working in the range that is stable at mid range

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14
Q

Does the joint have to be in neutral for stabilization

A

True

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15
Q

What can cause subluxation

A

Lax ligaments or trauma

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16
Q

Who performed the first shoulder arthropathy and when

A

Jules Emile Pean in 1893

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17
Q

How was the first arthropathy done

A

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

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18
Q

Who performed a shoulder arthropathy with and anatomic design and when

A

Krueger in 1950

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19
Q

Who performed the first hemiarthroplasty and when

A

Neer in 1953

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20
Q

Why did Neer perform a hemiarthoplasty

A

To treat a complex proximal humeral fracture

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21
Q

When was the reversed ball and socket first introduced

22
Q

What was reversed ball and socket invented to treat

A

Shoulder OA and massive rotator cuff tear

23
Q

What are the benefits of reversed ball and socket

A

requires less recruitment of muscle

24
Q

What are other reasons to do reversed ball and socket arthroplasty

A

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

25
Q

What has caused an increase in shoulder arthoplasty

A

The baby boomers aging

26
Q

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

27
Q

How many TSA occurred in 2003

28
Q

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

29
Q

What number most common arthroplasty is TSA

A

3rd behind hip and knee

30
Q

What does overstuffed mean

A

Humeral head is too bog for glenoid fossa

31
Q

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

A

Bringing head of humerus down

32
Q

What does an overstuffed joint cause

A

decreased ROM and increased strain on the subscapularis

33
Q

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

A

Lateral humeral offset

34
Q

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

A

Lateral humeral offset

35
Q

What does success of the TSA depend on (6)

A
  1. Anatomic design
  2. Biomechanical functon
  3. Adequate fixation
  4. Component durability
  5. Soft tissue balance restoration
  6. Surgical skill
36
Q

What shape is the arthritic glenoid

37
Q

What is the normal shape of the glenoid

38
Q

What is the glenoid component made of

A

Polyethylene or polyethylene with a metal backed base

39
Q

What degree of retroversion is the humeral component placed in

A

30 degrees

40
Q

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

A
  1. Cementing

2. Press fit technique

41
Q

How is the glenoid component placed in respect to the scapula

A

Neutral position

42
Q

What is the most common component that fails

A

Glenoid component

43
Q

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

A

More medial and move distally

44
Q

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

A
  1. Inspection
  2. ROM and strength
  3. Outcome measures
  4. Imaging studies
45
Q

What do you look for during inspection (3)

A
  1. Purulent
  2. Oozing
  3. Infectect
46
Q

What is hemiarthroplasty

A

One component is changed

47
Q

What is total shoulder arthroplasy

A

Humeral component is convex

48
Q

What is reverse shoulder arthroplasty

A

Humeral component is concave

49
Q

What is the most common hemiarthroplasty approach

A

Deltopectoral

50
Q

Where is the incision made in the deltopectoral approach

A

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

51
Q

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

A

Subscapularis and anterior capsule

52
Q

What degree is the arthritic humeral head cut at

A

45 degrees from inclination of humerus and 30 degree of retroversion

pt clin med (15 decks)

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