Surgery knowledge

Question 1

Massive rotator cuff tear, how long until AROM?

Answer 1

about 2 months

Question 2

Small rotator cuff tear, how long until AROM

Answer 2

about 1 month

Question 3

How large does a rotator cuff tear have to be to be considered large?

Answer 3

3-5 cm

Question 4

How small does a rotator cuff tear have to be to be considered small?

Answer 4

1-3 cm

Question 5

Go to exercises for first month of ACL reconstruction rehab

Answer 5

quad set, 4 way SLR, mini squats, closed chain TKE, SL balance with compliant surface, LAQ BL 20-90, hamstring curls prone/seated

Question 6

Go to treatment for tendonitis/tendonopathy?

Answer 6

?

Question 7

Arthroscopic approach for a rotator cuff repair?

Answer 7

arthroscopically few small incisions

Question 8

Mini open (arthroscopic)

Answer 8

sub acromial decompression with deltoid splitting (cut made from acromion anterolateral incision to along fibers of deltoids insertion) deltoid snipped from acromion and then reattached

Question 9

Traditional open approach

Answer 9

anterolateral incision coracoid-proximal humerus, deltoid snipped from acromion and then reattached

Question 10

Patient is approaching 2nd month in their ACL rehab, what exercises if all is going according to plan would be applicable?

Answer 10

DL SL leg press (endurance) , mini squats with weight now (2# medicine ball), stool scoots, step ups/laterals, rebounder in squat with medicine ball push, 5 point star skaters, rebounder on foam SLS 4 min each side

Question 11

structures to think about when there is a bankart repair or a SLAP tear?

Answer 11

Subscapularis/proximal attachment of long head of biceps tendon/superior labrum extending anterior to posterior.

Question 12

With a bankart lesion repair? what has happened?

Answer 12

shoulder instability, capsulolabrum pops off glenoid, they will sometimes clip the subscapularis, so be cautious when taking patients into ER

Question 13

With a SLAP lesion repair? what has happened?

Answer 13

shoulder instability, usually accompanines a tear of the proximal attachment of the long head of the biceps

Question 14

How long for cortical bone to heal?

Answer 14

6-10 weeks up to 18 weeks for adults. Many factors including age location blood supply worth looking at

Question 15

Process of cortical bone healing?

Answer 15

torn blood vessels to clotting > callus surrounding site with osteoblasts/chondroblasts > callus hardens, usually no more immobilization, then callus reabsorbed

Question 16

sprain vs strain?

Answer 16

sprain is ligament, strain is muscle

Question 17

explain tendinopathy, tenosynovitis, and tendinitis.

Answer 17

tendinopathy general term for issues with tendon, tenosynovitis is inflammation of the synovial membrane surrounding a tendon, and tedinitis is inflammation of the tendon which may have scarring and calcium deposits

Question 18

explain tenovaginitis, and tendinosis

Answer 18

tenovaginitis is the inflammation of the sheath of the tendon, and tendinosis is degeneration of the tendon due to repetitive microtrauma

Question 19

how long on estimate are the 3 phases of soft tissue healing? therapy’s goal?

Answer 19

acute is about 5 days, we control inflammation/avoid too much rest, sub acute last about 15 days, we help to make a more mobile scar and promote healing through exercise, chronic/maturing phase can last 6 months to a year, we increase tensile strength and function.