Surgical Considerations

Question 1

timing of acute/inflammatory phase

Answer 1

0-2 weeks
immediately after injury/onset

Question 2

associated losses of acute/inflammatory phase

Answer 2

loss of function
- ROM, muscle tolerance, weightbearing, PLOF

Question 3

timing of subacute phase

Answer 3

2-6 weeks

Question 4

what happens in the subacute/proliferation phase

Answer 4

decline of inflammation
influx of fibroblasts and capillaries

Question 5

explain the tissue that is laid down during subacute phase

Answer 5

thin and disorganized
can be damaged easily
needs to be appropriately loaded to direct growth and alignment

Question 6

what is the indicator of remodeling phase

Answer 6

no inflammation
tissue strengthen and returning towards prior level of strength

Question 7

instead of being limited by pain, those in the remodeling phase typically are held back by

Answer 7

weakness
poor endurance / NM control

Question 8

what indicates centralization / nociplastic pain

Answer 8

generalization of the pain
pain not being linked to direct tissue harm

Question 9

maximal protection phase goals

Answer 9

protect surgical repair
achieve ROM goals
education on post-op restrictions
minimize pain/inflammation
ensure adequate regional function

Question 10

functional phase goals

Answer 10

achieve ROM goals
- normalize PROM and AROM
minimize pain
begin increases to strength and endurance
increase functional activities

Question 11

normalization phase goals

Answer 11

normalize
- strength, endurance, NM control and power
build up of stress on involved tissue (indirect and direct)
gradual return to ADLs, work and recreational activities

Question 12

what are return to sport/work requirements

Answer 12

clearance from physician

no report of pain at rest/activity

no or minimal sense of fear/instability with activity

sufficient ROM/flexibility to perform desired tasks

adequate strength and endurance

Question 13

fracture precautions

Answer 13

WB restriction

Question 14

cemented joint replacements precautions

Answer 14

precautions but mobilize

Question 15

non-cemented joints precautions

Answer 15

WB restrictions
precautions
mobilize

Question 16

meniscectomy precautions

Answer 16

minimal limitations
restore PLOF

Question 17

cartilage repairs

Answer 17

+/- WB restrictions
bracing (ROM limits)
minimize HS activation

Question 18

tendon or ligament repair precautions

Answer 18

WB/ROM – use precautions
bracing

Question 19

posterior hip replacement

Answer 19

90° flexion
hip IR
hip adduction

Question 20

anterior hip replacement precautions

Answer 20

excessive hip extension

Question 21

spine surgery precautions

Answer 21

bending
lifting
twisting

Question 22

reverse total shoulder precautions

Answer 22

limit shoulder extension
WB while arm is across the body

Question 23

s/s of a DVT

Answer 23

redness
swelling of whole limb
significant pain increase
tenderness to palpation

Question 24

pulmonary embolism s/s

Answer 24

chest pain
SOB
increased HR

Question 25

for those at risk of a clot, what is the best management

Answer 25

interventions should start immediately

include leg exercise and ambulation in conjunction of medical management

Question 26

benefits of mobilization after DVT

Answer 26

minimize deconditioning
shorten hospital stay
reduce occurrence of pressure ulcers

Question 27

5 w’s of post operative fever

Answer 27

wind
water
wound
walking
wonder drugs