Surgical Procedures

Question 1

What are the 2 types of Surgical procedure

Answer 1

• Elective = planned in advance

- Trauma = treat traumatic injuries

Question 2

Hip procedures

Answer 2

• Hemiarthroplasty :

• replace half the hip
• replace only femoral head

• Hip resurfacing :

• replace surface of hip joint
• preserves bone
• head of femur is reshaped

• Total Hip Replacement :

• spinal anaesthetic
• dislocate hip joint
• femoral head cut off
• acetabulum reshaped
• cup liner
• prosthetic femoral stem

Question 3

Post op physio for Hip and total knee replacement

Answer 3

• fully weight bearing
• mobilise from day 0
• ROM + strength exercise
• pain + swelling management

Question 4

Total knee replacement

Answer 4

• spinal anaesthetic
• anterior knee incision
• distal femur = covered metal prosthetic
• proximal tibia = flat prosthetic
• Plastic spa er in between

Question 5

Complications of hip and knee procedures

Answer 5

• infection
• deep vein thrombosis
• malfunction of prosthetic
• nerves injury

Question 6

ACL reconstruction

Answer 6

• for ruptured ACL
• 9-12 months return to sport
• hamstring or patella tendon graft
• hamstring = increased hamstring injury
• patella tendon = increased patella temdonopathy

Question 7

ACL reconstruction post op

Answer 7

Initial = AROM, strength , Gait

Early = progress ROM , cycling, closed chain quads

Middle = Progress ROM, proprioception, running

Late = Sport specific drills

Question 8

Achilles repair

Answer 8

• for Achilles rupture
• can be treated conservatively
• ruptured ends stitched together
• put into boot for 8-12 weeks
• toe touch weight bearing

Question 9

Achilles repair post op

Answer 9

• gentle ROM
• walking encouraged
• strength / mobility exercise

Question 10

Rotator cuff repair

Answer 10

• for patient with full tear of rotator cuff tendons
• arthroscopy / open surgery
• examination
• tendon re-attached using anchor and sutures

Question 11

Rotator cuff repair post op

Answer 11

• 3-6 month rehab

• 6 weeks in sling
• AROM , scapula stability
• strengthening , sport specific exercise

Question 12

Describe the 2 types of total shoulder repair

Answer 12

• Traditional :

• GHJ accessed anteriorly
• sub scapula cut
• arthritic area removed
• implant inserted
• stitched up and repaired

• Reverse

• humorous prepared for socket
• numeral head is concave
• glenoid is convex
• insisting closed

Question 13

Total shoulder repair post op

Answer 13

• sling for 2 weeks
• ROM
• pain management
• wean out sling
• scapula Rhythm
• patient specific rehab based on goals

Question 14

Spinal fusion

Answer 14

• elective or traumatic
• if patient has nerve root compression or spondilolythesis or sclerosis
• screws and rods used to keep it in place

Question 15

Spinal fusion post op

Answer 15

• regain mobility

- chest physio required

Question 16

Dissectomy / decompression of spine

Answer 16

• due to spinal cord compression from bony spurs, stenosis , disc prolapse
• Surgery is urgent if it’s cauda equine
• reduces compression
• often lumbar or cervical spine

Disectomy :
- remove disc material that is compressing

Decompression :
- removal of osteocytes, thickened ligaments

Process :

• Posterior incision
• Spinal muscles split
• Access to spine Gaines

Question 17

Open reduction internal fixation (ORIF)

Answer 17

• trauma surgery

Fix displaced or unstable bones
Nails
Screws
Plates

Internal fixation used to maintain shape and position

Question 18

Dynamic hip screws

Answer 18

• Common in osteoporotic patients
• Used in case of a fractured neck or femur
• allows some movement in direction of screws

Question 19

External fixation

Answer 19

• Screws / rods into the bone from an external structure
• can remain in place for weeks - months
• rehab starts while structure is still in place