THR Flashcards
1
Q
Presentation of hip arthritis
History
A
- pain: OPQRST
- start up pain: limp
- previous treatment
- Functional limitiations
2
Q
Presentation of hip arthritis
Physical Examination
A
- Gait pattern: trendelenbeg
- loss of internal rotation
- painful PROM at motion limits
- leg length discrepancy: ddx
3
Q
Presentation of hip arthritis
Pelvis X-ray
A
- joint space narrows
- subchondral whitening = sclerosis - osteophytes formation
- subchondral cysts
4
Q
Non-surgical treatments for arthritis
A
- Activity modification
- weight reduction/exerrcise
- Shoe wear: shock abosrbing sole
- medication (tylenol, NSAIDs)
- vitamins/supplements
- goals: relieve pain, restore, maintain function of joint
5
Q
Therapeutic injections: corticosteriods
A
- Intra-articular anti-inflammattory agen
- potent and targeted
- rx acute arthritic flare up
6
Q
Therapeutic: Viscoelastic Gels
A
- Hyaluronic acid
- Augments joint fluid
- lubrication/anti-inflammatory
- chondro-protective
- selective candidates
7
Q
Surgical treatment for arthitis: indications
A
- pain significantly interferes with ADLs
- Quality of life unnaccepttable (variable)
- non-surgical inteventions are unsuccessful
- advanced joint disease visable on X-ray
- age limitation – relative
- patient driven decision
7
Q
Surgicals Technique
A
- Patient position
- surgical aproach: anterior, anterolateral, direct lateral, posterior
8
Q
Therapy goals
A
- Safe transfers
- early WBAT ambulation
- Giat and balance with AD
- guard against dislocation
- muscles response
- gain functional ROM and strength
- Normalize Gait
- gradual strengthening
- avoid SLR and reciprocating stairs x 6 weeks
9
Q
Post op rehab
A
- Walker –> cane
- pain and strength
- hip flexors/extensors
- abductors: trendelenburg giat
- confidence/safety
- avoid increased rotational forces early
- isometrics
- cane until limp resolves
10
Q
THR complications
A
- dislocations
- infection
- DVT
- fatal PE
- dislocation and infection (late)
- Loosening
- ostteolysis
- prei-prosthetic femur
11
Q
THR dislocation risk factors
A
- alcohol use
- cerebral dysfunction
- muscular weakness
- previous surgery
- obesity
- non-coompliant behavior
12
Q
How does a THR
dislocate
A
- posterior: adduction, flexion IR
- Anterior: abduction, extension, ER
