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Aging Adults > Total Joint Arthroplasty > Flashcards

Total Joint Arthroplasty Flashcards

1
Q

True or False: While TKA surgeries are on the rise significantly, THA operations are projected to be stagnant over the next 10 years in the aging population

A

False, THA is projected to grow 171% and TKAs are projected at 185% increase

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2
Q

What are the 4 main categories of contextual factors affecting patient outcomes after primary TJA or OA? What are some examples of each?

A

Behavioral/psychosocial (expectations, satisfaction w/ care, motivation, coping skills, anxiety/depression, level of education)

Support and Attitudes (support from family, friends, and community as well as attitude of health professionals)

Biological/Intrinsic (pain, age, gender, comorbidities, fitness/activity level, obesity, post-op complications)

Provider and System Factors (surgical wait time, access to providers, health professional skills, access to transportation)

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3
Q

What are the main intervention goals for Pre-operative PT?

A
  • high intensity strength training
  • patient training on assistive devices
  • planning for recovery
  • managing expectations
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4
Q

True or False: Engaging in a pre-op PT strengthening program has highly correlated stats that show decreased length of stay at hospital post-op.

A

False, there needs to be more studies because the jury is still out

Overall pre-op PT may or may not decrease hospital LOS or d/c disposition just like it may or may not affect post-op function

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5
Q

What are the goals of a pre-op educational class for patients?

A
  • prepare patient for the surgery and recovery related issues
  • decrease post-op complications
  • increase likelihood of discharge to home vs a facility and decrease length of stay/hospital costs
  • help patient identify post-op support system and decrease anxiety
  • encourage pt’s active role in recovery process
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6
Q

When can you begin acute care PT for THA/TKA patients?

A

as early as post-op day 0

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7
Q

What is early intensive rehab associated with for THA/TKA?

A
  • decreased risk of DVT/PE risk, chest infections, urinary retension and HAI
  • Results in accelerated functional recovery and earlier hospital d/c
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8
Q

What should early intensive rehab focus on for TKA/THA?

A
  • emphasize function for otpimal d/c dispo of home
  • education is very important (not all THA have posterior prec)
  • early strengthening (possibl e-stim for TKA)
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9
Q

True or False: TKA usually has a longer rheba time than a THA but THA surgeries lead to longer lingering gait abnormalities

A

True

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10
Q

True or False: While TSA surgeries are more common in males, females have higher rates of complications

A

True

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11
Q

True or False: If you have TSA surgery before your 6th decade of life usually you will not need a revision procedure later on in life

A

False, men w/ first procedure at less than 59 y.o o were more likely to need revision procedure

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12
Q

If a patient has an intact rotator cuff but has a degenerative disease that has caused damage to the shoulder joint, what surgery will they normally have for a TSA?

A

Anatomic TSA

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13
Q

If a patient has a complete tear of the rotator cuff and a fracture in the proximal humerus, but has an intact deltoid, what TSA surgery ill they most likely have?

A

Reverse TSA

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14
Q

True or False: There is not an extensive pre-op education pathway for TSA patients like there is for THA/TKA patients

A

True

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15
Q

What acute post-op factors can you work with a patient on that has just had a TSA surgery?

A
  • work on gait abnormalities and balance
  • work on joint mobility at other shoulder joint complex components
  • functional reach using alternate strategies
  • core strengthening
  • one-armed ADL strategies
  • functional mobility and bed mobility strategies
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16
Q

What age do low trauma/low energy hip fractures typically occur?

A

~80 years old (75% of pts. are over 70)

17
Q

Roughly how many hip fracture deaths may be causally related to pre-existing medical conditions rather than the fracture itself?

A

3 out of 4

18
Q

True or False: Initial mortality after a hip fracture is relatively low considering the level of disability caused by fractures

A

False, initial mortality is very high and 1/3 of elderly pts are dead one year after fracture and this increased mortality is sustained up to ten years post hip fracture

19
Q

True or False: Unlike a TJA, hip fracture surgery is considered urgent.

A

True

20
Q

If a patient has a hip fracture, what three factors could highly increase their mortality risk?

A
  • advanced age (over 90)
  • presence of several co-morbidities
  • new acute medical condition
21
Q

What are the two main types of hip fractures?

A

Intracapsular (involved femoral head and neck and is roughly 45% of cases)

Intertrochanteric (approx. 45% of cases)

there can be others which are known as subtrochanteric (10%)

22
Q

What does surgical management type for hip fractures depend on?

A
  • type and severity of fracture
  • preference of ortho MD
  • pt age
  • co-morbidities
  • prognosis
23
Q

What is the typical surgical management for femoral neck fractures?

A
  • if less than 65 years old then internal fixation

- older pts or those with already limited mobility: THA

24
Q

What is the typical surgical management for intertrochanteric fractures?

A
  • sliding hip screws
  • intermeduallary nails
  • often PWB
25
Q

What is the typical surgical management for subtrochanteric fractures?

A

hemiarthroplasty

26
Q

What is the goal of the acute stage of hip fracture rehab?

A

Restore mobility ASAP because there is a much higher risk of complication with bed rest

27
Q

What are some pre-fracture factors that indicate poor functional recovery?

A
  • decrease pre-fracture functional independence
  • greater co-morbid disease burden
  • cognitive impairment
  • affective status/depression
  • poor nutritional status
  • poor social support
  • presence of frailty

Aging Adults (19 decks)

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