Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

AC- Simon > wk9 Lower limb > Flashcards

wk9 Lower limb Flashcards

1
Q

any evidence for post op management of THA/TKA?

A

Study done by Chen, suggested that early mobilisation on day 0 post op is better than the day 1 post op.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Limitations of Chen’s study?

A
  1. Mixed group - i.e. THA and TKA
  2. No specific intervention was described
  3. Total number of group received intervention (Day0) was significantly less than the control group (Day1)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

4 major components of implant/ prosthesis

A
  1. Cup
  2. Cup liner
  3. Stem
  4. Ball
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

pros of rehabilitation for THA

A
  1. improving mobility
  2. reducing pain
  3. reducing limp
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

cons of rehab for THA

A
  1. wear and tear (longevity)

2. surgical risk (e.g. dislocation, break-down wounds)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

types of materials used for THA implant

A
  1. Metal on Plastic
  2. Metal on Ceramic
  3. Metal on Metal
  4. Ceramic on Ceramic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

precaution for selecting Metal on metal implant?

A

check metal sensitivity - it might increase metal concentration in the blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Advantage and disadvantage of metal on metal

A

adv-long lasting

disadv- incr risk of metal concentration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Advantage and disadvantage of ceramic on ceramic

A

adv - lighter than metal, no risk of increased metal concentration

Disadvan- can be broken off following a trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

is risk or complication following THA high?

A

No, very low approx 5%, even if occur, can be managed well

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are possible complications for THA

A

Infection
Dislocation
Blood clot or DVT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

incidence rate of blood clot or DVT

A

30%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

when is Dislocation risk highest?

A

in the first 6 weeks - maybe due to muscles around hip joint is not stable enough to hold

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Management of DVT or blood clot

A
  1. Early mobilisation
  2. Elastic stocking
  3. Aspirin for 6 wks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Why have a hip joint replacement?

A 
pain with activity
pain at rest 
loss of movement
loss of strength
Limp
OA/RA/Fracture (displaced intra-capsular fracture NOF)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Brief description of THA surgery

A
  1. dislocation of head of femur from acetabulum
  2. remove the head of femur
  3. replace acetabulum with cup and cup liner
  4. insert stem and ball into femur
  5. relocate it in place
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Incision site (surgical approach) for THA

A

over Greater Trochanter
Anterior approach
Posterior approach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

movements increasing risk of dislocation for each of Anterior and Posterior approach

A 
Anterior = Extension, Adduction, External Rotation
Posterior = Flexion, Adduction, Internal rotation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Role of Physio post op management

A
  1. Education - precaution with activity, teach how to get in/out of car
  2. mobilisation
  3. Exercise programme - strengthen GLUT and QUAD
20
Q

Hours of surgery

A

1-2 hours

21
Q

Average blood loss

A

400 - 600 mls

22
Q

incidence of blood tranfusion

A

25%

23
Q

what is anaemia

A

Decrease in number of RBC

24
Q

post-op anaemia last approx – weeks

A

4-6 wks

25
Q

Total length of hospital stay

A

3-7 days

26
Q

Discharging requirements for THA

A
  1. able to transfer independently
  2. able to walk with crutches
  3. able to do steps
  4. medically stable - wound healing and normal temperature
27
Q

pros of Minimally invasive technique

A

less exposure

28
Q

cons of Minimally invasive technique

A
  1. longer procedure

2. more chance of mal-positioning

29
Q

surgeon’s age preference for THA

A

> 50 year old because it last around 10 year in term of wear and tear.
Earlier than 50 yr can shortens the life of implant.
Later than late 50 yr can cause Pain Centralisation and REDUCED ROM

30
Q

Acceptable results

A

leg length differnce less than 1.5cm

normal gait pattern without a limp

31
Q

What is Birmingham hip joint Resurfacing?

A

resurfacing femoral head without removing femoral head

32
Q

Age requirement and criteria for Birmingham hip joint Resurfacing

A

under 60 years

must have good femoral bone stock and blood supply

33
Q

Patients selection - consideration for THA

A 
quality of bone stock
renal insufficiency
leg length discrepancy <1cm
obesity 
infection
34
Q

Aetiology of fractured neck of femur (NOF)

A

External force - twisting while foot fixed, knocked over

Internal force - collapse of bone due to osteoporosis, ischemia or cancer

35
Q

which population is at most risk of fractured NOF

A

Elderly women especially after menopause. as estrogen decreases, bone cell loss –> increase osteoporosis

36
Q

classifications of fracture NOF

- Intra-capsular and Extra capsular

A

Intra-capsular
Sub-capital (beneath Head)
mid-cervical ( between head and surgical neck)

Extra-capsular
per-trochanteric (above)
inter-trochanteric (btw)
sub-trochanteric (below)

37
Q

Surgical management of Undisplaced Intracapsular Fracture

A

screws - better fixation than pins

38
Q

Surgical management of Dispaced intracapsular fracture

A

Arthroplasty has lower re-operation rate than internal fixation - Unipolar Hemi-arthroplasty

39
Q

surgical managment of extracapsular fracture

A

sliding hip screw (dynamic hip screw) is better than fixed nail and plate

40
Q

what is Hemi-arthroplasty

A

only replace head of femur with stem and ball implant/prosthesis but not acetabulum

41
Q

evidence of PT management for hip fracture (fractured NOF)

A

Limited literature on acute care
interventions are NOT detailed
But focus is on EARLY mobility in acute care to restore independent return to ADLs

42
Q

what is ORIF?

A

Open Reduction Internal Fixation

A method of surgically repairing a fractured bone - using plate, screws or intramedullary nail

43
Q

what are some common post op problems for hip fractures?

A

pain
difficulty with IR/ER
HIgh rate of dislocation (Emergency THJR as opposed to elective THJR)

44
Q

who is at the most risk of fracture of SHAFT of femur

A

Young MALE patient- involving high impact injury such as Road Traffic Accident (RTA)

45
Q

Post operative Weight Bearing Status for Fracture of SHAFT of femur is dependent on 3 Factors. What are they?

A
  1. Type of fracture (oblique, transverse, spiral,comminuted)
  2. Quality of bone stock (healthy bone)
  3. Quality of surgical repair
46
Q

what is Knee arthroscopy is used for?

A
  1. Examine
  2. Diagnose
  3. Treat - Meniscal tears, Cartilage, Ligament (ACL)

AC- Simon (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions