wk9 TKJR/TKA Flashcards

1
Q

Indication for TKJR/ TKA

A
  1. Pain
  2. Minimum age - 50years old
  3. Significant joint space narrowing - bone to bone
  4. Avascular necrosis
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2
Q

Rate of TKA in the last 10 years in NZ

A

It has been doubled up from 3000 to more than 6000 in the last Decade
94% for OA

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3
Q

3 Main components of TKA

A
  1. Femoral Component
  2. Plastic Spacer
  3. Tibial component
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4
Q

brief description of TKA

A
  1. ACL is always sacrificed
  2. PCL may be removed
  3. Patella may be resurfaced
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5
Q

Some general failures of TKA

A
  1. polyethylene wear
  2. infection
  3. mal-alignment
  4. ligament instability
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6
Q

Mobile Bearing VS Fixed Bearing

A

0

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7
Q

disadvantages of Minimally invasive surgery

A

difficult alignment
diffcult landmarks
gap imbalancing

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8
Q

Total procedure

A

75-90 mins

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9
Q

hospital stay

A

5 days

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10
Q

Discharging requirements

A
  1. Pain controlled
  2. Flex the knee 90 degree
  3. Independently Mobile (toilet & shower)
  4. Walk 100m and do stairs
  5. ride exercycle
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11
Q

How long does swelling last following TKA

A

3 months

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12
Q

Huge Swelling reduces ROM

A

-

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13
Q

what are physio post Rehab following TKA?

A
  1. Mobilisation on day 1 post op
  2. Knee flexion 90 degree by end of hospital stay (5days)
  3. knee flexion 115 by end of 3 months
  4. Quad strength exercise
  5. CPM started within first 24 hrs. - dependent on surgeon
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14
Q

What is CPM?

A

A machine that is used for moving knee joint passively within specified range. It may reduce for forceful manipulation done by surgeon during general anesthesia.

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15
Q

evidence for CPM

A

No evidence on improving AROM, Pain, Function, QOL

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16
Q

High correlation between 6MWT and Quad strength

True False

A

True- can use in the clinical setting

17
Q

Complications

A
  1. patella dislocation
  2. DVT
  3. Infection
  4. Surgical Fracture
  5. Post op swelling and Pain ++
  6. Poor Rom
18
Q

survival rate in NZ

A

97% at 6 years

19
Q

Factors affecting TKJR outcome

A
  1. co-morbidities
  2. Age
  3. BMI
  4. Quad strength (50-60% decreased in 1month postop
  5. ROM
  6. Pre op pain and function
  7. Gender