orthopaedics: elective surgery Flashcards

1
Q

what is an arthroplasty

A

reshaping/ joint replacement/ removal of diseased joint

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2
Q

what is a hemiarthroplasty

A

replacing 1 part of joint

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3
Q

what are common arthroplasty sites

A

hip, knee, shoulder, elbow, ankle, 1 MTPJ

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4
Q

what materials are joint replacements usually made of

A

stainless steel, cobalt chrome, titanium, polyethylene, ceramic

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5
Q

what can metal particles caue in muscle and bone

A

pseudotumour –> muscle and bone necrosis

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6
Q

what can polyethylene cause

A

osteolysis

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7
Q

what are early complications of a joint replacement

A

infection, dislocation, instability, fracture, nerve injury, ischaemia, DVT bleeding

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8
Q

what is a deep infection of arthroplasty

A

biofilm form on new joint

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9
Q

how do you treat deep infections of arthroplasties

A

if early detection joint surgically washed out and debrided to save it, if after 3 weeks needs to be removed and then replaced 6 weeks later

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10
Q

what early complications are there of arthroplasty

A

hypovolaemia, shock, MI, acute renal failure, urine infection, ARDS,PE

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11
Q

what are late complications are there of arthroplasty

A

infection (haematogenous spread), loosening, fracture, break, pseudotumour

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12
Q

when is excision or resection of a bone used

A

usually in small joints, (remove bone and cartilage of joint), occasionally in failed shoulder replacement

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13
Q

what is surgical arthrodesis

A

surgical stiffening or fusion of a joint into position

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14
Q

what are pros and cons of arthrodesis

A

alleviates pain but can have limited function (esp larger joints), increases pressure in surrounding joints –> OA

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15
Q

which joitns is arthrodesis normally used

A

end stage ankle, wrists, 1st MTPJ arthritis

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16
Q

what is osteotomy

A

surgical realignment of a bone by taking a bit out

17
Q

when is osteotomy used

A

deformity correction or share load of arthritic joint (knee or hip)

18
Q

what non-surgical treatment can be given in soft tissue problems

A

rest, anaglesia, anti-inflamm, steroid injections around tendon (not achilles)

19
Q

what surgical treatment can be given in soft tissue problems (6)

A

debridement and decompression, synovectomy (wrists and tibialis posterior tendon), splint (achilles), surgical repair (quadriceps/ patellar), tendon transfer, arthroscopic removal (meniscal tear)

20
Q

how can you surgically manage joint instability

A

ligament tightening, ligament reconstruction, soft tissue reattachment