[AC] Orthopaedics Lower Limb

Question 1

Femoralacetabular Impingement is an intra-articular cause of hip pain. What does it involve?

Answer 1

Impingement occurring when the ball shaped femoral head rubs abnormally

Question 2

Perthes Disease is a condition an intra-articular cause of hip pain. What is it?

Answer 2

A condition characterised by a temporary loss of blood supply to the hip. Without adequate blood supply there is avascular necrosis of the head of the femur

Question 3

Hip Arthroscopy refers to the

Answer 3

viewing of the interior of the acetabulofemoral joint through an athroscope and the treatment of hip pathology through a minimally invasive approach

Question 4

What are the contraindications of hip arthroscopy?

Answer 4

Obesity
Osteoporosis
Arthritis without mechanical symptoms
Hip dysplasia

Question 5

What are the four components/implants of total hip replacement?

Answer 5

Stem
Ball
Cup
Cup Liner

Question 6

What is the usual incision site for total hip replacement surgery?

Answer 6

Usually over the greater trochanter and the size of the incision is determined by the size of the patient. i.e. 15-30 cm - hugely variable

Question 7

Briefly describe total hip replacement surgery

Answer 7

Incision over greater trochanter, head of femur removed, cup and cup liner inserted. stem inserted and hip then closed/sowed up

Question 8

Blood clots or DVT can occur in up to ____% of people undergoing joint replacement

Answer 8

30%

Question 9

What is the aetiology of fractured neck of femur ?

Answer 9

• External force - twisting while foot fixed, slip or being knocked over
• Internal force - collapse of bone due to osteoporosis, ischemia, or cancer

Patient group is typically elderly women

Question 10

The shaft of femur is long and strong, therefore those cause of a fracture of the shaft of the femur would most likely involve

Answer 10

high loads, lots of force, i.e. high impact injury

Question 11

Outline the surgery duration, length of stay and recovery time for Arthroscopy - Menisectomy

Answer 11

Surgery Duration = 30 minutes
Length of stay = half a day, sometimes over night depending on when surgery is done
Usually takes 2-3 weeks to recover - small incisions

Question 12

Total Knee Arthroplasty has _____ in the last 10 years

Answer 12

doubled

Question 13

94% of Total Knee Arthroplasty in NZ was done because of

Answer 13

Osteoarthritis

Question 14

What ROM do you need to climb stairs? What about sit in a chair?

Answer 14

83 degrees stairs

90 degrees sit in a chair

Question 15

Why are older females at risk of hip fractures?

Answer 15

Due to osteoporosis
Women in particular experience significant bone loss when menopause starts and the level of oestrogen falls; lower bone density increases the risk of the development of osteoporosis