Elective Joint Replacement Flashcards
What is the most common indication for joint replacement?
Osteoarthritis
What can affect joint replacements?
Loosening
Wear
Dislocation
May need further surgery and replacement
What are the alternatives to joint replacement?
Analgesia
Steroid injections
Physiotherapy
What other conditions may you need a joint replacement for?
Fractures
Septic arthritis
Osteonecrosis
Bone tumours
Rheumatoid arthritis
What do each of the following mean?
Total joint replacement
Hemiarthroplasty
Partial joint resurfacing
Total joint replacement
Replacing both articular surfaces of the joint
Hemiarthroplasty
Replacing half of the joint
Partial joint resurfacing
Replacing part of the joint surfaces e.g. only medial surfaces of the knee
How is a total hip replacement carried out?
- Lateral incision over outer hip aspect
- Joint dislocated to access both articular surfaces
- Head of the femur is removed
- Metal replacement on a stem is inserted and cemented in place
- Acetabulum of the pelvis is hollowed out and replaced my metal socket which is cemented or screwed in place
Where is a spacer used in a total hip replacement?
Between the new head and socket
How is a total knee replacement carried out?
- Vertical anterior incision down front of the knee
- Patella rotated out of the way for access
- Articular surfaces of femur and tibia removed
- New metal surface replaces articular surfaces which are cemented in place
Where is the spacer added in a total knee replacement?
Between the articular surfaces of the femur and tibia
How is a total shoulder replacement carried out?
- Anterior incision down front of the shoulder along deltoid
- Joint dislocated to access both articular surfaces
- Head of the humerus removed and replaced with metal ball
- Replacement is attached by metal stem or screws
- Glenoid is hollowed out and replaced by metal socket
What is a reverse total shoulder replacement?
Both articular surfaces of the shoulder joint are replaced but socket is now on the humeral head rather than glenoid fossa
What does a reverse total shoulder replacement involve?
Adding a sphere in place of the glenoid and a spacer with a cup to replace the head of the humerus
Why is a reverse total shoulder replacement done instead of a total shoulder replacement?
Regular replacement relies on the rotator cuffs these muscles can often be damaged in people with shoulder arthritis
What anaesthetic is used for different types of replacement?
General anaesthetic
Spinal may be used for lower limb
Alongside anaesthetic what must be also given and why?
Prophylactic antibiotics
Reduce infection risk
Tranexamic acid
Minimise blood loss
