Ortho 4 Flashcards
(31 cards)
What is a prosthesis?
An arthritic or damaged joint is removed with an artificial joint
What is the goal for a joint replacement?
To relieve pain and restore joint function in the joint
What are the indications of a hip replacement?
Rheumatoid arthritis
Osteoarthritis
What are the disadvantages of metal implants?
Upsets body mechanisms
Metal fatigue which weakens the implant and causes it to break
Corrosion cause ld by surface irregularities
What are the indications of a total hip replacement?
Pain
Decreased ROM
Age(young age won’t last under 60)
Obesity-More weight wears out replacement
Levels of activities (heavy work will reduce life of implant)
What are the contraindications for THR?
Recent or recurrent sepsis
Neuropathic aryhrophy
What are approaches can be done for THR?
Hardinge (Anterolat )
Muller (post capsule)
Charnley(detachment of greater trochanter)
What are the precautions-In bed?
Avoid excessive hip and knee flex and adduction so put adduction pillow
And combo of hip flex,add,int rot
What are the precautions -when moving out of bed?
High sit chair to keep flex less than 90 for 6 weeks
Legs may not be crossed
What are the precautions -when walking?
PWB on affected side initially then elbow crutches
What is the PT management pre op?
Asses ROM,muscle strength around hip
Gait,resp function
Explain post op treatment
Teach crutch walking
Quads and upper limbs stregthening
Teach pt how to get out of bed
What is the PT management post op-Day 1-2?
Elevate foot of bed
Anti embolism socks should be worn
Check resp function
Bridging (affected leg straight)
Circulatory drill (isometric quads and foot pumps)
Walking (parallel bars then parallel Walking frame later elbow crutches)
What is the PT management day 3 post op?
-Teach stair climbing before discharge
-gradually increase distance of walking
-mobilize pt over edge of bed not more than 90
What advice would be giving to pt?
Don’t turn to affected side when sleeping
Wear socks or stocking
No squatting
Need high seat toilet
Cannot sit in bath for 3mons
What are the indications of Knee replacement?
Serious joint damage
Sufficiently disabled
Can still use joint
RA or OA
What are the contraindications of TKR?
Obesity
Very active pt
Knee flex less than 60
Gross instability
What are the complications of TKR?
Infection
Instability of knee
Subluxation,dislocation or loosen of implants
What are the contraindications of TKR?
No knee flexion for 5 days
What are the precautions of TKR?
Besdrest until wound is healed
Pt in backslab for 3-5 days
What is the PT management for 1-2 days?
Check chest
Circulatory drill
Keep limb elevated to decrease swelling
Compression bandage to decrease swelling
What PT management should be done day 3?
Drain removed
Bandages removed only plaster if would see how much flex you can do
SLR
What is PT management day 4 ?
Leg supported in extension
Strengthen quads through full range
Mobilize with parallel bars then walking frame and crutches
What are the indications for a shoulder replacement?
OA
RA
Instability
Neoplasm
Avascular necrosis
Trauma
What are the contraindications of a shoulder replacement?
Infection
Painless stiff shoulder
Destroyed rotator cuff
Paralyzed deltoid mucle ipsilaterally
