Total Knee and Hip Arthroplasty Flashcards
(43 cards)
What is the trend in the incidence of total hip arthroplasty in the United States?
The incidence of total hip arthroplasty has been increasing steadily over the years, across various age groups.
Which age group represents the largest number of total joint replacements?
The age group 60 to 79 years old represents the largest number of total joint replacements, including both hip and knee replacements.
Which type of joint replacement is more common: total hip or total knee arthroplasty?
Total knee replacements are more common than total hip replacements.
How does the prevalence of joint replacements vary by region in the United States?
The greatest prevalence of joint replacements is found in Midwestern states like Iowa, Wisconsin, Montana, and North Dakota.
What is the age-specific prevalence of joint replacements based on the duration since the initial procedure?
Most people with joint replacements have had them for less than 10 years, with fewer having replacements for 10-20 years or over 20 years.
How has the duration people live with joint replacements changed, and what might this indicate?
More people are living with joint replacements for over 20 years, suggesting improvements in technology and procedure quality.
What are the projected growth rates for total hip and knee replacements according to the American Academy of Orthopedic Surgeons?
Total hip replacements are projected to grow by 171%, and knee replacements by 189%.
What is a potential consequence of the growth in primary hip and knee replacements?
There will likely be an increase in the number of revision cases as the number of long-term joint replacement patients grows.
What is the primary purpose of total hip or knee arthroplasty?
To relieve pain in a joint with end-stage degenerative changes or arthritis, which results in loss of function.
What is arthritis?
A general term that describes joint pain or disease, encompassing over 100 different types of arthritic conditions.
What is osteoarthritis?
A degenerative type of arthritis characterized by the breakdown of cartilage over time, often leading to joint replacements.
What is post-traumatic osteoarthritis?
A type of osteoarthritis that can develop after joint trauma or injury, such as a fracture or ligament tear like an ACL injury.
Name some types of inflammatory arthritis.
Rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis.
What is the significance of “bone on bone” contact seen on X-rays?
It indicates a complete loss of articular cartilage, leading to bone surfaces contacting each other directly.
Why is it important not to rely solely on X-rays for determining the need for joint replacement?
X-rays may show significant degeneration, but they do not always correlate with the patient’s pain levels or functional abilities.
What are some conservative treatments before considering joint replacement?
Physical therapy, low-impact exercise, activity modification, NSAIDs, prescription medications, and joint injections.
What are indications for considering joint replacement?
Non-response to conservative care, chronic pain lasting more than 3 months, impaired joint function, and significant functional limitations.
What factors should be considered before a total joint replacement?
Psychosocial factors like depression, preoperative function, pain processing changes, arthritis in other joints, and comorbidities like liver disease or malnutrition.
How can preoperative function affect recovery after joint replacement?
A significant preoperative deficit may result in a longer recovery period to regain functional levels after surgery.
How can central sensitization affect outcomes in joint replacement?
It can impact the way pain is processed, potentially affecting functional outcomes after surgery.
What is the main focus of rehabilitation following total hip arthroplasty (THA)?
The main focus is to manage post-operative range-of-motion precautions, address force demands at the hip joint, and ensure proper muscle activation and control during rehabilitation.
What are post-operative range-of-motion precautions?
These are specific movements patients must avoid after THA, such as flexion past 90 degrees, crossing legs, adduction past midline, and internal rotation, which can lead to dislocation of the hip joint.
How do the post-operative precautions differ based on surgical approach?
Precautions can vary depending on whether a posterior or anterior approach was used. For example, a posterior approach requires avoiding flexion, while an anterior approach may have different restrictions related to extension and external rotation.
Why is it important to consider forces at the hip joint during rehabilitation?
The hip joint experiences significant forces during activities such as walking (up to three times body weight), necessitating strength and control training to prepare patients for functional activities post-surgery.
