Week 4: Common Orthopaedic Procedures Flashcards
(22 cards)
What is elective and trauma surgery?
-Elective procedure is one that is planned in advance and does not need to be performed immediately
-trauma surgery is used to treat traumatic injuries
What is joint replacement?
-orthopaedic surgery procedure in which an arthritic or dysfunctional joint surface is replaced with a prosthesis
What is a total hip replacement?
-spinal anaesthetic
-femoral head cut off and is grind down and reshape the acetabulum
-acetabular cup placed into the socket
-prosthetic femoral stem is placed into the shaft
-muscle and other soft tissues are repaired
What is hemiarthroplasty?
-surgical procedure that involves replacing half of the hip joint
-replaces only the femoral head portion of the joint
What is hip resurfacing?
-replaces the surfaces of the hip joint-preserves more bone than a THR
-head of femur is not removed but its reshaped to allow a metal cap to be cemented onto it
What is total knee replacement?
-incision on the front of the knee
-kneecap is moved to the side to access knee joint
-distal femur and proximal tibia are cut away, the bone is reshaped to fit the prosthetic component
-distal end of femur replaced with the curved metal and proximal tibia with a flat prosthesis and plastic spacer in between
What are the post-op physio for hip and knee surgery?
-Knee and hip replacements are usually FWB after surgery
-start mobilising day 0 if possible
-ROM and strength exercises
What are the complication with fhr and fkr?
-post op infection
-malfunction of prosthesis
-nerve injury
What is tradition total shoulder replacement?
-GHJ accessed anteriorly
-deltoid and pecs separated to access shoulder joint
-subscapularis cut to gain access
-arthritic areas removed
-implants inserted
-subscapularis repaired and incision closed
What is reverse total shoulder replacement?
-shoulder accessed anteriorly
-humerus prepared for new socket and glenoid prepared for ball shaped prosthesis
-numeral stem inserted, humeral cup and glenosphere attached
-muscles repaired and incision closed
What is the post op for TSR?
Early: sling for 2 weeks, Rom exercise allowed and taught to complete ADL.
Week 2-6: wean out of sling, progressive ROM and start isometric rotator cuff exercise
Week 6-12: progress strength and functional exercise
Up to 6 months: patient specific rehab depending on goals.
What is ACL Reconstruction?
-Patients who have ruptured their ACL
-Hamstring or patella tendon used as graft
-9-12 months rehab to return to sports
What is the post op rehab for ACL reconstruction?
-initial phase: gait education,AROM, strengthening
-Early: progression of ROM/Strength
-middle: continue to progress strength and ROM, progress proprioceptive exercises
-Late: start sport specific drills
What is Rotator cuff repair?
-patients with complete tear or partial tears who failed conservative treatment
-surgeon start with EUA
-Joint/tendon will be debrided also a subacromial decompression
-rotator cuff tendon will be reattached to the bone with an anchor and sutures
What is the post op rehab for rotator cuff repair?
-3-6 months physio
-early phase: immobilised up to 6 weeks in a sling
-Middle: AROM and scapula stability
-Late: shoulder strengthening, proprioception and sport specific rehab depending
What is Achilles repair?
-Achilles ruptures can be treated conservatively or surgically
-posterior incision made
-ruptured ends of Achilles stitched together
-normally put in a boot in plantar flexion
-initially likely toe touch weight bearing
What is discectomy/decompression?
-nerve root or spinal cord compression
-can be caused by disc prolapse, bony spurs, intervertebral foramen or spinal canal stenosis
-discectomy is removal of disc material
-decompression- removal of osteophytes,laminectomy, thickened ligament or foraminotomy
What is post op physio for discectomy or decompression?
-sitting restricted to 30 mins a day
-gentle ROM and isometric exercise given initially
-walking encouraged from immediately post-op
-strength and mobility exercises progressed 4-6 weeks post op
What is spinal fusion and when is it used?
Can be either elective or trauma surgery- nerve root compression, unstable, spondylolisthesis, unstable fractures, scoliosis
-surgeons use screws and rods to fix vertebra in place
What is open reduction internal fixation?
-surgery used to fix broken bones that are displaced or unstable
-refers to the process of resetting the bones into the correct position
-implants maintain this position
-fixation remains in place unless fixation becomes problematic
What is dynamic hip screw?
-common in Older osteoporotic patients
-allows some movement in the femoral head
What is external fixation?
-surgical treatment where the rods are screwed into the bone, and exit the body to be attached to a stabilising structure
-case of severe open fractures
-sometimes allows weight bearing
-can remain in place for weeks or months
