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TKA
| Question | Answer |
|---|---|
| What is the definition of Total Knee Arthroplasty? | Surigical Procedure that removes the degenerated articular surfaces of the proximal tibia, distal femur and occasionally the articular surface of the patella, replacing those surfaces with metal, plastic or a combination. |
| What are two idications of TKA? | 1. Eliminate or reduce knee pain. 2. Improve Indep with functional activities. |
| What are two causes of TKA? | 1. Osteoarthritis (pts usually 60+). 2. Rhematoid arthritis (pts usually under 60). |
| What are three different types of degeneration? | Unicompartmental, Bicompartmental, and Tricompartmental. |
| What does Unicompartmental mean? | Medial or lateral side of the knee has degenerative changes with pain and dysfunction. (Valgum and varum). |
| What does Bicompartmental mean? | Degeneration of both the medial and lateral joint compartments. |
| What does Tricompartmental mean? | Degenration of medial, lateral and patellogemoral compartments fof the knee joint. |
| What are four contraindications of TKA? | 1. Active or recent septic arthritis. 2. "Non-Funtioning extensor mechanism". 3. Sever neuroligic dysgunction that prevents extention or control of the knee. 4. Neuropathic joint. |
| What are the two prosthetic designs? | Constrained(conforming implants), Non-Constrained(cruciate-sparing) |
| What does the Constrained prosthetic design do? | Cruciiate ligaments (ACL, PCL or both) but rely of the complete conformity of compnents for stability. |
| What does the Non-Constrained prosthetic design do? | Resurfacing implants retain ACL and PCL for stabilization. |
| What are two types of Prostheses? | Cemented and Non-cemented |
| What is used more commonly now Cemented or Non-cemented? | Cemented |
| What is the Cemented protheses? | Prosthesis secured with cement usually WBAT within a few days. May loosen over time, especially in active patients. |
| What is the Non-Cemented prosthesis? | Bone grows into proshtesis May be PWB TTWB for 1-2 weeks. |
| What types do you do for rehab after a TKA surgery? | Weight bearing, CPM, Patellar Mobilization, Bed mobility, transfer training, and Gait Training. |
| How often do you use Weight Bearing rehab? | For Cemented patients almost always, WBAT, Non-cemented may be PWB. |
| What do you do for CPM rehab? | Surgeon may prescribe if pt has limited ROM or depending what type of procedure was done, Use with ice or E-stim. |
| What do you do for Gait training rehab? | With a walker or crutches. Progress to SEC and stairs, dynamic surfaces. |
| What do you do for exercise in rehab? | Initially do AAROM, progress to AROM. Hamstrings stretch. |
| What do you do for rehab after TKA? | Start with QS, HS, GS, AP. progress to SAQ, SLR, ABD, seated KF KE, isometric ADD. |
| What are some indications of High Tibial Osteotomy? | 1. Pt's with advanced OA/DJD of just one compartment of the knee. 2. Varus defomity-degeneration of hte medial component (more common). 3. Valgus Deformity-degeneration of lateral component. |
| What is the goal of the surgical procedure? | The goal is to redistribute the forces and compressive loads more evenly across the joint line. |
| What do you attempt to do in the surgical procedure? | Attempts to realign the tibiofemoral joint by surgically creating a wedge in the proximal tibia or distal femur depending on if they have a varus or valgus deformity. |
| What is Varus? | Varus is deformity with medial compartment degeneration- remove leteral wedge form proximal tibia. |
| What is Valgus? | Valgus is the deformity with lateral compartment degeneration-remove wedge form distal femur. |
| What do you do for rehab after HTO? | 1. Ambulation-usually TDWB-PWB with brace and crutches or walker. Usually limited weight bearing for about 12 weeks but it is dependent on bone healing 2. At about 3-4 weeks post-op strengthenin PRE's can be initiated 3.assitive device D/C CKC can begin |
| What do you do for Exercise after HTO? | isometrics- QS, GS, Hs progress to SLR in splint |
| What can be used occasonaly for valgus in HTO? | CPM. |
| When can ROM and patellar mobilization begin? | Once incision has healed. |
| What do you use for HTO? | A knee immobolizer in full extension with a suction drain to help evacuate the excess blood. |
| What is HTO? | High Tibial Osteotomy |
| What is a CPM used for? | Valgus |
| What is involved with rehab of HTO? | Ex iso. QS GS HS progress to SLR in splint and ROM and patellar mobs once incision has healed |
Created by:
demiller243
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