Scorebuilders 2010
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| What are the surgical indications for a total hip arthroplasy? | Osteoarthritis, Rheumatoid arthritis, failed internal fixation of a fracture, developmental dysplasia, osteomyelitis, and avascular necrosis
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| What are the surgical contraindications for a total hip arthroplasty? | Poor periarticular support, sepsis, active infection
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| What are the two types of THA? | Cemented and non cemented
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| What type of THA can you weight bear immediately as tolerated? | Cemented; Noncemented is toe touch wb for up to 6 weeks
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| What type of THA has a longer life expectancy secondary to allowing a larger amount of bone tissue to remain intact and allows for continued tissue growth | Noncemented
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| What type of THA requires more bone tissue removal and may experience loosening of the prosthesis? | Cemented
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| Which of the following nerves may get damaged with a THA?A)Tibial B)Peroneal C)Sciatic | Sciatic
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| Where would the THA be at risk for fracture?A) Through the prostheticB) Around the prosthetic (periprosthetic)C) Along the femoral headD) At the neck of the femur | periprosthetic
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| What four potential post-surgical complications can occur both in THA and TKA? | DVT, infection, pulmonary embolus,periprosthetic fracture
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| Which of the following are not a potential post-surgical complication of a THA?A)chronic joint effusion B) heterotopic ossification C) disclocation/subluxation of the femoral head D) infection | chronic joint effusion
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| What motions are limited and to what degree with a posterolateral approach to a THA? | Avoid hip adduction, avoid medial rotation, avoid hip flexion > 90 degrees
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| What types of advice can you give to a patient to help them avoid going past 90 degrees of hip flexion after a THA? | Do not sit on low surfaces, do not bend over towards the ground, do not lean over to get up from a chair, do not bend over to tie shoes
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| What types of advice can you give to a patient to help them avoid hip adduction after a THA? | Use an abduction pillow,do not cross the legs when sitting or lying down, use a pillow between the legs when in sidelying.
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| What types of advice can you give a patient to help them avoid hip medial rotation after a THA? | Do not pivot towards the surgical side
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| What should PT do with patients after a THA? | Maintain appropriate wb status, mobility training and early ambulation using hip precautions, initiate strengthening with isometric exercises and progress as tolerated, gentle stretching
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| What are the surgical indications of a TKA? | Disabling pain, failed conservative treatment, impaired mobility due to advanced arthritis
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| What are the surgical contraindications of a TKA? | Active infection, advanced osteoporosis, severe peripheral vascular disease, sepsis, morbid obesity
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| What are the types of a TKA? | Cemented, hybrid,noncemented
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| What type of TKA allows you to be wb immediately as tolerated? | Cemented
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| What does the hybrid TKA consist of? | Cemented tibial component and noncemented femoral and patellar components
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| What types of TKA want you to be toe touch wb for up to 6 weeks? | Hybrid and noncemented
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| What type of TKA has a longer life expectancy than cemented? | Non-cemented
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| What does the noncemented TKA consist of? | Femoral, tibial and patellar components are all noncemented
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| What nerve can be damaged after a TKA?A) SciaticB) TibialC) PeronealD) Radial | Peroneal
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| It is important to perform strengthening exercises and passive motion early after a TKA because the post surgical complications include: | Chronic joint effusion, restricted ROM, pulmonary embolus, DVT
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| Where would a TKA fracture post surgically? | periprosthetic
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| Why is a post surgical knee immobilizer used post operative TKA? | For stability
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| When you perform early ambulation after a TKA, would you use the knee immobilzer? | Yes, there will likely be swelling and inhibition of the quads and decreased stability, you will wean them from the knee immoblizer once the quad gains control
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| How would you gain ROM in a TKA patient post-op? | CPM and also passive ROM to gain 90 flexion and 0 degrees extension
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| Who developed the CPM machine and what did his research say? | Robert Salter first developed this device based on research that CPM had beneficial healing effects for joints and surrounding soft tissue
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| Is the research consistent that CPM is beneficial? | NO, some studies show no significant difference in short-term outcome for CPM use versus an alternate form of early motion, other say YES that using CPM results in shorter hospitilizations
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| What is the primary use of CPM and for what joint? | Improve ROM after surgery, knee joint
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| What are the therapeutic effects of CPM? | May lessen the debilitating effects from immobilization May improve the rate of recovery May provide a stimulating effect on tissue healing May provide a quicker increase in ROM May decrease post-operative pain May reduce edema by assisting veno
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| Why is particular anticoagulant therapy a contraindication for CPM? | May place patient at risk for an intracompartment hematoma
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| the patient has more pain with the use of CPM, what should your actions be? | Discontinue the CPM because pain is a contraindication
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| If the patient has unwanted translation of opposing bones with the use of CPM, what should your actions be? | Discontinue the CPM because pain is a contraindication
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| How soon can CPM be applied and to what degrees should it be applied? | Immediately after surgery; different protocols are specific to each joint regarding time of use and degrees of motion
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| What must you do in order to receive effective and safe treatment from the CPM? | Align the joint with the fulcrum of the CPM
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| How many degrees per day do you add for patients on the CPM? | Begin with small arc of motion and progress about 10 degrees per day or as tolerated
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