TKA
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| 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.
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| What are two idications of TKA? | 1. Eliminate or reduce knee pain.
2. Improve Indep with functional activities.
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| What are two causes of TKA? | 1. Osteoarthritis (pts usually 60+).
2. Rhematoid arthritis (pts usually under 60).
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| What are three different types of degeneration? | Unicompartmental, Bicompartmental, and Tricompartmental.
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| What does Unicompartmental mean? | Medial or lateral side of the knee has degenerative changes with pain and dysfunction. (Valgum and varum).
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| What does Bicompartmental mean? | Degeneration of both the medial and lateral joint compartments.
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| What does Tricompartmental mean? | Degenration of medial, lateral and patellogemoral compartments fof the knee joint.
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| 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.
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| What are the two prosthetic designs? | Constrained(conforming implants),
Non-Constrained(cruciate-sparing)
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| What does the Constrained prosthetic design do? | Cruciiate ligaments (ACL, PCL or both) but rely of the complete conformity of compnents for stability.
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| What does the Non-Constrained prosthetic design do? | Resurfacing implants retain ACL and PCL for stabilization.
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| What are two types of Prostheses? | Cemented and Non-cemented
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| What is used more commonly now Cemented or Non-cemented? | Cemented
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| What is the Cemented protheses? | Prosthesis secured with cement usually WBAT within a few days. May loosen over time, especially in active patients.
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| What is the Non-Cemented prosthesis? | Bone grows into proshtesis May be PWB TTWB for 1-2 weeks.
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| What types do you do for rehab after a TKA surgery? | Weight bearing, CPM, Patellar Mobilization, Bed mobility, transfer training, and Gait Training.
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| How often do you use Weight Bearing rehab? | For Cemented patients almost always, WBAT, Non-cemented may be PWB.
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| 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.
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| What do you do for Gait training rehab? | With a walker or crutches. Progress to SEC and stairs, dynamic surfaces.
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| What do you do for exercise in rehab? | Initially do AAROM, progress to AROM. Hamstrings stretch.
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| What do you do for rehab after TKA? | Start with QS, HS, GS, AP. progress to SAQ, SLR, ABD, seated KF KE, isometric ADD.
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| 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.
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| What is the goal of the surgical procedure? | The goal is to redistribute the forces and compressive loads more evenly across the joint line.
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| 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.
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| What is Varus? | Varus is deformity with medial compartment degeneration- remove leteral wedge form proximal tibia.
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| What is Valgus? | Valgus is the deformity with lateral compartment degeneration-remove wedge form distal femur.
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| 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
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| What do you do for Exercise after HTO? | isometrics- QS, GS, Hs progress to SLR in splint
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| What can be used occasonaly for valgus in HTO? | CPM.
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| When can ROM and patellar mobilization begin? | Once incision has healed.
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| What do you use for HTO? | A knee immobolizer in full extension with a suction drain to help evacuate the excess blood.
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| What is HTO? | High Tibial Osteotomy
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| What is a CPM used for? | Valgus
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| 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
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demiller243
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