Surgical Specialties - Questions With Verified Solutions
Arthroscopy vs arthroplasty Right Ans - arthroscopy:
-Minimally invasive
-Faster recovery
-Good for debridement
-Helps with diagnosis
arthroplasty:
-Open procedure
-Joint is replaced, remodeled or realigned
-Relieves pain in the joint
-Restores function of the joint
_ is one of the most widely performed orthopedic surgeries Right Ans -
Knee arthroscopy
Postoperative Treatment for Orthopedic Surgeries Right Ans - -Restore
movement:
°Physical therapy
°Massage therapy
°Exercises
-Pain management
-Prevent injury and infection
-DVT/ PE prophylaxis- Enoxaparin /warfarin /aspirin
VARIABLE as per surgeon preference (generally 4-6 weeks)
indications for hip replacement Right Ans - OA, RA, fractures, cancer, joint
instability, congenital hip disorder
contraindications for hip replacement Right Ans - Recent infection, pain is
not severe, <60 yoa with alternative surgery available
total vs half hip replacement Right Ans - Total- Replaces BOTH acetabulum
and femoral head
,Half- Replaces ONLY the femoral head
Parts of the hip Implant Right Ans - °Acetabular cup
°Femoral component
°Articular interface
types of hip implants Right Ans - -Ceramic
-Metal on metal
-Cemented
cemented vs uncemented hip fixation Right Ans - Cemented fixation-
Cement stem uses acrylic bone cement between the stem and bone
Uncemented fixation- Uncemented stem uses friction, shape and surface
coating to stimulate bone remodeling
Postoperative Management for hip replacement Right Ans - -Avoid acute
hip flexion and/or adduction immediately postop:
Can lead to subluxation or dislocation of hip -> shortened extremity, increased
discomfort, inability to move
-Exercises
-Bed to chair transfers
-DVT prophylaxis
-Abx as needed
Complications Following Hip Replacement Right Ans - ±DVT/PE
±Dislocation
±Osteolysis
±Metal sensitivity/toxicity
±Chronic leg pain
±Leg length inequality
±Nerve palsy
indications for knee replacement Right Ans - OA, RA, daily life affected,
daily pain, osteonecrosis, severe deformity
, contraindications for knee replacement Right Ans - Knee infection, sepsis,
morbid obesity, severe hip OA on same side, flexion contractures, poor
vasculature
Steps for a Knee Replacement Right Ans - -Remove the end of the femur
-Remove the top of the tibia
-Remove back of patella
-Femoral implant inserted
-Insert tibial components (plastic spacer and metal tray)
-Insert patellar implant
Types of Knee Implants Right Ans - Uni-compartmental:
°AKA partial knee replacement
°Medial or lateral tibiofemoral surface
Bi-compartmental:
°Both medial and lateral surfaces
Tri-compartmental:
°AKA total knee replacement
°Both medial and lateral surfaces and the patellar-femoral articulation
Postop Rehabilitation for Knee Replacement Right Ans - Mobilization
°Want to see >90 degrees flexion at 2 weeks and within preoperative range of
flexion within 6 weeks
Flexion / extension exercises
Muscle strengthening
Complications Following Knee Replacement Right Ans - -DVT/PE
-Infection
-Patellofemoral instability/fracture
-Neurovascular complications
-Supracondylar fractures of the femur
-Flexion contracture
Arthroscopy vs arthroplasty Right Ans - arthroscopy:
-Minimally invasive
-Faster recovery
-Good for debridement
-Helps with diagnosis
arthroplasty:
-Open procedure
-Joint is replaced, remodeled or realigned
-Relieves pain in the joint
-Restores function of the joint
_ is one of the most widely performed orthopedic surgeries Right Ans -
Knee arthroscopy
Postoperative Treatment for Orthopedic Surgeries Right Ans - -Restore
movement:
°Physical therapy
°Massage therapy
°Exercises
-Pain management
-Prevent injury and infection
-DVT/ PE prophylaxis- Enoxaparin /warfarin /aspirin
VARIABLE as per surgeon preference (generally 4-6 weeks)
indications for hip replacement Right Ans - OA, RA, fractures, cancer, joint
instability, congenital hip disorder
contraindications for hip replacement Right Ans - Recent infection, pain is
not severe, <60 yoa with alternative surgery available
total vs half hip replacement Right Ans - Total- Replaces BOTH acetabulum
and femoral head
,Half- Replaces ONLY the femoral head
Parts of the hip Implant Right Ans - °Acetabular cup
°Femoral component
°Articular interface
types of hip implants Right Ans - -Ceramic
-Metal on metal
-Cemented
cemented vs uncemented hip fixation Right Ans - Cemented fixation-
Cement stem uses acrylic bone cement between the stem and bone
Uncemented fixation- Uncemented stem uses friction, shape and surface
coating to stimulate bone remodeling
Postoperative Management for hip replacement Right Ans - -Avoid acute
hip flexion and/or adduction immediately postop:
Can lead to subluxation or dislocation of hip -> shortened extremity, increased
discomfort, inability to move
-Exercises
-Bed to chair transfers
-DVT prophylaxis
-Abx as needed
Complications Following Hip Replacement Right Ans - ±DVT/PE
±Dislocation
±Osteolysis
±Metal sensitivity/toxicity
±Chronic leg pain
±Leg length inequality
±Nerve palsy
indications for knee replacement Right Ans - OA, RA, daily life affected,
daily pain, osteonecrosis, severe deformity
, contraindications for knee replacement Right Ans - Knee infection, sepsis,
morbid obesity, severe hip OA on same side, flexion contractures, poor
vasculature
Steps for a Knee Replacement Right Ans - -Remove the end of the femur
-Remove the top of the tibia
-Remove back of patella
-Femoral implant inserted
-Insert tibial components (plastic spacer and metal tray)
-Insert patellar implant
Types of Knee Implants Right Ans - Uni-compartmental:
°AKA partial knee replacement
°Medial or lateral tibiofemoral surface
Bi-compartmental:
°Both medial and lateral surfaces
Tri-compartmental:
°AKA total knee replacement
°Both medial and lateral surfaces and the patellar-femoral articulation
Postop Rehabilitation for Knee Replacement Right Ans - Mobilization
°Want to see >90 degrees flexion at 2 weeks and within preoperative range of
flexion within 6 weeks
Flexion / extension exercises
Muscle strengthening
Complications Following Knee Replacement Right Ans - -DVT/PE
-Infection
-Patellofemoral instability/fracture
-Neurovascular complications
-Supracondylar fractures of the femur
-Flexion contracture
