Orthopaedic Upper limb lab

Question 1

Week 0-6 post shoulder operatioon exercise

Sling at all the time

Answer 1

• AROM elbow flexion/extension (supine)
• AROM hand (supine)
• Pendular exercise (standing)
• make sure no AROM shoulder

Question 2

Week 2 post shoulder operatioon exercise

ORIF [open reduction internal fixation] from 3-4 weeks

Answer 2

• Passive elevation of arms with a stick (supine)

- Passive ER of arms with a stick (supine)

Question 3

Week 6-12 post shoulder operatioon exercise

No sling

Answer 3

-Pulleys

Question 4

Week 12-16 post shoulder operatioon exercise

Answer 4

-Strengthening (resisted)

[Tendon healing at least 12 weeks]

Question 5

Week 16 post shoulder operatioon exercise

Answer 5

• Work towards full function

- Work and sport specific exercises

Question 6

Most patients encouraged to continue exercises for at least ____

Answer 6

1 year after surgery

Question 7

Return to sports

Answer 7

6 - 9 months

Question 8

After Reverse total shoulder replacement, for 12 weeks, you want to avoid moving your arm in which direction?

Answer 8

• IR
• Adduction
• Extension

Question 9

After Standard total shoulder replacement, for 12 weeks, you want to avoid moving your arm in which direction?

Answer 9

• ER

- ABduction

Question 10

RA

Answer 10

• Inflammatory / autoimmune disease (attacks panas synovium = synovial membrane)
• Rapid onset
• Small joints / Bilateral
• Worse in the morning / Stiff > 1hr
• Blood test

Question 11

OA

Answer 11

• “wear and tear” / “degenerative” disease (articular cartilage)
• Gradual onset
• Large WB joints / Uilateral
• Worse in the morning / Stiff < 1hr
• X-ray (Kellgren-Lawrence Grading Scale)

Question 12

Are there any likely cardiopulmonary complications following shoulder Arthtoplasty?

Answer 12

The risk is low.

[however, elderly and prior cardiac event are associated with higher risk of having cardiac complications]

Question 13

Name 2 most common complications in Reverse total shoulder replacement.

Answer 13

-Instability
-Infection
[both are around 4 %, but the most common]

Question 14

Process of OA

Answer 14

1. superficial collagen fibres fray = loss of tensile stiffness
2. high stresses in tissue beneath form fissures following the direction of collagen (obliquely)
3. disturbance in PG synthesis and degradation = decreased ability of cartilage to resist compression