Total joint replacement

Question 1

6 main indications for replacmeent

Answer 1

1. joint derangment
2. age
3. pain
4. funciton
5. able to rehab
6. reduced and painful ROM

Question 2

age indications

Answer 2

over 60

- no real age

Question 3

what are are most noticable increases

Answer 3

45-55 range

Question 4

4 pain indications

Answer 4

1. not-releived by non-operative
2. affect QOL
3. affect sleep
4. pain at rest and activity

Question 5

5 function indications

Answer 5

1. walking distance
2. cane/crutch need
3. need for analgesics
4. stair climbing issues
5. diff. putting on shoes and socks

Question 6

what are joint derangement indications

Answer 6

• osteoarthritis #1
• RA
• psoriatic arth
• avasc. necrosis
• traumatic arth
• hip knee fractures
• bone tumors
• pagets

Question 7

** 4 radiographic indications

Answer 7

1. lost joint space
2. osteophytes
3. subchondral cysts
4. subchondral sclerosis

Question 8

8 contraindications

Answer 8

1. infection
2. too young and active
3. poor skin coverage around hip
4. paralyzed quad or abductors
5. neuromusc. disease
6. mental dysfuctional
7. serious physical disease
8. obesity

Question 9

5 parts of preop planning

Answer 9

1. old incision
2. limb length discrepancies
3. vasc. status
4. neuro status
5. signs if infections

Question 10

what radiographs are needed?

Answer 10

hip: AP and lat hip, AP pelvis
knee; standing AP, lateral skyline
NO MRI
templating

Question 11

important parts of procedure

Answer 11

1. sterility critical
2. anathestheitc
   - postitioning
   - incorporate old scars

Question 12

6 possible complications

Answer 12

1. DVT
2. nerve injuries
3. vascular injury
4. dislocations
5. infection
6. wound problems

Question 13

what are typical nerve injuries

Answer 13

• palsy

- most imcomplete and with resolve to greater or lesser extent

Question 14

what are dislocation rates

Answer 14

• concern for both 1ry and revisions
• ## incidence inversely related to surg .experience

Question 15

infection rates

Answer 15

1% in new and 4% in revisions

- prophylaxis is critical