wk 1 intro to x-ray and joint replacement surgery

reading an x-ray

• check patients naem to make sure its the right x-ray

• check the date of film was taken (if patient has multiple put them in date order)

• put film on x-ray box right way around

• look at markers on film for left and right

ABC’s of reading an x-ray

• alignment : relationship of bones to each other

• bones: does it appear normal, any deviations, does it look dense

• cartiliage: discs in spine

• soft tissue: may be able to see shadow of muscles, fat in joint

• too little density - underexposure (appears white)

• too much density - overexposure (appears too dark)

arthroplasty

surgical joint replacement

primary purpose to improve quality of life

who is a good candidate

severe pain and stiffness affecting adls

failed conservative management

impacted mobility and function

when surgery is not the right option

• mild symptoms

• psychological distress

• high BMI (>40)

• young age (<60 years)

surgical options for hip

total hip replacement - a procedure to replace the hip joint with a prosthesis. for OA, slightly higher in female

hemiarthroplasty - replacement of femoral head only - associated with #NOF

hip resurfacing - replacement of articular surface - osteonecrosis and OA - younger population 53yrs

revision THR - removal and replacement of hip prosthesis

three main approaches to hip surgery

• posterolateral approach - common, muscle cutting, more precautions

• anterior approach - muscle sparing, fewer restrictions

• direct lateral approach - may affect abductors, caution with GT repair

surgical options for knee

total knee replacment - a procedure to replace the knee joint with a prosthesis, often for arthritisv- OA - 68yrs - females higher

unicompartmental knee repacment - OA - males more

revision TKR

knee surgical approaches

most common is medial parapatellar approach because avoids quad muscles

shoulder surgical approach

deltopectoral approach - common -

superior - common for reverse total shoulder

anterior approach

post op restrictions

for lower limb usually WBAT unless complications then go to PWB

for revision surgeries usually go on the side of caution and PWB

shoulder - COTWB or NWB, cup of tea wb