Joint replacement

an orthopedic operative procedure in which the dysfunctional joint surface is replaced with an orthopedic prosthesis; or by remodeling or realigning the joint surfaces

joint replacement or arthroplasty

difference in hip replacement and hip resurfacing

hip replacement is when bone is removed and replaced by proshtheses, and hip resurfacing is when it is reshaped to accept a metal cup with a small guide stem

what joints are most likely the ones to be replaced

hips and knees

condition where the bones of the hip are abnormally shaped; results in damage to the joint

femoroacetabular impingement (FAI)

how to treat a FAI

non surgical: NSAIDS, activity modifications, therapy

Surgical: arthroscopic surgery

what are the three types of FAI

pincer, cam, and combined

extra bone extends out over the normal rim of acetabulum

pincer FAI

femoral head is not round (can have abnormally large radius) and cannot rotate smoothly inside acetabulum

cam FAI

both pincer and cam types are present

Combined FAI

both the femoral head and acetabulum are replaced; highly successful

total hip arthroplasty

generally replace just the femoral head with a cap; is alternative to total hip replacement

hemiarthroplasty

how long is normal healing for a hip replacement

8-12 weeks

what is the most common approach to the hip

posterior approach which is done by taking piriformis and the short hip external rotators off the femur

which approach is elevation of the g. medius and minimus allowing for lower risk of dislocations

lateral approach

which approach is between sartorius and TFL with a lower dislocation rate but can posibly cause thigh numbness

anterior approach

which cup has an outer shell and a liner? shell is made of metal, the outside of which is porous coating to form a frictionless fit and eventually bone grows onto the porous coating

modular cups

cartilage and bone are removed from the acetabulum and the cup is placed, the cup is attached using biological fixation or cement

acetabular cups

may be metal or polyethylene, may be cemented in place

one piece cups

t/f heads can be metal or ceramic

true

does resurfacing arthroplasty of hip replacements have a higher risk of complications

resurfacing arthroplasty

what is the alternative to a total hip replacement

resurfacing arthroplasty

the surgical replacement of the head of the femur using a metal or plastic cup

cup arthroplasty

removal of the head of the femur and the acetabular rim; may be used following a failed THA

resection arthroplasty

what is the most common complication of THA

dislocation

what are some common complications of THA

dislocation, loosening, metal sensitivity, nerve palsy, chronic pain, leg length inequality

how long should you wait to cross your legs post THA

6 weeks

replacement of the weight-bearing surfaces of the knee joint to relieve pain and improve function

knee arthroplasty

where is the surgery approach for a knee arthroplasty

anterior, on medial side of patella, resulting in exposure of the femur and tibia

what are some goals for surgery

pain relief, restore functional mobility, restore alignment, restore stability

for patients with damage to one compartment (usually teh medial) they may be candidates for which kind of knee replacement

unicompartmental arthroplasty

what are some advantages to a unicompartmental arthroplasy

include a smaller incision; ACL intact; easier post-op rehabilitation; shorter hospital stay; less risk of infection

what are some risks ans complications to joint replacements

infection, implant failure, deep vein thrombosis, injury to nerves, fractures, loss of motion, instability

what is the most common complication following joint replacement

deep vein thrombosis

how long might recovery take

up to three months

what can an OT do to help assist in the rehabilitation post op

ADL’s, transfers, home and work improvements, etc

all or part of the glenohumeral joint is replaced by a prosthetic implant

shoulder replacement

what are the three types of shoulder replacement

hemi-arthroplasty, total shoulder arthroplasty, and reverse shoulder arthroplasty

involves replacing the humeral head only; done when glenoid cavity does not have arthritis or when concern is regarding the failure of the glenoid component

hemi-arthroplasty

both parts of the shoulder are replaced; humeral head is replaced with stem and ‘ball’ attached; glenoid fossa with metal and polyethylene liner

total shoulder arthroplasty

ball and socket are reversed. the ‘ball’ part is attached to the glenoid fossa; the ‘socket’ to the humerus

reverse shoulder arthroplasty

how can an OT help those recovering from a shoulder replacement

passive and active ROM exercises

used for patients with arthritis or with severe joint damage; loss of functional use

elbow arthroplasty

how long is recovery for a elbow replacement

can take up to 3 months

most wrist arthroplastys have what two components

radial component and carpal component

what goes in between the radial and carpal component in a wrist arthroplasty

plastic spacer

which approach is used with wrist replacement

posterior approach to access the region; damaged bone ends removed

where is the carpal component of a wrist replacement inserted

into the third metacarpal bone or screwed into the distal carpal row

which approach is taken for a finger athroplasty

posterior approach to expose the bone ends and remove the ends of the bone to allow insertion of implant components

how long are you splinted post op for finger arthroplasty

12 weeks