Orthopedic Surgery and Joint Reconstruction Overview
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Questions and Answers

What is the main purpose of injections in the treatment of joint conditions?

  • To cause joint infection
  • To increase inflammation
  • To perform viscosupplementation (correct)
  • To worsen cartilage injury

    • Which surgical procedure involves cutting the bone to change its position for improving alignment or length?

  • Pelvic osteotomy (correct)
  • Arthroplasty
  • Hip arthroplasty
  • Arthrodesis

    • What is the primary goal of surgical arthroplasty or joint replacement?

  • Maximize patient function (correct)
  • Cause joint infection
  • Increase pain
  • Preserve motion

    • In what cases might arthrodesis be considered as a surgical option?

    <p>For elderly low-demand patients</p> Signup and view all the answers

    What is a potential risk associated with common injections like corticosteroids?

    <p>Joint infection</p> Signup and view all the answers

    For what reason might an isolated medial compartment knee osteotomy be performed?

    <p>To correct varus deformity</p> Signup and view all the answers

    Which surgical approach to the hip is also known as Smith Peterson?

    <p>Anterior</p> Signup and view all the answers

    What is the main consideration for conservative management and prevention of arthritis?

    <p>Weight loss</p> Signup and view all the answers

    What is the most common bearing surface combination in hip arthroplasty?

    <p>Metal femoral head on polyethylene liner</p> Signup and view all the answers

    Which symptom is associated with arthritis according to the text?

    <p>Decreased ability to perform</p> Signup and view all the answers

    Which type of prosthetic component relationship can lead to metallic staining on the ceramic femoral head in hip arthroplasty?

    <p>Metal on ceramic</p> Signup and view all the answers

    In hip arthroplasty, what is the Austin Moore Prosthesis primarily used for?

    <p>End-stage hip arthritis failed non-operative management</p> Signup and view all the answers

    What type of gait is observed in the physical examination of a patient with hip problems?

    <p>Antalgic gait</p> Signup and view all the answers

    When considering total joint arthroplasty, what is the final option for patients suffering from pain associated with arthritis in the joint?

    <p>Hip arthrodesis</p> Signup and view all the answers

    Which is NOT a method mentioned for the conservative management and prevention of arthritis?

    <p>Medication</p> Signup and view all the answers

    In what type of patients can a decrease of 11lbs reduce the risk of developing knee osteoarthritis?

    <p>Only women</p> Signup and view all the answers

    Which condition might present with peritrochanteric pain according to the text?

    <p>Hip arthritis</p> Signup and view all the answers

    What is the major concern associated with metal on metal bearing surfaces in hip arthroplasty?

    <p>Production of metal ions</p> Signup and view all the answers

    In hip arthroplasty, which type of fixation offers biologic fixation without the use of cement?

    <p>Cementless</p> Signup and view all the answers

    What is the main cause of osteolysis and aseptic loosening in joint arthroplasty?

    <p>Abnormal resorption of bone</p> Signup and view all the answers

    Which complication is unique to hip replacement among the listed options?

    <p>Dislocation</p> Signup and view all the answers

    Among the complications shared by hip and knee replacement, which one poses the risk of venous thromboembolic disease?

    <p>Infection</p> Signup and view all the answers

    What is the primary concern with ceramic on ceramic bearing surfaces in hip arthroplasty?

    <p>Brittleness</p> Signup and view all the answers

    What is the primary purpose of weight loss in the conservative management and prevention of arthritis?

    <p>To reduce the incidence of arthritis</p> Signup and view all the answers

    Which of the following is NOT a factor considered in the examination of a patient with arthritis according to the text?

    <p>Color of the skin surrounding the joint</p> Signup and view all the answers

    What is the term used to describe lateral hip pain often linked to peritrochanteric conditions as mentioned in the text?

    <p>Trochanteric bursitis</p> Signup and view all the answers

    Which of the following activities would be LEAST recommended for a patient with hip arthritis based on the text?

    <p>Running on hard surfaces</p> Signup and view all the answers

    In hip arthroplasty, what type of fixation offers biologic bonding without the use of cement as mentioned in the text?

    <p>Hydroxyapatite-coated fixation</p> Signup and view all the answers

    Which type of pain management technique is NOT typically recommended in the conservative management of arthritis according to the text?

    <p>Opioid medications</p> Signup and view all the answers

    What is the primary indication for hip arthrodesis as mentioned in the text?

    <p>Failed non-operative management of hip arthritis</p> Signup and view all the answers

    Which of the following surgical approaches to the hip is NOT correctly matched with its alternative name?

    <p>Anterior (Smith Peterson)</p> Signup and view all the answers

    Which bearing surface combination is considered an alternative to the common metal femoral head on polyethylene liner in hip arthroplasty?

    <p>Metal on ceramic</p> Signup and view all the answers

    What is a potential complication specifically associated with failed ceramic on metal hip arthroplasty components?

    <p>Metallic staining on the ceramic femoral head</p> Signup and view all the answers

    What distinguishes hip arthroplasty from hip arthrodesis in terms of surgical management, as highlighted in the text?

    <p>Hip arthroplasty involves replacing the joint, while arthrodesis involves fusing it.</p> Signup and view all the answers

    What is the primary concern associated with ceramic on ceramic bearing surfaces in hip arthroplasty?

    <p>Brittle nature making them prone to fractures</p> Signup and view all the answers

    What is the major risk associated with cemented fixation in joint arthroplasty?

    <p>Abnormal resorption of bone</p> Signup and view all the answers

    Which complication is unique to hip replacement among the listed options?

    <p>Leg length discrepancy</p> Signup and view all the answers

    What is the primary purpose of joint replacement surgery?

    <p>To maximize patient function and quality of life</p> Signup and view all the answers

    What is one of the complications shared by hip and knee replacement surgeries?

    <p>Intra/post-operative fracture</p> Signup and view all the answers

    What is the major concern associated with metal on metal bearing surfaces in hip arthroplasty?

    <p>Development of pseudotumors</p> Signup and view all the answers

    Which type of surgical management involves cutting the bone to improve alignment or length?

    <p>Femur Osteotomy</p> Signup and view all the answers

    What is a potential risk when administering corticosteroid injections for joint conditions?

    <p>Increased risk of joint infection</p> Signup and view all the answers

    What is the primary reason for the lowest wear rate in ceramic on ceramic bearing surfaces?

    <p>Brittle nature of ceramics</p> Signup and view all the answers

    In surgical management, when might arthroplasty/joint replacement be the preferred option?

    <p>As a last resort for elderly low-demand patients</p> Signup and view all the answers

    What is a common risk associated with surgical arthrodesis?

    <p>Limited mobility post-surgery</p> Signup and view all the answers

    What is a potential complication unique to osteotomy procedures compared to other surgical options?

    <p>Failure to achieve the desired alignment</p> Signup and view all the answers

    Study Notes

    Joint Arthroplasty/Replacement

    • Hip arthroplasty is used for end-stage hip arthritis that has failed non-operative management
    • Austin Moore Prosthesis is a type of hip arthroplasty
    • Surgical approaches to the hip include:
    • Anterior (Smith Peterson)
    • Anterolateral (Watson-Jones)
    • Lateral (Hardinge)
    • Posterior (Kocher Langenbach)

    Bearing Surfaces

    • Metal on metal bearing surfaces are associated with production of metal ions, pseudotumors, hypersensitivity reactions, and early failure
    • Ceramic on ceramic bearing surfaces have the lowest wear rate and friction, but are brittle
    • Metal femoral head on polyethylene liner is the most common bearing surface
    • Ceramic and metal are alternative bearing surfaces

    Fixation Options

    • Cementless fixation uses biologic fixation
    • Cemented fixation uses PMMA, which serves as grout

    Complications

    • 5-10% of joint arthroplasty patients experience complications
    • Shared complications of hip and knee replacement include:
      • Infection
      • Intra/post-operative fracture
      • Vascular injury
      • Nerve injury or palsy
      • Periprosthetic fracture
      • Stress shielding
      • Component fracture or wear
      • Medical complications (DVT, PE, MI, CVA)
    • Unique complications of hip replacement include:
      • Dislocation
      • Leg length discrepancy
      • Iliopsoas impingement or tendonitis

    Osteolysis and Aseptic Loosening

    • Caused by infection, metastatic disease, or production of wear debris
    • Results in abnormal resorption of bone

    Examination of the Patient

    • Physical examination includes:
      • Leg length discrepancy
      • Joint contractures
      • Skin changes
      • Prior surgical incisions
      • Neurovascular exam
      • Strength
      • Range of motion
    • Goals of treatment include:
      • Improving pain
      • Preserving motion
      • Maximizing patient function, independence, and quality of life

    Injections

    • Common injections include:
      • Corticosteroids to decrease inflammation
      • Hyaluronic acid for viscosupplementation
    • Risks include:
      • Joint infection
      • Cartilage injury from the needle
      • Hemarthrosis
      • Failure to receive benefit

    Surgical Management

    • Arthroplasty/joint replacement is the most commonly performed procedure for arthritis of a major joint
    • Hip and knee arthroplasty are the most successful procedures
    • Other non-arthroplasty options exist

    Osteotomy

    • Cutting the bone to change position of the fragments to improve length, rotation, alignment, or angulation
    • Performed for both congenital and acquired deformities
    • Types of osteotomy include:
      • Pelvic osteotomy
      • Femur osteotomy
      • Proximal tibia osteotomy for isolated medial compartment knee osteoarthritis with varus deformity
      • Knee osteotomy

    Arthrodesis

    • Surgical option for infection, elderly low-demand patients, or young and active patients too young for a joint replacement
    • Can also serve as a last resort

    Conservative Management and Prevention

    • Weight loss of 11lbs can decrease the risk of developing knee osteoarthritis by 50% in women
    • Regular activities can lower the incidence of arthritis
    • Conservative management includes:
      • Weight loss
      • Activity modification
      • Rest
      • Bracing
      • Physical therapy
      • Pain management
      • Assistive devices (cane, walker)

    Arthritis

    • Types of arthritis include:
      • Osteoarthritis
      • Rheumatoid arthritis
      • Septic arthritis
      • Post-traumatic arthritis
    • Symptoms include:
      • Pain
      • Loss of range of motion
      • Decreased ability to perform daily activities
      • Decreased quality of life

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    Description

    Explore the field of Orthopedic Surgery and Joint Reconstruction with topics including complex trauma, minimally invasive fracture surgery, arthritis types, conservative management, and prevention strategies like weight loss and physical therapy.

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