Elective surgery

Question 1

What are the four surgical strategies for treating OA?

Answer 1

Arthroplasty
Excision arthroplasty
Arthrodesis
Osteotomy

Question 2

What is arthroplasty?

Answer 2

Joint replacement.

Can be full or hemi

Question 3

What materials are often used in joint replacement?

Answer 3

Stainless steel
Cobalt chrome
TItanium
Polyethene
Ceramics

Question 4

How are arthroplasties attached?

Answer 4

EIther cemented or uncemented (bone grows into them)

Question 5

What are some of the problems associated with arthroplasty?

Answer 5

Muscle and bone necrosis and bone lysis from metal particles.
Infection
Recurrent dislocation
Neurovascular injury
PE

Question 6

What is an excision/resection arthroplasty?

Answer 6

Removal of bone or cartilage from one or both sides of joint.

Question 7

What joints are excision arthroplasties good for?

Answer 7

Small joints

Sometimes used for failed hip to shoulder replacements

Question 8

What is arthrodesis?

Answer 8

Fusion of a joint in position of function

Question 9

How is a arthrodesis performed?

Answer 9

Remove diseased bone and cartilage then let it heal together.

Question 10

What are the benefits and problems of arthrodesis?

Answer 10

Good for alleviating pain

Increases pressure on surrounding joints

Question 11

What joint are often arthrodesed?

Answer 11

End stage ankle, wrist and MTP arthritis.

Question 12

What is an osteotomy?

Answer 12

Surgical realignment of bone

Question 13

What are osteotomies used for?

Answer 13

To correct deformities or redistribute load- move load from diseased part to undiseased.

Question 14

Give some examples of soft tissue problems

Answer 14

Tendonitis
Enthesopathies
Cartilage tears
Labrum tears
Bursitis
Capsulitis
Non-infectious fasciitis

Question 15

What are the eight options for treatment of soft tissue injuries?

Answer 15

Rest
Steroid injection
Debridement
Decompression
Synovectomy
Splinting
Surgical repair
Tendon transfer

Question 16

What is the best treatment for soft tissue injury?

Answer 16

Rest, analgesia and anti-inflammatories

Question 17

When should steroid injections be and not be used?

Answer 17

Use: Rotator cuff and lateral epicondylitis

Do NOT use: Achilles

Question 18

What is debridement?

Answer 18

Removal of diseased tissue

Question 19

What is decompression

Answer 19

Making more space

Question 20

What is a synovectomy?

Answer 20

Removal of synovial membrane

Question 21

When is splintage used for soft tissue injuries?

Answer 21

Large tendons like Achilles

Question 22

What is joint instability?

Answer 22

Abnormal motion of a joint resulting in dislocation

Question 23

In what joints is instability common?

Answer 23

Knee and shoulder

Question 24

What is conservative management for joint instability?

Answer 24

Physio and splints etc

Question 25

What surgeries are available for joint instability?

Answer 25

Ligament tightening
Ligament reconstruction
Soft tissue reattachment
Arthrodesis 
Osteotomy

Question 26

What is nerve compression?

Answer 26

COmpression of nerves.
Carpal/cubital tunnel syndrome and slipped discs
Operate to release pressure

Question 27

What Infections do orthopedics deal with?

Answer 27

Soft tissue- Infected bursitis and Abscess
Osteomyelitis
Infection of arthroplasty

Question 28

What surgery is given for osteomyelitis?

Answer 28

Acute: Drain abscess
Chronic: Deep bone samples, remove sequestrum (bone fragment) and debride. Stabilize debrided bone

Question 29

What surgery is performed for infected arthroplasty?

Answer 29

Removal of prosthetic and debridement if needed.