This document discusses various types of arthroplasty procedures for different joints. Arthroplasty involves surgically reconstructing a joint by replacing worn or damaged parts with prosthetic implants. It summarizes arthroplasty of the hip, knee, ankle, shoulder, elbow, wrist and hand joints. For each joint, it describes the indications, surgical techniques and postoperative rehabilitation for both partial and total joint replacement arthroplasty. The goal of arthroplasty is to relieve pain and restore function by replacing dysfunctional joint surfaces with prosthetic components.
The presentation investigates the following characteristics of the meniscus;
Role of the Meniscus
Material Properties
Structural Limitations / Failure Limits
Mechanism & Treatment of Injuries
The presentation investigates the following characteristics of the meniscus;
Role of the Meniscus
Material Properties
Structural Limitations / Failure Limits
Mechanism & Treatment of Injuries
Acromioclavicular (AC) joint injury is a term used to describe an injury to the top of the shoulder, where the front of the shoulder blade (acromion) attaches to the collarbone (clavicle).
This presentation is made to act as a guide and a short reminder to clinicians and medical students on Volkmann's Ischaemic Contracture, which is a medical condition that can lead to activities limitation and public participation restriction. This presentation explore aspects of the condition such as what it is, causes, how it can be diagnosed, how it can be managed and others.
Bicipital tendonitis is inflammation of long head of the biceps tendon under the bicipital groove.
In early stage, tendon becomes red and swollen, as tendonitis develops the tendon sheath can thicken.
In late stage, often become dark red in color due to inflammation.
Hello everyone here I upload mckenzie exrercise basic details and some of its position.Its technique for use to cervical, Lumabar pain relief via particular position.Thank you.
Myofascial release refers to the manual
technique for stretching the fascia and
releasing bonds between fascia and
Lintegument, musles,and bones, with the goal of
eliminating pain, increasing range of motion
and balancing the body.
Acromioclavicular (AC) joint injury is a term used to describe an injury to the top of the shoulder, where the front of the shoulder blade (acromion) attaches to the collarbone (clavicle).
This presentation is made to act as a guide and a short reminder to clinicians and medical students on Volkmann's Ischaemic Contracture, which is a medical condition that can lead to activities limitation and public participation restriction. This presentation explore aspects of the condition such as what it is, causes, how it can be diagnosed, how it can be managed and others.
Bicipital tendonitis is inflammation of long head of the biceps tendon under the bicipital groove.
In early stage, tendon becomes red and swollen, as tendonitis develops the tendon sheath can thicken.
In late stage, often become dark red in color due to inflammation.
Hello everyone here I upload mckenzie exrercise basic details and some of its position.Its technique for use to cervical, Lumabar pain relief via particular position.Thank you.
Myofascial release refers to the manual
technique for stretching the fascia and
releasing bonds between fascia and
Lintegument, musles,and bones, with the goal of
eliminating pain, increasing range of motion
and balancing the body.
The “Bony Bankart Bridge” Procedure Shoulder Instability | Shoudler Surgery |...Peter Millett MD
Arthroscopic treatment of bony Bankart lesions can be challenging. We present a new easy and reproducible technique for arthroscopic reduction and suture anchor fixation of bony Bankart fragments. A suture anchor is placed medially to the fracture on the glenoid neck, and its sutures are passed around the bony fragment through the soft tissue including the inferior glenohumeral ligament complex. The sutures of this anchor are loaded in a second anchor that is placed on the glenoid face. This creates a nontilting 2-point fixation that compresses the fragment into its bed. By use of the standard technique, additional suture anchors are used superiorly and inferiorly to the bony Bankart piece to repair the labrum and shift the joint capsule. We call this the “bony Bankart bridge” procedure. Key Words: Arthroscopy—Bony Bankart lesion—Suture bridge—Instability—Shoulder. For more shoulder surgery and shoulder instability studies, visit Dr. Millett, The Steadman Clinic, Greater Denver Area http://drmillett.com/shoulder-studies
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
Deep Leg Vein Thrombosis (DVT): Meaning, Causes, Symptoms, Treatment, and Mor...The Lifesciences Magazine
Deep Leg Vein Thrombosis occurs when a blood clot forms in one or more of the deep veins in the legs. These clots can impede blood flow, leading to severe complications.
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
ICH Guidelines for Pharmacovigilance.pdfNEHA GUPTA
The "ICH Guidelines for Pharmacovigilance" PDF provides a comprehensive overview of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines related to pharmacovigilance. These guidelines aim to ensure that drugs are safe and effective for patients by monitoring and assessing adverse effects, ensuring proper reporting systems, and improving risk management practices. The document is essential for professionals in the pharmaceutical industry, regulatory authorities, and healthcare providers, offering detailed procedures and standards for pharmacovigilance activities to enhance drug safety and protect public health.
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
Explore our infographic on 'Essential Metrics for Palliative Care Management' which highlights key performance indicators crucial for enhancing the quality and efficiency of palliative care services.
This visual guide breaks down important metrics across four categories: Patient-Centered Metrics, Care Efficiency Metrics, Quality of Life Metrics, and Staff Metrics. Each section is designed to help healthcare professionals monitor and improve care delivery for patients facing serious illnesses. Understand how to implement these metrics in your palliative care practices for better outcomes and higher satisfaction levels.
The Importance of Community Nursing Care.pdfAD Healthcare
NDIS and Community 24/7 Nursing Care is a specific type of support that may be provided under the NDIS for individuals with complex medical needs who require ongoing nursing care in a community setting, such as their home or a supported accommodation facility.
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
3. DEFINITION
“Arthroplasty” is a surgical procedure to construct a
new mobile joint.
Arthroplasty is performed to restore pain-free
functional range of motion(ROM) in a stiff and or
painful joint by replacing the joint partially or totally
with an artificial joint (prosthesis).
4. PRINCIPLES OF ARTHROPLASTY
ῷThe prosthetic implant must be durable.
ῷThey must permit low friction movement at the articulation.
ῷThey must be firmly fixed to the skeleton.
ῷThey must be inert and not provoke any unwanted reaction in the
tissue.
ῷSelection of the prosthesis and fixation technique depends on patient’s
bone structure, joint stability and other individual characteristics,
including age, weight and activity level.
ῷTo reduce the risk of an infected prosthesis, special precautions should
be carried out. Source: Harborview Illustrated Orthopaedics
5. ARTHROPLASTY OF
THE LOWER LIMB
ARTHROPLASTY OF HIP JOINT
This may be of two types:-
a) Replacement Arthroplasty
b) Excisional Arthroplasty
6. a) REPLACEMENT
ARTHROPLASTY
Replacement Arthroplasty is reconstruction of the joint by replacing the
joint partially or totally. It can be :-
i. Hemireplacement
ii. Total joint replacement
1)HEMIREPLACEMENT ARTHROPLASTY:- Either of the articulating
surfaces is removed and replaced by prosthesis of similar shape and size.
It is indicated in fractures of the femoral neck in elderly patients.
In this operation, femoral components-head and neck are replaced with a
metal prosthesis.
Two types of prostheses are commonly used- Austin Moore & Thompson.
7. The stem of the prosthesis is implanted into the upper shaft
of the femur with the help of bone cement( methyl
methacrylate) while the head of the prosthesis is put in the
acetabulum inside a metal cup which moves freely into the
acetabulum.
PHYSIOTHERAPY MANAGEMENT- Postoperatively, patient
is immobilized in the bed in supine position with the limb in
abduction to prevent dislocation of the prosthesis.
The movements of flexion and adduction are particularly
avoided for a period of 4-6 weeks.
Partial weight bearing crutch walking is started after 3 weeks
Full weight bearing is allowed after 6-8 weeks.
10. 2)Total Hip Replacement
♪ Here both the articular surfaces –the acetabular as well as the femoral
head components are excised and replaced by prosthetic components.
♪ It is indicated in severe Osteoarthritis , Rheumatoid Arthritis or
following any severe trauma.
♪ There are two types of total hip joint arthroplasty:-
1. Cemented hip arthroplasty: In this the acetabular as well as the
femoral components are fixed into place with the help bone cement.
This technique is generally used in elderly patients where the bone
stock is poor.
2. Noncemented hip arthroplasty: In this the acetabular component, is
fixed into place with the help of screws and the femoral component is
fitted tightly into the medullary canal of femur. This technique is used
in young adults where the bone stock is good.
13. b) EXCISIONAL(GIRDLESTONE)
ARTHROPLASTY
☺Here one or both articular surfaces are excised ; fibrous tissue fills up in the gap
created and provides mobility.
☺Excisional Arthroplasty is indicated in the following conditions:-
1) An advanced case of tuberculosis of the hip with extensive destruction of the hip
joint.
2) Severe osteoarthritis of the hip
3) Painful ankylosis of the hip
4) Septic arthritis of the hip
5) Pyogenic infection of the hip following hemireplacement or total hip replacement
arthroplasty
6) Failed Total Hip Replacement(THR) or ORIF.
14. In this procedure, the femoral head and neck are resected down to the
base of the trochanter; the superior margin of the acetabulum is also
resected to curette out the diseased portion. A gap is thus created between
the acetabulum and the trochanter.
15. ARTHROPLASTY OF KNEE
JOINT
TOTAL KNEE REPLACEMENT(TKR)
ARTHROPLASTY
INDICATIONS:-
a. Severe Osteoarthritis of the knee
b. Rheumatoid Arthritis causing severe destruction
c. Unremitting severe pain in the knee with or without
deformity.
TKR relieves pain, provides adequate mobility and corrects
deformity.
16.
17.
18. TYPES OF TKR:-
1) Unicompartmental arthroplasty:- It is also called
unicondylar arthroplasty. The articular surfaces of the
femur and tibia of either the medial or the lateral
compartment of the knee are replaced by implant.
2) Bicompartmental arthroplasty:- The articular surface of the
tibia and the femur of both medial and lateral
compartments of the knee joint are replaced by an implant.
3) Tricompartmental arthroplasty:- The articular surfaces of
the lower femur , upper tibia and the patella are replaced by
prostheses. The prosthesis consists of a tibial component, a
metal femoral component and a high molecular weight
polyethylene(HMWPE) button for the articular surface of
the patella.
21. ARTHROPLASTY OF ANKLE
JOINT
TOTAL JOINT REPALCEMENT OF ANKLE is indicated in selected
cases of rheumatoid arthritis, osteoarthritis and haemophilic arthropathy.
Arthrodesis (fusion of joint) is more common procedure than
arthroplasty.
The presently available ankle joint prosthesis consists of a metal plate
over the dome of the talus which articulates with a platform consisting
of high molecular weight polyethylene attached to the lower end of
tibia.
Postoperatively, mobilization is begun as soon as the pain reduces and
partial weight bearing on affected leg is allowed by 2-3 weeks.
22.
23.
24.
25. ARTHROPLASTY OF UPPER
LIMB
ARTHROPLASTY OF SHOULDER JOINT
Like hip, the arthroplasty of shoulder is also of
two types:-
a) Hemireplacement arthroplasty
b) Total joint replacement
26. a) Hemireplacement
arthroplasty
It is indicated in severely comminuted fractures of
proximal humerus.
In this procedure, the fractured humeral component
is replaced by a prosthesis and fixed with the help of
bone cement.
27.
28. b) Total Shoulder Arthroplasty
¶In total shoulder arthroplasty, the humeral head and the glenoid
articulating surfaces are replaced by prosthetic components.
¶It may be indicated in severely comminuted fractures of the shoulder ,
secondary osteoarthritis or rheumatoid arthritis of the shoulder joint.
¶Types of Prosthesis used:-
1.Neer’s Prosthesis( Neer & Watson,1982): It is the most commonly used.
Here the glenoid cavity is replaced by a shallow cup while the humeral
head is replaced by a ball.
2. Liverpool( reverse) Prosthesis( Beddow & Elloy, 1977): It has a reverse
ball and socket arrangement, the ball is on the glenoid cavity and the cup
on the humeral side.
¶ The shoulder joint is mobilized 2-3 weeks after the operation.
31. ARTHROPLASTY OF ELBOW
JOINT
INDICATIONS:-
♦Post traumatic stiffness of elbow
♦Advanced stages of Rheumatoid Arthritis
♦Severe Osteoarthritis
♦Bilateral elbow ankylosis
♦Severe fractures and dislocations of the elbow
♦Tumour
32. TYPES OF ARTHROPLASTY:- 3 types of elbow arthroplasty are generally
described-
1)Resection(Excisional) Arthroplasty:- It is indicated in stiff(ankylosed)
elbow joint due to rheumatoid arthritis or trauma.
• In this operation, a gap is created by excision of the lower end of the
humerus and / or upper end of the ulna and radius
2)Interpositional (Fascial) Arthroplasty:- In this procedure, the lower end of
the humerus and upper end of ulna are excised. The exposed ends of both
these bones are covered by tensor fascia lata strip.
3)Implant(Total Joint Replacement) Arthroplasty:- Total replacement of the
elbow joint is undertaken when there is massive destruction of the joint due
to rheumatoid arthritis, post-traumatic arthritis,etc., and as a
reconstructive procedure after tumour resection.
• In this, the joint is replaced by metal or plastic hinge prosthesis.
37. ARTHROPLASTY OF WRIST JOINT
Wrist Arthroplasty has not been in much demand when compared to hip,
knee etc.
Because Arthrodesis of the wrist provides better functional stability
which facilitates hand function and is hence preferred.
Indications:-
1. Severe wrist fractures and dislocations
2. Severe pain due to OA
3. Advanced RA
4. Total ankylosis of the wrist
38. Total replacement of the wrist joint allows limited
mobility and pain relief.
The metacarpal component is fitted into the capitate,
3rd metacarpal bed and the radial component is fitted
with bone cement into the distal radius.
After the operation, the wrist is immobilized for
about 8-10 days, after which gradually the
mobilization is begun.
However , a splint is used intermittently for the next
6 weeks.
39.
40.
41. ARTHROPLASTY OF HAND
Arthroplasty of the joints of the hand is indicated in painful
stiff joints and/or in case of deformity preventing hand function
, following RA , degenerative or traumatic conditions or crush
injury.
TYPES:-
1)Excisional (Resection) Arthroplasty of PIP joints of the finger is
rarely indicated in cases of infective arthritis.
In this operation, the head of the proximal phalanx is excised,
the wound is closed and the finger is given traction through the
distal phalanx for about 6 weeks .
42. 2)Implant (Replacement) Arthroplasty:
This type of arthroplasty is commonly indicated in MCP joints
and occasionally in PIP joints.
Swanson(Swanson et al., 1982) silicone prosthesis are most
commonly used in this procedure.
The articular surfaces of the two adjoining bones of a
particular joint of the finger are excised and the stem of the
prosthesis are fixed into the medullary canals of the two
bones.
Postoperatively, the joint is mobilized after a week or 10 days.
45. REFERENCE
A. Essentials of Orthopaedics and Applied
Physiotherapy, Jayant Joshi & Prakash
Kotwal
B. Essentials of Orthopaedics for
Physiotherapists, John Ebnezar & Rakesh
John
