N2261 - Total Hip Replacement/ Total Hip Arthroplasty Exam Questions and Answers Already Passed
Osteoarthritis - Answers - chronic, progressive joint disease
- most common joint disease
- primary cause is unknown
- secondary causes may be due to trauma (ex: sports injury), metabolic disease, decreased oestrogen
production following menopause, overuse (ex: running), infection, joint instability, being overweight or
obese
Osteoarthritis - Answers Patients may wait months before coming in to see their physician. The pain is
what brings them in and the swelling can be intense
Symptoms:
- pain (may be slow progression of localized pain)
- stiffness and swelling around the joint(s) lasting > 2 weeks
- limitation of joint movement (stiffness)
- crepitus (grating sound caused by bone rubbing against bone)
- may effect any joint in body (ex: spine, knees, hips, hands, and shoulders etc)
Osteoarthritis - Answers Diagnostics:
- rheumatoid factor (to eliminate the possibility of RA)
- erythrocyte sedimentation rate (ESR), which is the gross measure of inflammation
- C-reactive protein
- bone scan (radioactive nucleotide is injected 60 minutes prior to scan; radioactive dye is picked up on
scan in bone that is fractured or porus, callused or weak)
- Dual X-Ray Absorptionmetry (DXA): scan for osteoporosis; important to conduct prior to a hip
replacement to determine whether the femur is strong enough to support the prosthetic (determines
areas of porousness)
Osteoarthritis - Answers Treatment:
- heat/cold (preference or physician, client and physio)
- protect joints
, - avoid heavy lifting, use proper body mechanics, grab bars and assistive devices (braces and canes)
- weight loss
- pain management is key (NSAIDs and tylenol)
- use of glucosamine and chondroitin
- steroid injections
Hip Fracture - Answers - common causes are falls and major trauma (ex: MVA)
- risk factors include age, chronic medical conditions (ex: A. fib, HTN, TIA - diseases that make patients
light-headed and dizzy, putting them at risk for fall), being female, nutrition (ex: diet ), physical inactivity,
tobacco/alcohol use; medications (ex: corticosteroids), environmental hazards (ex: mats, extension
cords, clutter)
- diagnosed by x-ray, physical exam, CT scan, ESR, RF, DXA scan
Hip Fracture - Answers - fractures occur commonly the femoral neck (ex: intertrochanteric,
subtrochanteric, subcapital, transcervical)
- where fracture is will influence type of prosthetic used (unipolar, cementless, intramedullary nailing -
doing whatever supports bone the best)
- based on age, co-morbidities and physical condition
Hip Fracture - Answers Manifestation:
- external rotation
- muscle spasm causing shortened extremity
- pain and tenderness
- unable to use limb or walk
- displaced femoral neck fracture can cause serious interruption of blood supply leading to avascular
necrosis
Hip Fracture - Answers Treatment:
- Total Hip Replacement (THR) or Total Hip Athroscopy (THA); reconstruction or replacement of joint to
relieve pain, to improve ROM or to correct a deformity
Osteoarthritis - Answers - chronic, progressive joint disease
- most common joint disease
- primary cause is unknown
- secondary causes may be due to trauma (ex: sports injury), metabolic disease, decreased oestrogen
production following menopause, overuse (ex: running), infection, joint instability, being overweight or
obese
Osteoarthritis - Answers Patients may wait months before coming in to see their physician. The pain is
what brings them in and the swelling can be intense
Symptoms:
- pain (may be slow progression of localized pain)
- stiffness and swelling around the joint(s) lasting > 2 weeks
- limitation of joint movement (stiffness)
- crepitus (grating sound caused by bone rubbing against bone)
- may effect any joint in body (ex: spine, knees, hips, hands, and shoulders etc)
Osteoarthritis - Answers Diagnostics:
- rheumatoid factor (to eliminate the possibility of RA)
- erythrocyte sedimentation rate (ESR), which is the gross measure of inflammation
- C-reactive protein
- bone scan (radioactive nucleotide is injected 60 minutes prior to scan; radioactive dye is picked up on
scan in bone that is fractured or porus, callused or weak)
- Dual X-Ray Absorptionmetry (DXA): scan for osteoporosis; important to conduct prior to a hip
replacement to determine whether the femur is strong enough to support the prosthetic (determines
areas of porousness)
Osteoarthritis - Answers Treatment:
- heat/cold (preference or physician, client and physio)
- protect joints
, - avoid heavy lifting, use proper body mechanics, grab bars and assistive devices (braces and canes)
- weight loss
- pain management is key (NSAIDs and tylenol)
- use of glucosamine and chondroitin
- steroid injections
Hip Fracture - Answers - common causes are falls and major trauma (ex: MVA)
- risk factors include age, chronic medical conditions (ex: A. fib, HTN, TIA - diseases that make patients
light-headed and dizzy, putting them at risk for fall), being female, nutrition (ex: diet ), physical inactivity,
tobacco/alcohol use; medications (ex: corticosteroids), environmental hazards (ex: mats, extension
cords, clutter)
- diagnosed by x-ray, physical exam, CT scan, ESR, RF, DXA scan
Hip Fracture - Answers - fractures occur commonly the femoral neck (ex: intertrochanteric,
subtrochanteric, subcapital, transcervical)
- where fracture is will influence type of prosthetic used (unipolar, cementless, intramedullary nailing -
doing whatever supports bone the best)
- based on age, co-morbidities and physical condition
Hip Fracture - Answers Manifestation:
- external rotation
- muscle spasm causing shortened extremity
- pain and tenderness
- unable to use limb or walk
- displaced femoral neck fracture can cause serious interruption of blood supply leading to avascular
necrosis
Hip Fracture - Answers Treatment:
- Total Hip Replacement (THR) or Total Hip Athroscopy (THA); reconstruction or replacement of joint to
relieve pain, to improve ROM or to correct a deformity
