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Published byDoreen Cobb Modified over 9 years ago
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Steffany Moonaz, PhD, RYT-500
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Damage to surrounding tissues Consider lifespan of surgical technique Don’t take surgery too lightly Consider all management strategies ◦ Weight loss ◦ Strengthen surrounding tissues ◦ Pain management
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Is QOL compromised? Is posture compromised? Relationship between fitness and recovery “Bone-on-bone” Pain is a subjective, individual experience
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Set timeline with doc Work around/with pain Consider fitness for best recovery Encourage education about options Ask doc about recovery process
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Get written permission to speak with doc Get written report of movement limitations Focus on other aspects of yoga practice ◦ Breathing ◦ Mindful movement ◦ Relaxation ◦ Meditation Hope and Planning Support network
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Get clear about type of procedure Know the movement limitations of each They are an expert on how the joint works Less about pain than ROM, function
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Non-constrained ◦ Most common ◦ Relies on ligaments, muscles ◦ Work on stability Semi-constrained ◦ More stable ◦ Some/all ligaments removed Constrained or hinged ◦ Severely damaged knees ◦ Elderly ◦ Revision procedures ◦ Doesn’t last as long Unicondylar ◦ Only one half replaced ◦ Some surgeons still opt for full replacement
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Quadriceps setting (contraction) Terminal knee extension (rolled towel under knees) Heels slides (toward glutes, slight stretch) Straight leg raising (opposite bent) Pillow squeezes (adductors)
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Cemented ◦ Age 60+ ◦ Gold standard ◦ Substance between bone and artificial component Non-cemented ◦ Bone grows into metal ◦ Young, active candidates (loosen components) ◦ Scar tissue acts as cement Hybrid fixation ◦ No cement on socket, cement on femur Surface Replacement ◦ Neck of femur is preserved
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For 6-8 weeks: ◦ Avoid bending the hip beyond 90 degrees. (Consider sitting surfaces. Raise hips.) ◦ Avoid bending over from the hip. ◦ Avoid crossing the surgical leg over the non- surgical leg. ◦ Keep the legs three to six inches apart. ◦ Avoid turning the operated leg inward (pigeon- toed)
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Standard ◦ One or both components replaced ◦ May be smoothed or capped with metal, plastic ◦ Cemented or uncemented Reverse ◦ Newer procedure ◦ Not all surgeons will perform it ◦ Ball becomes socket and vice-versa ◦ Allows more ROM (above shoulder height)
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No use of muscles for 6 weeks (pulleys, sling, support during sleep) 3 months of gradual muscle use, stretching, rehab More intense muscle use after 3 months 2 years of antibiotics before medical procedures, dental work Intended for ADLs, not repetitive motion
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Why do you need to know about these procedures? What is your role in each stage (before, recovery, long term)? Can/should you communicate with medical providers? How? What is the edge of your scope of work?
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