Surgical & Post-Operative Care Flashcards

A patient 6 weeks post-SLAP repair is cleared to begin active-assisted ROM. Which motion should be introduced LAST due to greatest risk of re-injury?

Answer: External rotation at 90° abduction

External rotation at 90° abduction places maximum stress on the repaired superior labrum and biceps anchor and is typically the final motion introduced.

Following a Bankart repair for anterior shoulder instability, which position must be strictly avoided in the early post-operative period?

Answer: Shoulder abduction combined with external rotation

Abduction with external rotation is the apprehension position that stresses the anterior capsule and labrum repair and must be avoided early post-operatively.

What is the primary purpose of wound drainage systems (e.g., Jackson-Pratt drains) in post-operative orthopedic patients?

Answer: Prevent hematoma formation and reduce infection risk by removing accumulated fluid

Drainage systems remove accumulated blood and fluid from the surgical site, preventing hematoma formation which can increase infection risk and impair healing.

A patient 4 months post-total shoulder arthroplasty (TSA) asks when they can return to golf. Which factor MOST influences this timeline?

Answer: Type of implant used (anatomic vs. reverse TSA) and surgeon protocol

Anatomic TSA may allow earlier return to golf than reverse TSA due to different muscle mechanics and implant constraints specific to each design.

Which sign indicates compartment syndrome following lower extremity orthopedic surgery and requires emergency intervention?

Answer: Pain out of proportion to injury with pain on passive stretch of the muscles in the compartment

Pain disproportionate to the clinical picture combined with pain on passive muscle stretch is the earliest and most reliable clinical indicator of compartment syndrome.

After cervical spine fusion (ACDF), which activity should the physical therapist avoid during the early post-operative phase?

Answer: Cervical rotation and extension exercises

Cervical rotation and extension stress the fusion site during the bony healing phase (typically first 6-12 weeks) and risk hardware failure or pseudarthrosis.

A patient undergoes a medial opening wedge high tibial osteotomy (HTO). What is the PRIMARY biomechanical goal of this procedure?

Answer: Shift mechanical axis load away from the diseased medial compartment to the healthier lateral compartment

HTO corrects varus malalignment by shifting the mechanical axis laterally, unloading the arthritic medial compartment and redistributing forces to the intact lateral compartment.