Surgical & Post-Operative Care Flashcards

Following a reverse total shoulder arthroplasty (rTSA), which muscle group becomes the PRIMARY shoulder abductor?

Answer: Deltoid

The reversed ball-and-socket geometry shifts the center of rotation medially and inferiorly, allowing the deltoid to become the primary abductor, compensating for irreparable rotator cuff deficiency.

What does the term 'arthrofibrosis' refer to in the post-operative orthopedic context?

Answer: Excessive intra-articular scar tissue formation causing significant loss of joint motion

Arthrofibrosis is pathological fibrosis within and around a joint that results in painful, significant motion restriction and is a known complication after TKA and ACL reconstruction.

A surgeon documents 'TPLO' in a post-operative report for a patient with knee instability. In human orthopedics, the analogous procedure corrects instability by:

Answer: Changing tibial plateau angle to eliminate anterior tibial shear forces without a ligament graft

TPLO (tibial plateau leveling osteotomy) alters joint geometry so dynamic stabilizers neutralize tibial shear without requiring ligament reconstruction.

Which post-operative intervention has the strongest evidence for reducing the risk of heterotopic ossification (HO) after total hip arthroplasty?

Answer: Indomethacin (NSAID) prophylaxis or low-dose radiation therapy

NSAIDs (particularly indomethacin) and single-dose radiation therapy are the best-evidenced prophylactic interventions against heterotopic ossification following THA.

After a distal radius ORIF, a patient develops a burning, allodynic pain with skin color/temperature changes and excessive sweating in the hand. What condition should be suspected?

Answer: Complex regional pain syndrome (CRPS)

Burning pain, allodynia, vasomotor changes (color/temperature), and sudomotor changes (sweating) after distal radius fracture fixation are the hallmark features of CRPS Type I.

When progressing weight-bearing after a tibial plateau fracture ORIF, which factor is MOST important in determining the timeline?

Answer: Radiographic evidence of fracture healing and surgeon's intraoperative stability assessment

Bony healing confirmed on radiograph and the surgeon's assessment of fixation stability are the primary determinants for safe weight-bearing progression after tibial plateau ORIF.

A physical therapist is treating a patient 8 weeks post-Achilles tendon repair. Active plantarflexion is introduced. Which statement BEST describes the appropriate loading progression?

Answer: Begin with concentric plantarflexion in non-weight-bearing before progressing to eccentric loading

Concentric loading in non-weight-bearing is introduced first to protect the repair, with gradual progression to eccentric and weight-bearing activities as tendon healing matures.