Ankle Arthroplasty

The auditor reviewed the history of three physicians employed with Foot and Ankle Centers of Georgia; Dr. William Pearson, Dr. Gregory C Taylor, DPM and Dr. Robert B. Weinstein, DPM. The review period was from 12/12/16 to 12/13/16. The auditor (using Epic generated information) reviewed over 30 patient records. This access audit included the review

The Ponseti method involves 4-8 weeks of plaster casts that run from the toes to the groin. The casts are changed every 5-7 days after gentle stretching and manipulation to slowly and gently move the foot into the correct position. Eighty percent of patients will require an Achilles tenotomy to correct residual equinus deformity (AFP, 2012). Achilles tenotomy is a quick minor procedure that can be done in the doctor’s office. After the procedure, the patient is placed back in a cast for a few more weeks while the Achilles tendon regrows to the needed length. After the Achilles tendon has healed, the cast is removed and the patient must use an abduction brace “which is worn 23 hours a day for 3 months and then 14-16 hours, while asleep, until the child’s fourth birthday (AFP,

Following the cast removal, the patient must undergo a rehabilitation program in order to return to normal movement and function. Heel lifts should be immediately placed in the patient's shoes. The reason why the lifts are placed in both shoes is to relive any pressure or tension in the injured foot and in the non-injured foot to keep the person balanced and not potentially hurt the other side (tendon, hip). Because immobilizing the foot in a cast may cause joint stiffness, muscle atrophy, and blood clots, many doctors recommend an early-motion approach. This approach puts the patient in physical therapy within just a few days after the surgery. Therapy may be needed for up to 4 or 5 months. Ice, massage, and whirlpool treatments may be used at first to control swelling and pain. Massage and ultrasound help heal and strengthen the tendon. Range of motion exercises should begin while in therapy. About 2 weeks after ROM exercises have been used is when the progressive resistance exercises are added. Some of these resistance exercises can be done in the pool. The buoyancy of the water helps people walk and exercise safely without putting too much pressure or tension on the healing tendon. If the patient chooses a splint may be worn while walking for 6 to 8 weeks after the surgery. Then 10 weeks after the surgery aggressive training exercises can

For this report I will concentrate on total hip replacement, its components, main surgical technique, and complications. Sir John Charnley first developed total joint arthroplasty in the 1960s (Skinner 395). In a total hip replacement "the articular surfaces of the acetabulum and femoral head are replaced" (Lemone 1241). A prosthesis is then used to replace the entire head of the femur

Majority of the patients that suffer with this injury have to have an open reduction internal fixation (ORIF) in order to correct the issue. The open reduction internal fixation is said to be less invasive on the bone, ligaments, muscles, and tendons, it also will relieve pain and prevent a reoccurring dislocation of the metatarsal.4 After surgery the patient is non-weight bearing for six weeks then will slowly progress to full weight bearing over a course of a couple of months. As for the rehabilitation process, the patient will most likely be in physical therapy for a long period of time. Part of the rehabilitation plan for an LFD consist of picking marbles up with the toes and placing them into a container, tracing the alphabet with the injured foot, balance exercises, and theraband exercises. One of the reason for the rehabilitation process is to regain most of the range of motion back in the ankle and foot. It also helps with rebuilding strength in the muscles of the foot and

Mean follow-up was 117 months. 86% are male. Average age of 26 years at surgery. 35 patients had partial meniscectomy (53% internal, 31% external, 16% bimeniscal). A significant improvement (p<0.001) between pre and postoperative parameters was demonstrated (pre-operative mean IKDC score 47 points; post-operative 94 points). 92% perform moderate demand activities, of which 40% returned to pre-injury activity levels without complaints. An increase in the time between rupture of the ACL and surgery was not associated with higher rates of meniscal lesions, osteoarthritis or lower IKDC scores. There was a correlation between clinical results and associated meniscal or chondral lesions. Clinically 6% had symptoms/signs of anterior instability (Lachman 2 A). Radiologically 25% had an anterior displacement of the tibia with an average distance of 3.9 mm [3.3-7.2]. 10% shown femoral tunnel enlargement (with a average of 1.8 mm) and 60% present with subchondral sclerosis in tibial plates. All patients with symptoms suggesting anterior instability shown anterior displacement of the tibia and sclerosis areas, yet only one has femoral tunnel

The surgical procedure. A total knee replacement is a surgical procedure where the diseased knee joint is completely replaced by artificial materials that resemble the original knee joint. The orthopedic surgeon removed the end of the femur and the end of the tibia by using metal pieces and sawing the bone, to ensure that he removes the right amount of bone. The end of the femur bone is replaced with metal and the end of the tibia bone is replaced with plastic and metal. A plastic piece was added under the patella because the surface under the patella was damaged as well. These artificial materials, called prosthesis, have smooth surfaces so when they rub against each other, it does not cause damage and is pain-free. The purpose of this surgery is to remove the diseased portions of the joint and replace it with artificial materials to prevent further deterioration and eliminate pain, stiffness, and decreases in function that were caused by the osteoarthritis.

The athlete that I was able to facilitate preforming his rehabilitation assignment had a slight fracture in the distal end of his fibula causing a tear in his interosseous membrane, which is the membrane in between the tibia and fibula, and a syndesmosis sprain due to the dislocation of the ankle. The surgery consisted of the athlete having a plate in so the fibula could heal correctly and metal pins in near the distal end of the fibula to connect the tibia and fibula back together. The athlete was not able to put weight on injured leg at all from the time of the surgery until two weeks after the athlete gets their pins removed. At the start of the

As stated earlier, medical surgeries are an option, though most people prefer to avoid this option. There are many different kinds of surgery that can be done to help with R.A. including joint replacement surgery, arthroplasty, arthroscopy, carpal tunnel release, cervical spinal fusion, phalangeal head resection, and total knee replacement. All these surgeries listed might not help with R.A. and may threaten the body during surgery. Blood clots, infections, and the possibility of the surgery not working at all are potential outcomes of having surgery. According to the CDC, "around 40% of all deaths occurring in individuals with R.A. are attributable to cardiovascular causes" (CDC, 2015). Some individuals may need cardiovascular surgery. Due to the risks involved, surgery isn't the number one treatment that patients with R.A. use.

In the first couple of days of rehab, she received high volt, and ice to help with the swelling she also did ankle pumps that also help with moving out the inflammation. As each day went by, towel scrunches, towel stretches were performed as three set each. Compression pumps were administered for 15 minutes several times a week, rhythmic stabilization, and aquatic therapeutic exercises were added as she

An incision will be made in your hip. Your surgeon will take out any damaged cartilage and bone.

A total knee replacement (TKA) is the most common joint surgery performed in the United States (Turner, 2011, pp. 27-32). Each year, over 650,000 Americans undergo this surgery (Wittig-Wells, 2015, pp. 45-49). It is an invasive surgery that involves an incision on top of the knee and replacing damaged parts of the knee with artificial parts that are either metal, ceramic or plastic. Someone would get a total knee replacement for damage of the joint, osteoarthritic, posttraumatic, or inflammatory arthritis. The cartilage is damaged, wears away and then you develop bony deformity and contracture of ligaments but it starts out with specific defects or wear of cartilage. The top nursing priorities for a total knee arthroplasty is to “prevent complications, promote optimal mobility, alleviate pain, and provide information about diagnosis, prognosis, and treatment needs” (Doenges, 2014, pg. 627). A possible nursing diagnosis from the patient who is undergoing a TKA might be ‘impaired physical mobility related to pain and discomfort as evidenced by reluctance to attempt movement.’ Another one could be ‘acute pain related to chronic joint disease as evidenced by reports of pain’ (Vera, 2014).

Advanced Footcare Group has a history for handling both common and uncommon severe circumstances of foot problems and damage, and can help with any form of sport surgery even if it is runner’s injury. Year after year, we invest in the most recent technologies to expand our assessment and treatments across a wide selection of foot and ankle related issues.

The foot and ankle are important weight-bearing organs that have a vital role in activities of daily life (Walker, 2014). The most familiar injury is an acute sprain (Mai and Cooper 2009). It is estimated that more than 300,000 people came to the emergency department with acute ankle sprains every year (Roche et al, 2009). The ankle is a synovial hinge joint which is made up of the distal fibula forming the lateral malleolus, while the distal tibia forming the medial malleolus and the talus (Walker, 2014). The ankle sprain happened when weight is put to the foot and the foot experienced an uneven surface or got twisted and it rotated towards or away from midline of body, known as eversion or inversion. This occurrence causes ligaments on outside

What were once considered high-tech, joint replacements are now a common operation. Surgeons replace more than a million hips and knees each year in the U.S. Studies show joint replacements can significantly relieve pain and increase mobility in about 90% of people who get them. Feature, R. Morgan, Griffin WebMD. “Should You Have Knee or Hip Replacement Surgery?” WebMD. WebMD, 30 Dec. 0089. Web. 21 Oct. 2013. What symptoms should tell a person that it is time for a hip replacement? The first and most important sign is pain and