2Arthrodesis Definitions: Bones of joint fuse, no articular cartilage. When and why would an arthrodesis be done?ArthrodesisDefinitions: Bones of joint fuse, no articular cartilage.Pseudoarthrodesis: fibrous union
3Prosthesis Non-porous coated Porous coated Non-cemented Use methylmetha-crylate (cement)Early ambulationPorous coatedNon-cementedBetter fitBone MUST healDelay full ambulation
4Cemented or non-porous coated prosthesis No bone healing for cemented prosthesis
26Total Hip ReplacementTotal hip replacement, patient guide
27Describe the surgical process of insertion of hip prosthesis.
28Critical Pathways! Fx Hip/ORIF/Partial Hip Replacement Day 1 (ER): 0-4 hrs Eval& schedule surgery; pain control; assess; consults; tests; etc4-23 hoursDay 2 )Post-op Day 1)Day 3 (Post-op Day 2)Day 4 (Post-op Day 3)Day 5 (Post-op Day 4)Discharge by 2 pm!
30Keys to Care Prevent dislocation! Progressive activity Prevent infection! Long term considerations? If little or no drainage post-op, what to do?
31Discharge Instructions Total Hip Do NotForce hip more than 90 degreesForce into adductionNo internal rotationPut on own shoes, stockings for 8 wksDoUse elevated toilet seatSleep with pillow between legs for 1st. 8 wksKeep hip neutralUse prophylactic antibioticsEXERCISE