Deck 12: Surgical Interventions and Postoperative Management

Question 1

Which of the following is a correct statement about osteochondral mosaicplasty?

A) The procedure is indicated for management of advanced (late-stage)arthritis of a joint.
B) The term is synonymous with autogenous chondrocyte implantation.
C) The procedure involves transplantation of small plugs of intact articular cartilage and some subchondral bone from a donor site to the site of an articular cartilage lesion.
D) Small drill holes into subchondral bone are made at the site of the articular lesion to stimulate regrowth of joint cartilage.

Answer 1

C

Question 2

Which of the following is correct about a tendon transfer versus a tendon realignment procedure?

A) A tendon realignment procedure,such as realignment of the extensor mechanism of the knee,not only alters the line of pull of the quadriceps,but it also alters the action of the quadriceps.
B) A tendon transfer from one bony surface of a joint to the opposite bony surface of the same joint changes the action of the muscle.
C) After tendon realignment or transfer,the muscle-tendon unit is immobilized in a lengthened position to prevent contracture.
D) Tendon transfer cannot be done to adjacent soft tissue but,rather,must be done to a different bony surface.

Answer 2

B

Question 3

Which of the following is a correct statement about a closed injury (tear or rupture)and surgical repair of a muscle or tendon?

A) A surgically repaired muscle or tendon is immobilized in a shortened position for a period of time after surgery.
B) After a tear or rupture of a muscle,the best results are achieved if the torn tissue is repaired immediately after injury rather than delaying the repair for 48 to 72 hours after injury.
C) During postoperative rehabilitation,muscle-setting exercises are initiated after the immobilization is removed.
D) Complete tear of a tendon tends to be more painful than a partial tear.

Answer 3

A

Question 4

Which of the following is a true statement about the use of autografts and allografts for repair of tissue lesions?

A) An autograft can be used to repair soft tissues,such as a torn ligament,but cannot be used for repair of articular cartilage lesions.
B) A risk associated with an autograft is potential weakening of a patient's otherwise healthy tissue at the donor site.
C) There is a greater risk of disease transmission with use of an autograft than an allograft.
D) There is a greater risk of graft failure with use of an autograft than an allograft.

Question 5

Which of the following soft tissue repairs are most commonly immobilized in a relative position of tension (elongation)postsurgically?

A) Tendon Z lengthening and ligament tears
B) Muscle fasciotomy and tendon realignments
C) All repairs of muscles and tendons
D) Muscle and ligament complete ruptures

Question 6

Synovectomy,when used,typically is indicated for:

A) Long-standing osteoarthritis.
B) Tear of a joint capsule as the result of trauma.
C) Rheumatoid arthritis.
D) Postimmobilization arthritis.

Question 7

Ambulation should begin in the early postoperative phase in order to:

A) Reduce the risk of a pulmonary embolism after a diagnosis of DVT is confirmed.
B) Reduce the risk of a DVT after surgery.
C) Provide an alternative circulatory activity for those who do not want to wear compression stockings.
D) Reduce the risk of a diagnosed embolism traveling to the lungs.

Question 8

There are several types of grafts that can be used to reconstruct a torn knee or ankle ligament.Of the following,which is the best description of an allograft?

A) Graft made of synthetic material
B) Patient's own tissue harvested from the identical ligament on the contralateral (noninvolved)extremity
C) Patient's own tissue harvested from one of many possible donor sites
D) Tissue graft from a cadaver

Question 9

In general terms,which of the following surgical procedures is performed primarily to release a contracture and improve ROM?

A) Capsulorrhaphy
B) Debridement
C) Osteotomy
D) Tenotomy

Question 10

Which of the following postoperative complications is least likely to be prevented by adherence to a carefully progressed postoperative exercise program?

A) Formation of adhesions
B) Local infection at the wound site
C) Subluxation or dislocation of a joint
D) Rupture of repaired soft tissue

Question 11

Which of the following is a true statement about the phases of postoperative rehabilitation?

A) Phases are based on the stages of tissue healing and each patient's responses to interventions.
B) It is important to strictly adhere to a progression of interventions spelled out in a predetermined protocol.
C) During the maximum protection phase of postoperative rehabilitation,movement of the operated body segment is contraindicated regardless of the type of surgery.
D) Once a patient reaches the minimum protection phase after surgery,there is no value to continuing postoperative exercise.

Question 12

Which of the following surgical procedures typically is performed with an arthroscope?

A) Minimally invasive joint replacement procedures
B) Reduction and internal fixation of a displaced fracture
C) Removal of a portion of a meniscus at the knee
D) Arthrodesis of the wrist

Question 13

What is the term used to describe a postoperative rehabilitation program in which a patient is progressed from one phase of rehabilitation to the next based on the attainment of predetermined levels of performance?

A) Norm-based rehabilitation
B) Time-based rehabilitation
C) Phase-specific rehabilitation
D) Criterion-based rehabilitation

Question 14

When arthroplasty involves first debriding and then resurfacing a joint by placing a foreign material-such as fascia,metal,or a silicone spacer-between the articulating surfaces of a joint,it is called a(n):

A) Abrasion arthroplasty.
B) Interposition arthroplasty.
C) Excision arthroplasty.
D) Hemireplacement arthroplasty.

Question 15

Which of the following is a true statement about a DVT?

A) It may occur in the greater saphenous veins.
B) It is most common in the deep arterial system of the calf muscles.
C) It usually resolves without complication if the patient is active.
D) It may result in a pulmonary embolism if undetected.

Question 16

Each of the following is a relative or absolute contraindication for use of total joint replacement arthroplasty except:

A) Severe loss of bone stock.
B) Active systemic infection or infection in the joint.
C) Significant paralysis of the muscles surrounding the joint.
D) Significant joint deformity.

Question 17

Active range of motion is not possible at a joint that has undergone:

A) Arthrodesis.
B) Arthroplasty.
C) Synovectomy.
D) Osteotomy.

Question 18

Which of the following surgical procedures is also considered to be a diagnostic tool?

A) Arthrotomy
B) Capsulorrhaphy
C) Arthroscopy
D) Osteotomy

Question 19

You are part of a team presenting a preoperative education program for a group of patients scheduled to undergo total knee or hip replacement during the next month at a large medical center where you are employed.As a therapist,you most likely would be responsible for presenting information on each of the following topics except:

A) An explanation and demonstration of exercises a patient is expected to do the day of or after surgery.
B) An explanation of early postoperative precautions,such as weight-bearing restrictions or safe and unsafe positioning.
C) An explanation of the administration of postoperative pain medication,such as patient-controlled analgesics.
D) Use of assistive devices,such as a walker or crutches,for early ambulation.

Question 20

All of the following are signs and symptoms your patient may exhibit that would alert you to a possible pulmonary embolism except:

A) Sudden onset of dyspnea.
B) Chest pain alleviated with deep breathing and rib compression.
C) Rapid,shallow breathing.
D) Diaphoresis with minimal activity.