Many of the cases this week involved total hip and knee arthoplasty (replacement). I was able to familiarize myself with the physical examination used to assess the degree of the patient’s pain and injury. Typically, candidates for such procedures are older individuals experiencing degeneration of cartilage and arthritic changes within their joints. Action does not have to be taken unless the patient feels that the pain is beginning to obstruct their life.
I also witnessed a few unique cases, one in which a patient had multidirectional instability. This is a condition that extremely flexible patients are susceptible to. You may hear these types of people referred to as “double jointed.” Of course this is an incorrect term but the individual’s joint flexibility allows for abnormal range of motion. The shoulder’s ligaments often become stretched out with MDI, allowing dislocation or subluxation (an incomplete or partial dislocation) to occur. The increased motion of the joint can lead to repetitive microtrauma (small injuries), producing tears of the labrum or rotator cuff.
I am beginning to see trends with the same injuries. I like to predict what Dr. Williams’ assessment and plan for each patient before his visits with the patient. Recently, I’ve been very consistent and accurate with my predictions. Of course each case is not exactly the same, the age, physical stature and activity level of the patient dictate his/her situation.
