8-nursing care after arthroscopy...
TRANSCRIPT
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Nursing Careafter Arthroscopy
Eva AUService Officer, Sports Team
APN, O&T, QEHMSc. SM&HS, MPHC, BHS(N)
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Sports Injuries
• All injuries associated with sports activities• Include all body parts and system• Not purely orthopedic problem
• Team work: athlete, health care professionals, coach, family members, teammates
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Pre-op• Prepare for operation
(physical & psychological)
• Sports History• Prepare for
rehabilitation• Team work: nurse
(coordinator), surgeon, physiotherapist, coach, family, athlete
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Post-op
• Stable haemodynamics
• Start rehabilitation ASAP
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PRICE
•• PP rotection•• R R est•• I I ce•• CC ompression•• E E levation
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ACL reconstruction D0
• Wound oozing• Fever/ infection• Neurovascular status• Swelling control• Keep IROM @ 0º
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D1
• Wound care• Swelling control• X ray• IROM @ 0º• FWB• Discharge
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Sports Rehabilitation =
Return to Sports!Return to Sports!
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Sports Rehabilitation
• Protection• PROM & AROM• Strength• Functional• Proprioception• Sports specific training
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Rehabilitation for ACLQEH Protocol
• ROM aim:
• D2 Full extension• 2nd week 0º-90º• 6th week Full ROM
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Sports specific training
• 6th week: closed chained activities, proprioceptivetraining
• 12th week: open chain activities, jogging
• 16th week: straight running (avoid pivoting and cutting)
• 20th week: progressive running program
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Return to Sports
• 6 months: resume sport in non-competitive manner +/- protective knee brace
• 9 mth - 1 yr: resume competitive sport after surgeon’s assessment
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Shoulser arthroscopy D0
• Wound oozing• Swelling control• Fever/ infection• Neurovascular status• Abduction brace/
arm sling
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Recurrent shoulder dislocationArthroscopic repair
QEH Protocol
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Acute Phase (0-2 wks)
• Pain & inflammation control• Maintain integrity of surgical repair• Retain ROM of effective joints• Prevent muscle atrophy e.g. gripping
exercise• Pendulum exercise• Passive ROM exercise with ER<35°
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Protective Phase (2-6 wks)
• Passive & active ROM
• External & internal strengthening exercise with exercise bend
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• Scapular strengthening exercise in prone position
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Intermediate Phase (7-14 wks)
• Progressive strengthening exercise• Full ROM exercise• External & internal rotation with exercise
bend• Lateral raise
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Strengthening Phase (15-22 wks)
• Muscle strengthening and power training
• Gradually return to functional activities
• Maintain full ROM of shoulder
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Return to Activity Phase (23-30 wks)
• From recreational sports to initiate interval sports program
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Prevention is Better than Cure
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Thank You!