THR/TPLO Prep & X-Rays

Re: THR/TPLO Prep & X-Rays

Melyssa Ford — Tue, 26 Apr 2011 21:24:24 GMT

Thankyou for taking the time to reply! That was so detailed, really helpful - cheers!

Re: THR/TPLO Prep & X-Rays

Sandra Taylor RVN, MBVNA — Mon, 27 Sep 2010 23:44:07 GMT

where the hell has my reply went?

Re: THR/TPLO Prep & X-Rays

Sandra Taylor RVN, MBVNA — Mon, 27 Sep 2010 23:43:14 GMT

[quote user="nikki84"]

[quote user="Sandra Taylor RVN, MBVNA"]

I dont know about THR, but when we do our TPLO we do pre op lateral x ray of the stifle, to get the angle measurements for the plate, and subsequent cutting of the bone.

This is done a few days before the actual op, just incase we need to order in any consumables etc.

We only bandage overnight to reduce post op swelling....whereas before we bandaged for days afterwards! could you explain the hydroflo system to me please?

We do a hanging leg prep and we give I/V antiobiotics pre and post op, as well as s/c antibiotics post op. and we use sterile saline to cool the blades, this is done via giving set and pink catheter as it is easier to control the flow and direction of flow of the saline.

Once the op is over, we do post op x rays and bandage the limb overnight.

[/quote]

We basically use this exact same procedure also.
Our ortho surgeon has started using epidurals to minimise the amount of post op pain etc. Seem to work really well on some, although the fatter labradors etc don't seem to benefit.
We use a Hydroflo system though to perform site irrigation to prevent the drill overheating.

We don't tend to bandage the limb though?

[/quote]

Re: THR/TPLO Prep & X-Rays

nikki84 — Mon, 27 Sep 2010 20:04:17 GMT

[quote user="Sandra Taylor RVN, MBVNA"]

I dont know about THR, but when we do our TPLO we do pre op lateral x ray of the stifle, to get the angle measurements for the plate, and subsequent cutting of the bone.

This is done a few days before the actual op, just incase we need to order in any consumables etc.

Once the op is over, we do post op x rays and bandage the limb overnight.

[/quote]

We don't tend to bandage the limb though?

Re: THR/TPLO Prep & X-Rays

Sandra Taylor RVN, MBVNA — Thu, 19 Aug 2010 09:54:15 GMT

I dont know about THR, but when we do our TPLO we do pre op lateral x ray of the stifle, to get the angle measurements for the plate, and subsequent cutting of the bone.

This is done a few days before the actual op, just incase we need to order in any consumables etc.

Once the op is over, we do post op x rays and bandage the limb overnight.

Re: THR/TPLO Prep & X-Rays

Nick Shackleton — Thu, 19 Aug 2010 09:51:33 GMT

Totally hip replacement require extreme sterility during the operation as failure of implants can be catastrophic (as with most orthopaedic procedures).

ALL our theatres used to be damp dusted in the morning, if we were doing a THR we would thoroughly clean that theatre the evening before, we had a separate buster bean bag that was only used for THR. A free limb drape technique was used with a hanging limb. One of our senior surgeons would come and do the precise positioning and the air was taken out of the buster bag and sand bags were used to wedge patient in place.

The patient is positioned in Lateral recumbency with the affected limb upper most. the area clipped would be dorsal midline (althou we used to go a bit over as we gave our THR patients an epidural prior to surgery), 360 degrees around limb down to tarsal joint, forward a couple of clipper blade widths, and backwards to tail base (this area was clipped last.

We used to express anal glands and evacuate bowls, two lubricated swabs were inserted and a purse string suture around the anus was placed.

All routine ortho patients would receive ABs at the time of prep then every 90 mins during surgery and then every 8hrs post of for the 1st 24hrs (all these were given IV). the 90 mins depends on which drugs you are using we used to use Augmentin or Zinacef.

When ever using power drills Saline should be used to cool bones as failure to do so can cause bone necrosis.

Radiographs:

TPLO: Lateral LSJ (lumbosacral junction), VD Hips (extended femurs), L + R lateral Tib/fib (inc stifle and tarsal joint) these must be centred over the stifle joint so that a true lateral of the stile can be obtained. L + R CC Tib/Fib. POST OP a lateral and CC of the affected limb is obtained

THR: Lateral LSJ (lumbosacral junction), VD hips (with extended femurs), L + R lateral Femurs, CC L + R Femur, Lat L + R Tib/Fib (as above). POST OP: Lat + CC of affected limb and VD pelvis (prob won't be able to extend femur, so a frog legged should be sufficient.

For THR we used to do a work up prior to surgery never on the same day. Used to check skin, teeth, ears, eyes for signs of infection. A joint aspiration was obtained and sent externally for cytology and a blood sample was obtained and sent away for full routine profile to check for underlying disease prior to surgery. Surgery would then be booked once all had come back clear.

TPLO work ups were general done on the same day. Joint aspirations were examined in hosue prior to the ok for going into theatre.

Hope this answers some of your questions if not all....... Feel free to ask more!