1 / 32

Joint Replacement

Joint Replacement. Arthroplasty: Joint reconstruction Osteotomy: change bone alignment Prosthesis: cemented, noncemented. When and why would an arthrodesis be done?. Arthrodesis. Definitions: Bones of joint fuse, no articular cartilage. Pseudoarthrodesis: fibrous union. Porous coated

bernad
Download Presentation

Joint Replacement

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Joint Replacement Arthroplasty: Joint reconstruction Osteotomy: change bone alignment Prosthesis: cemented, noncemented

  2. When and why would an arthrodesis be done? Arthrodesis Definitions: Bones of joint fuse, no articular cartilage. Pseudoarthrodesis: fibrous union

  3. Porous coated Non-cemented Better fit Bone MUST heal Delay full ambulation Non-porous coated Use methylmetha-crylate (cement) Early ambulation Prosthesis

  4. Cemented or non-porous coated prosthesis No bone healing for cemented prosthesis

  5. Porous-coated: allows for ingrowth ofbone

  6. Pre-op Generally elective Assessment Diagnostic work-up Teaching Discharge planning Post-op Anesthesia Assessment blood loss/wound Blood admin. Pain management Prevent complications Joint Replacement

  7. Rehabilitation Exercises PREVENT INFECTIONS Precautions

  8. Common Joint Replacements • Fingers • Shoulder • Dec. pain, inc. mobility • Slow rehabilitation • Post-op care

  9. Shoulder Post-op Care • Assessment CMS • Pain Management • Wound Drainage • CPM • Infection Prevention • EXERCISE

  10. KNEE REPLACEMENT • Pre-Post-op care • Pain management • Assess CMS, drainage • Prevent resp. complications, DVT • EXERCISES Knee replacement, patient guide

  11. Normal and diseased knee joint

  12. Components of knee joint: femoral, tibial (metal tray and plastic tray), patellar (button)

  13. Porous-coated components needed for knee replacement

  14. Identify post-op knee replacement patient care priorities!

  15. Hip, Hip Hooray!

  16. Causes of Falls Hip anatomy Intracapsular Extracapsular Ligaments Intracapsular capital subcapital basilar transcervical Extracapsular Shortened, externally rotated, flexed, abducted Strong abductors displace Intertrochanteric Hip Fracture/Hip Replacement

  17. Intracapsular • capital • subcapital • basilar • transcervical • Extracapsular • Intertrochanteric

  18. Blood supply Medial circumflex Lateral circumflex Fovealar Blood supply determines healing! Hip Fracture/Hip Replacement

  19. Recognition Hip Fractures • Shortened, externally rotated, flexed, abducted • Strong abductors displace! • Pain, swelling, ecchymosis • *Type fracture, displacement effect

  20. What factors should your assess? What is Priority? Treatment Options: ORIF: pins, plates, screws Femoral head replacement Maybe total joint replacement Pre-op Care Initial Assessment for Hip Fracture

  21. Post-op Care: ORIF/Joint Replacement • Post-op ORIF • Blood loss • Pain • Positioning • Tissue perfusion • Complications • Exercise

  22. Repair of Hip Fractures; ORIF or Prosthesis Compare the nursing care of patient with joint prosthesis and Joint Replacement.

  23. Types of Prosthesis Pre-op Preparation Intra-op considerations: approach, methylmethracrylate Post-op Nursing Care: Complications: blood loss Neurovascular integrity Potential dislocation: Prevent hip flexion, internal rotation Weight bearing Prevent DVT Heterotrophic ossification Total Hip

  24. Preparing for Insertion of the Prosthesis

  25. Total Hip Replacement Total hip replacement, patient guide

  26. Describe the surgical process of insertion of hip prosthesis.

  27. Critical Pathways! • Fx Hip/ORIF/Partial Hip Replacement • Day 1 (ER): 0-4 hrs Eval& schedule surgery; pain control; assess; consults; tests; etc • 4-23 hours • Day 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!

  28. Why is this called a total joint replacement?

  29. Keys to Care • Prevent dislocation! • Progressive activity • Prevent infection! Long term considerations • ? If little or no drainage post-op, what to do?

  30. Do Not Force hip more than 90 degrees Force into adduction No internal rotation Put on own shoes, stockings for 8 wks Do Use elevated toilet seat Sleep with pillow between legs for 1st. 8 wks Keep hip neutral Use prophylactic antibiotics EXERCISE Discharge Instructions Total Hip

More Related