Advanced Knee Arthroplasty Essay

A patient arrives at the hospital for their knee replacement surgery that has been scheduled for today. The patient is checked in at admitting and is called back to the pre-operative area by the nurse. The patient changes and the nursing staff begin to take the patient’s vital signs, review the patient’s history, draw blood for lab work and they let the patient know what to expect before, during and after surgery. The surgeon arrives and checks in with the patient, asks if they have any final questions before surgery and then leaves for the operating room to prepare. The patient is taken to the operating room, anesthesia is given, and the operation begins. The procedure goes smoothly and the patient is taken to the post-op area. When the patient comes out of the anesthesia, the surgeon

A total knee replacement (TKA) is the most common joint surgery performed in the United States (Turner, 2011, pp. 27-32). Each year, over 650,000 Americans undergo this surgery (Wittig-Wells, 2015, pp. 45-49). It is an invasive surgery that involves an incision on top of the knee and replacing damaged parts of the knee with artificial parts that are either metal, ceramic or plastic. Someone would get a total knee replacement for damage of the joint, osteoarthritic, posttraumatic, or inflammatory arthritis. The cartilage is damaged, wears away and then you develop bony deformity and contracture of ligaments but it starts out with specific defects or wear of cartilage. The top nursing priorities for a total knee arthroplasty is to “prevent complications, promote optimal mobility, alleviate pain, and provide information about diagnosis, prognosis, and treatment needs” (Doenges, 2014, pg. 627). A possible nursing diagnosis from the patient who is undergoing a TKA might be ‘impaired physical mobility related to pain and discomfort as evidenced by reluctance to attempt movement.’ Another one could be ‘acute pain related to chronic joint disease as evidenced by reports of pain’ (Vera, 2014).

Jackson’s knee pain was a result of OA. 44% of the doctors (297) recommended TKR for Mr. Jackson. Participants that completed the racial IAT before making the TKR decision were more likely to recommend this option (50%) as compared to those who did the Racial IAT after making the decision (39%). Results from questioner of TKR recommendation during explicit using a 5-point Likert scale showed a bimodal distribution, highly related with the dichotomous measure (r =0.75;

Please be aware I am finalizing the CT Reverse Compliance Matrix and require your assistance.

Our comprehensive synthesis of available evidence showed a strong association between the LISA and the risk of late/very late ST and MI during the post imaging follow up. The low incidence of ST events over 18,145 person-months follow up (≈1.4% ST per person-year) in LISA group explains the limited power of previous studies evaluating this association. Our results are consistent with a prior meta-analysis of five studies which found LISA to be associated with increased risk of late ST (OR = 6.51; 95% CI 1.34-34.91)(13). We extended these findings by including 11 additional studies and longer follow up of previous studies published subsequently. Also, we accounted for variable follow up period of included studies by using person-months as offset rather than the number of patients in each group. Moreover, as recommended in literature (17-18), we used multiple statistical methods as part of our sensitivity analysis to assess the robustness of our findings. Our finding stood the test of these sensitivity analysis confirming a strong association between LISA ( and LAISA) and late/very late ST.

The retrospective cohort study: It has weaker evidence and less control of extraneous variables. The finding also suggests associations or relationships and does not establish cause and effect relationship. Rationale: this study is mainly a data collection of previous total knee replacement surgeries were outcome and exposure have already occurred. It can better analyze multiple outcome and it is less expensive.

The primary outcome measure will be circumferential measurements of the lower extremity and secondary outcome measures will be quality of life and adherence. These measures will be taken one month before start of the study, post 4-weeks of treatment, and at a two month follow up. This research could provide evidence for the use of KT as an alternative treatment within CDT, or to enhance current CDT outcomes.

Introduction: Femoral component malrotation is a common cause of patient dissatisfaction after total knee arthroplasty. The Sulcus Line (SL) is formed from multiple points along the floor of the trochlear groove, and has been shown to be more accurate than Whiteside Line. A trochlear alignment guide (TAG) is required to maintain the accuracy of the SL and allow intraoperative comparison of the SL and the posterior condylar axis (PCA).

Osteoarthritis is the most common joint disorder, and more than half of all Americans who are older than 65 have been diagnosed with osteoarthritis. However, recent US data has revealed knee osteoarthritis does not discriminate age, and there is growing evidence that osteoarthritis affects individuals at a young age. The annual cost of osteoarthritis due to treatment and loss of productivity in the US is estimated to be more than 65 billion dollars.1 With no cure currently available for osteoarthritis, current treatments focus on management of symptoms. The primary goals of therapy include improved joint function, pain relief, and increased joint stability. Although the exact cause of osteoarthritis is unknown, many risk factors have been identified including increased age, female gender, obesity, and trauma.2 Within these risk factors, the etiology of osteoarthritis has been divided into anatomy, body mass, and gender.

According to Goodman and Fuller (2009) Osteoarthritis is divided into 2 classifications: Primary and secondary. Primary OA is a disorder of unknown cause which in the cascade of joint degeneration it is believed to be a related defect in the articular cartilage. Secondary OA has a known cause, which may be trauma, infection, hemarthrosis, osteonecrosis, or some condition Primary Osteoarthritis (OA) is the most common joint disorder in the world and often affects the knee and hip joints (Rubak, Svendsen, Soballe, & Frost, 2013). For patients with primary hip OA, pain and disability are the most important indications for total hip replacement (THR) (Rubake et al., 2013, p.486) Primary symptoms of OA include joint pain, stiffness, and limitation of movement. Disease progression is usually slow but can

The most common indication for total knee replacement is osteoarthritis, or degenerative joint disease. The end stage of osteoarthritis is wearing out of cartilage (smooth, gliding bone ends) resulting in bone-to-bone contact in diseased joints. It is progressive and becomes increasingly painful as the cartilage erodes. Younger people who get knee replacements have damaged their joints by trauma (accidents that destroy joint surfaces), infection, cancer or tumor, and inflammatory conditions such as rheumatoid arthritis.

The knee joint is formed by the articulation of the distal end of the femur and the proximal end of the tibia. The fibula is only involved to the extent that it serves as an attachment site for connective tissue. In this paper, the anatomy of the joint will be discussed.

Figure 1. Enhanced mechanical hyperalgesia was persistent in CCI model until 56 days post-surgery (A). * denotes significant differences compared to naive (p ≤ .05 and .001) and # denotes significant differences compared to sham (p ≤ .01 and .001) using 2-way ANOVA and Bonferroni test. CCI showed higher mechanical hyperalgesia 56 days compared to 14 days post-surgery (B). * denotes significant differences compared to baseline (p ≤ .0001) and # denotes significant differences compared to CCI 14 days (p ≤ .0001) using 1-way ANOVA and Bonferroni test.

DN is a 68 year old Caucasian male who lives in Pomona, Missouri. On September 14, 2009, DN underwent a scheduled left total knee arthroplasty at Baxter County Regional Medical Center. A consultation appointment about a total knee arthroplasty was scheduled when DN had increasing pain in his knees while doing chores and working on his dairy farm. The increasing pain DN was having been due to a history of osteoarthritis and the wear-and-tear on his joints throughout his life, no specific injury was noted. Depending on the outcome of the left knee, DN was consulted on having his right knee done in the future

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