Additional study of 60,848 patients, authors compared cemented and cementless hemiarthroplasty (Jameson et al., 2013). In their study which had very large sample of patients, majority of the patient were between 80 to 90 years of age and 76-78% patients were females Similar results were shown in a prospective randomized trial between cemented and cementless hemiarthroplasty (Figved et al., 2009). The average age of patient group was 83 years and 74-78% patients in this study were females. Review of Swedish arthroplasty register between 2005 to 2009, which included 21,346 patients with intra-capsular fracture neck of femur, has shown similar data (Leonardsson et al., 2012). Their patient group included 72% females and mean age of their …show more content…
We didn’t include ASA I or ASA IV patients who didn’t have cemented hemiarthroplasty. This may be the cause for higher percentage representation of ASA grade III patients in our study. When we compare our two groups (A & B), our patient groups were similar with no statistical difference in their age, sex or ASA grades. They also had similar representation of their demographics compare to the published results. In addition, all of our patients received cemented hemiarthroplasty through anterolateral approach which is considered to be the safest approach with minimal risk of dislocation (Varley and Parker, 2004). All of our patient had similar post-operative rehabilitation protocol. Therefore, any difference in complications including dislocation may be attributed to the difference in the implants used between two groups. We included patients with six months follow up following primary surgery. Most of non-traumatic dislocations of hemiarthroplasty occur in first six months following surgery. In literature mean time to dislocation following primary operation was between 19.2 days to 5.5 months (Noon et al., 2005; Sierra et al., 2006). However further studies have shown that most of the dislocations occur within first six weeks after hemiarthroplasty surgery (Enocson et al., 2008; Ninh et al., 2009) Similar results were shown (47) in a review of 1000 hip hemiarthroplasty patients (Blewitt and Mortimore, 1992).
Katz, J. N., Wright, E. A., Polaris, J. J., Harris, M. B., & Losina, E. (2014, May 22). Prevalence and risk factors for periprosthetic fracture in older recipients of total hip replacement: a cohort study. BMC Musculoskeletal Disorders, 15(1), 1-9. http://dx.doi.org/10.1186/1471-2474-15-168Lewis, S. L., Dirksen, S. R., Heitkemper, M. M., Bucher, L., & Camera, I. M. (2011). Medical-surgical nursing: Assessment and management of clinical problems (8th ed.). St. Louis, MO: else
A dislocation of the actebulofemoral joint is a very serious condition and need immediate medical attention. It is often accompanied with soft tissue damage; in this case a labral tear. In a case of a hip dislocation and a labral tear, an open hip surgery will need to be executed. Following the surgery, the athlete will enter phase 1 of the rehabilitation process. This phase is mainly focused on protecting the repaired tissue, regaining passive range of motion, preventing muscular inhibition, prevent gait abnormalities, decrease pain, and decrease inflammation. The main precaution of this phase is that the patient should not push through pain or pinching in the hip because it may be injuring healing tissue. Phase 1 will last for 6 weeks and
HISTORY OF PRESENT ILLNESS: Patient is a candidate for a total right hip revision. She has 2 units of directed packed red blood cells. It is not autologous. She does had Hepatitis B. She has arthrogryposis. She had a right total hip replacement many years ago by Dr. Dodd at the University of Miami. She has had multiple other surgical procedures as follows. A: She had bilateral foot surgery In the remote past. B: She had left hip surgery a year ago. C: She had right foot
After obtaining approval from our Institutional Ethics Committee, a prospective double-blind, randomized, controlled study was conducted in El-Minia University Hospital. Ninety patients of both sex undergoing lower extremities surgery their age ranging from 17- 60 years old, ASA physical status I or II. This study was done from December 2010 to December 2011. All patients gave written informed
Mrs. Pink, aged 75 was admitted to the orthopaedic ward after suffering a fall at home, resulting in an intracapsular fracture of the hip at the femoral neck. Mrs. Pink has a history of cancer and cardiac diseases and has severe rheumatoid arthritis. Due to ageing patients putting a great deal of strain on the health care system, the incidences of hip fractures in the elderly are a major concern and requires careful consideration regarding treatment. Known as a major cause of disability in the elderly, hip fractures and their subsequent need for surgery result in chronic pain and an altered quality of life (Strike, Sieber, Gottschalk & Mears, 2013). Although important to improve a patient’s quality of life and physical independence, pain related to a total hip replacement (THR), also known as hip arthroplasty (HA) can lead to delays in ambulation, longer hospital stays, poor functional outcomes and quality of life. The purpose of this essay is to identify the rationale behind nursing interventions provided to post-operative THR patients as well as the pathology of a femoral neck hip fracture and their procedure for assessment and diagnosis.
The agenda was quite clear that during their observations the recovery showed needs were decreased according to age and BMI. They stated older patients were in need of more assistance and longer stay in the hospital as opposed to younger adults. I found it interesting that they saw patients with bilateral knees had decreased needs and that unilateral were in need of more assistance before discharge. Managing pain was their first priority during research and rehabilitation, followed by instructing care of their own surgical wound. The aim of this study was to actively reinforce assessment and management after this procedure and giving guidance to those in health care.
For this report I will concentrate on total hip replacement, its components, main surgical technique, and complications. Sir John Charnley first developed total joint arthroplasty in the 1960s (Skinner 395). In a total hip replacement "the articular surfaces of the acetabulum and femoral head are replaced" (Lemone 1241). A prosthesis is then used to replace the entire head of the femur
Research into the outcomes for successful ACL construction is necessary to ensure the improvement of the surgery, and thus the quality of the knee.[i] In the past, effectiveness of treatment was documented using empiric evaluation. Due to the discrepancies among existing scales, conclusions were often inaccurate, causing limitations in researchers’ abilities to compare treatment effectively.[ii] In addition, to confirm the most successful outcome of treatment, long term follow up studies are vital to analyze the successfulness. To do so, successive exams of patient progress and accuracy of surgery is important for an allowable duration.[iii] The Activities of Daily Living Scale, ADLS, is a reliable patient reported form that assesses the progress concerning the functional limitations of knee impairments.
DOI: 12/28/2014. Patient is a 31-year-old male rebar installer who sustained injury while he was installing a rebar when he twisted his right knee. Per OMNI, he was initially diagnosed with right knee strain/sprain. MRI showed positive for a tear and he underwent surgery on 02/10/15 and subsequent MRI revealed teat versus scar tissue and he underwent right knee arthroscopic lateral meniscal debridement and synovectomy on 12/22/15.
If the swelling is too severe, then the surgery might need to be delayed up to a week. There are two surgeries recommended, but depends on the area fractured. The first one is if the radial head is fractured, can be repaired with or without plates and small screws. If the injury isn’t repairable, they might replace the radial head with a metallic implant. The second one is if the top of the ulna, the coronoid, is fractured then they will repair with sutures or screws. The patient cannot perform any heavy lifting for 6 weeks following the surgery. The first 6 weeks to 3 months, regaining ROM is the key. Exercises are begun after strengthening has occurred which could be after 3 months depending on how severe the injury
A patient reported measured form, using the IKDC and ADLS was evaluated. Patients recovering from ACL reconstruction surgery were given both forms to fill out simultaneously over a period of time during their recovery. The forms were handed out four times in the course of one year- one month, three months, six months, and yearly. A baseline form was given prior to surgery as a control to determine the progress, impairments, and success of functionality post-surgery.
Early studies predominately focused on re-rupture rates in surgical and non-surgical patients. Research shows that re-rupture rates are similar in both treatment groups (Jackson et al., 2013) (Soroceanu et al., 2012). I can inform patients that this complication would be unlikely to have an effect on their outcome measures for function and ATRS long-term (Olsson et al., 2013). I would educate patients that those with re-rupture had similar outcomes to those without after 6 and 12 months of re-injury (Olsson et al., 2013). Functional bracing was a common theme in a meta-analysis by Soroceanu et al., (2012) and Olsson et al., (2013). Two patients who experienced re-rupture complications in the latter study were non-compliant with their braces. I would emphasis adherence to wearing their functional braces to shadow previous research and improve patient safety. In addition, I would be aware of complications specific to the chosen treatment. While this population in general is at increased risk of deep vein thrombosis and sural nerve damage, surgical treatment yields more complications than nonsurgical treatment. A systematic review revealed that patients with surgical treatment had higher risk for wound infection, adhesions, and sensorimotor dysfunction especially after open repair (Khan & Smith, 2010). Patients who receive nonsurgical treatment may require more time for rehabilitation (Olsson et al., 2013).
CBT screw that is inserted through a more medial starting point by following a more vertical trajectory showed greater pullout load and similar ROM to traditional pedicle trajectory screw. CBT technique has four major advantages: 1. Direction with caudocephalad path sagittally and laterally directed path in the transverse plane protects the screw away from the nerve tissue. 2. It needs less tissue trauma and less recovery time.3. Osteopenic or osteoporotic patients will earn more advantage[18-20, 31, 32], 4. The incidence of postoperative radiculitis
This case report is about total knee arthroplasty in a Rheumatoid patient with both valgus deformity and flexion contracture. Rheumatoid patients still have deformity occurring despite new treatment, hence the need for surgery such as total knee arthroplasty. In this case report we will discuss more about the different techniques in the management of bone defect during surgery and use of the screw and cement method for defect correction. This method has been through several debates about its efficacy and failure and a global consensus has not still been