Total Knee Arthroscopy Essay

The surgical procedure. A total knee replacement is a surgical procedure where the diseased knee joint is completely replaced by artificial materials that resemble the original knee joint. The orthopedic surgeon removed the end of the femur and the end of the tibia by using metal pieces and sawing the bone, to ensure that he removes the right amount of bone. The end of the femur bone is replaced with metal and the end of the tibia bone is replaced with plastic and metal. A plastic piece was added under the patella because the surface under the patella was damaged as well. These artificial materials, called prosthesis, have smooth surfaces so when they rub against each other, it does not cause damage and is pain-free. The purpose of this surgery is to remove the diseased portions of the joint and replace it with artificial materials to prevent further deterioration and eliminate pain, stiffness, and decreases in function that were caused by the osteoarthritis.

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

ACLs are one of the easiest injuries to get for athletes and average people alike, and a lot of people don't know what the ACL is or how to treat it until they tear it.

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).

Oliver et al. (2014), exemplifies how some physicians may not be aware of their implicit bias that could be causing healthcare disparities. This study determines whether physicians’ implicit racial views of African Americans affect their decision making, regarding total knee replacement (TKR) as a treatment option for OA. They also assessed whether not, if the Racial Implicit Association test would impact TKR recommendations. In the study implicit bias was determined by the racial implicit association test (IAT) and explicit bias was tested using a questionnaire that asked physicians which race they preferred (black or white) using a 5-point Likert scale and 10-point thermometer scaled to grade physician’s feelings.

According to Su et all (2009), knee replacement is an effective way to find relief of pain and improve mobility, but most importantly giving the patient education and skills during early recovery. In comparison, all articles focused on the need of improving mobility after surgery. Assessing the patient’s abilities and the need for physical therapy and keeping an eye out for complications. A main focus was pain relief and that recovery for each patient varies, but it is important to get them ambulating with assistive devices soon after surgery. My patient at Kindred, had continuous assessment and an interdisciplinary team that assisted in her road to

12/24/15 Progress Report describes that the patient has right knee pain. The pain is frequent. It is aching and burning in quality. The current pain level is 0/10 and worst pain is 4/10. Bending, squatting, walking, weight bearing, changing clothes and ROM aggravate the pain. Rest, ice,

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.

Total knee replacements are known as the most effective orthopedic procedures in the world. These surgeries are most often preformed on geriatric patients. Over time, because the knee is one of the lowest joints in the body, it is typically more prone to wear compared to joints holding less body weight. In the United States, the overall amount of total knee replacements exceeds over four times the overall number of total hip replacements. In the year of 2015, the estimated number of total knee replacements was predicted to be about 719,000 ("Inpatient Surgery." Centers for Disease Control and Prevention). Ordinarily knee replacements are used to ease pain and disability caused by arthritis or other joint problems, while preserving movement.

The medical evidence shows the claimant had twisting injury to left knee with lateral meniscus tear on 7/1/13. He was also noted to have preexisting osteoarthritis of the left knee. The claimant underwent arthrosopic partial meniscectomy on the left knee on 2/27/14 with some symptomatic relief. An orthopedic report on 1/13/14 noted ongoing left knee pain. The physical exam showed tenderness; pain with flexion and extension; positive McMuray's test and negative Drawer's test. X-rays of left knee on 1/13/15 showed mild left knee osteoarthritis.

The patient may also complain of crepitation being heard during movement due to irregularity of the joint surfaces in the knee gliding over one another. Knee osteoarthritis is characterized by structural changes in the knee seen on radiographs involving loss of articular cartilage, joint space loss, and the presence of osteophytes.3 Primary care providers is the ones who primarily manage osteoarthritis with conservative and pharmacological treatments. Conservative treatment consists of exercise, strength training, and weight loss in order to reduce pain and progression of the disease. However, many conservative treatments fail over time and pharmacological treatment is needed to reduce pain in the patient.1 This literature review will look into the knee portal techniques, corticosteroid injections, and hyaluronic acid injections for knee

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.

It is a joint disease and commonly the leading cause of pain in older adults. With osteoarthritis, joint cartilage becomes rough and worn. The damaged tissue causes the cells to release an enzyme which contributes to breakdown the cartilage. Inflammation is present in synovium, the lining of the joint. Overtime, the space in the joint becomes narrower. Patient with osteoarthritis experience joint stiffness and pain with weight bearing and movement. As the disease progresses, pain becomes extremely severe (VanMeter & Hubert, 2014 p 175). This the reason why patient had left knee arthroplasty. In left knee arthroplasty, the femoral and tibia component of the knee are replaced with an artificial material called prosthesis to relieve pain and allow a person to restore performance of activities of daily living (LeMone et.al, 2014 p 1356). According to Shmerling (2014), the patient’s risk for developing blood clots increases after surgery. Clots can form inside the blood vessels and this is where it becomes dangerous. Blood clots in the veins will hinder or block the return of blood to the vital organs of the body such as the heart. Due to the patient’s inactivity the flow of her blood becomes sluggish and causes the blood to pool commonly at the lower part of the body such as the leg and could lead to a clot. This is often called as Deep vein thrombosis. There is a tendency, that this clot could travel in the body and lodge in other

The patient stated that he began experiencing painful swelling in his right knee over a decade ago. A large mass grew around the knee and he underwent a total knee arthroplasty. Not long after the arthroplasty of his right knee, he began experiencing similar symptoms in his left knee and right elbow.

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