TOTAL KNEE ARTHROPLASTY SURGERY

Total Knee Arthroplasty Surgery & Nursing Care Strategies

Total Knee Arthroplasty Surgery & Nursing Care Strategies

Introduction Patients total knee replacement (TKR) surgery require skilled nursing care in order to recover from surgery and anaesthesia. The role of the nurse in primary and secondary care in monitoring and identifying complications will be highlighted. This is the second of two articles on nursing care for patients undergoing TKR surgery. In a total knee replacement surgery, the damaged cartilage and bone is removed and replaced with a metal and plastic knee. Preoperative nursing care prepares the patient for the surgery as well as what to expect afterward. (Spangehl & O'Connell 2008)

History of Total knee Arthroplasty

Knee replacement, or knee arthroplasty, is a surgical procedure to replace the weight-bearing surfaces of the knee joint to relieve the pain and disability of osteoarthritis.[1] It may be performed for other knee diseases such as rheumatoid arthritis and psoriatic arthritis. In patients with severe deformity from advanced rheumatoid arthritis, trauma, or long standing osteoarthritis, the surgery may be more complicated and carry higher risk. Osteoporosis does not typically cause knee pain, deformity, or inflammation and is not a reason to perform knee replacement.

Other major causes of debilitating pain include meniscus tears, cartilage defects, and ligament tears. Debilitating pain from osteoarthritis is much more common in the elderly.

Knee replacement surgery can be performed as a partial or a total knee replacement. In general, the surgery consists of replacing the diseased or damaged joint surfaces of the knee with metal and plastic components shaped to allow continued motion of the knee. (Bauer & Krebs 2006)

The operation involves substantial postoperative pain, and includes vigorous physical rehabilitation. The recovery period may be 6 weeks or longer and may involve the use of mobility aids (e.g. walking frames, canes, crutches) to enable the patient's return to preoperative mobility.

Total Knee Replacement

Total knee replacement is a surgical procedure in which injured or damaged parts of the knee joint are replaced with artificial parts. The procedure is performed by opening up the knee capsule and removing the ends of the thigh bone (femur), the shin bone (tibia), and the underside of the kneecap (patella). Artificial parts are cemented into place and make up the new knee joint. The new knee consists of metal implants on the ends of the shin bone and thigh bone, and a plastic trough in between them.

Clinical Pathway of Total Knee Arthroplasty

All patients come to the clinic before their surgery to meet with the health care team. This visit will take several hours, so you should plan to spend at least half the day or more to complete it. The visit begins in the Orthopaedic clinic, where a nurse will ask you about your medical history and the medicines you take, including prescription medicines and over-the-counter medicines. Bring a list of your past surgeries and a list of the medicines with the dose (amount) that you take at home. (Bauer & Krebs 2006)

The nurse practitioner will meet with ...