Lecture on Osteoarthritis and Arthroplasty Surgeries

Introduction

• Professor Witherspoon discusses osteoarthritis and related surgeries.
• Includes total knee arthroplasty (TKA), total hip arthroplasty, and total shoulder arthroplasty.

Objectives

1. Identify pathophysiology, clinical manifestations, medical, surgical, and nursing management of osteoarthritis.
2. Use the nursing process for arthroplasty patients.
3. Examine post-operative assessment after TKA.
4. Identify pathophysiology and management of post-operative complications.

Osteoarthritis

Definition

• Also known as degenerative joint disease.
• Idiopathic in nature, often called 'wear and tear' arthritis.
• Differentiated from rheumatoid arthritis, which is autoimmune.

Pathophysiology

• Progressive joint damage over time.
• Non-inflammatory primary manifestation.

Risk Factors

• Non-modifiable: Gender (female), ethnicity (Hispanic or African American), aging.
• Modifiable: Obesity, diet, and lifestyle.

Clinical Manifestations

• Pain, stiffness, and functional impairment.
• Localized to affected joints.
• Common in weight-bearing joints: knees, hips, spine.

Assessment

• Focus on musculoskeletal system and affected joints.
• Consider impact on quality of life and mental health.

Management

• Diagnosed via imaging (X-rays, MRI, CT scans).
• Use of orthotics, canes, walkers.
• Physical therapy and pain management (OTC or prescription).
• Surgical interventions: osteotomy, arthroplasty.

Arthroplasty Surgeries

Total Knee Arthroplasty (TKA)

• Most common elective joint surgery.
• Post-op: assessment, complication monitoring, patient safety.
• Early physical therapy.

Total Hip Arthroplasty

• Precautions: Limit joint movement (<90 degrees), no crossing legs.
• Requires assistive devices for ambulation.

Total Shoulder Arthroplasty

• Requires sling and swath for immobilization.
• Later start for physical therapy compared to knee and hip.

Post-operative Assessment and Complications

Assessment

• Head to toe examination, focus on surgical site.
• Monitor vital signs and neurovascular status.

Common Complications

• Pain, atelectasis, constipation.
• Risk of DVT and PE.
• Watch for signs of infection.

Life-Threatening Complications

• Bleeding/hemorrhage, DVT/PE, infections, paralytic ileus.

Patient Education and Safety

• Medication management and understanding.
• Use of assistive devices and equipment.
• Post-discharge: therapy continuation, adaptations at home.

Psychosocial and Holistic Care

• Address fears and anxieties, encourage patience in recovery.
• Consider work and family responsibilities.

Conclusion

• Students encouraged to ask questions for clarification.
• Professor available for further discussion.