Care of a Patient in Acute Pain from a Total Knee Replacement Jahaira Melendez
Nursing care after a total knee replacement is very essential in promoting a speedy and safe recovery for a patient. In an attempt to replicate the knee’s natural ability to roll and glide as it bends by cutting away damaged bone and cartilage and replacing it with an artificial joint, acute pain following the procedure can be unbearable. In assisting the patient in controlling the pain would only guarantee the best recovery possible. With pain control, the patient will be able to perform follow up care and exercises to the best of their ability and over 90% of patients who undergo a total knee replacement have good results with recovery and ability to resume performing normal daily activities and minimizing the risks of complications to the surgical site. Keywords: Pain management, encouragement, total knee replacement, arthritis, prosthetic Care of a Patient in Acute Pain from a Total Knee Replacement A common medical condition seen in many aspects of the medical field is arthritis. Arthritis is the inflammation of a joint and the most common type of arthritis is osteoarthritis, also known as wear and tear. Pain from any medical condition or procedure can be very stressful to a patient and inhibit any recovery. Arthritis can be diagnosed by performing an x-ray to determine the extent of joint damage. Someone with arthritis of the knee usually has difficulty walking, climbing stairs and getting in and out of chairs. An orthopedic physician can recommend interventions. The most common joint replacement surgical intervention to help control and alleviate chronic pain for a patient is a Total Knee Replacement, also known as arthroplasty. A total knee replacement is performed to relieve moderate or severe pain and restore function in severely diseased knee joints. This procedure is not performed until pain is no longer controlled with non-operative treatment such as weight loss, activity modification, anti-inflammatory medications, joint supplements and cortisone injections. It is also not performed frequently on younger patients due to the implant wearing out quickly. An orthopedic physician would determine the type of prosthetic needed in order to achieve the most success. There are also modified implants to provide the best possible functioning with long lasting results such as partial knee, rotating knee, gender specific knee and custom knee. To perform the procedure, an orthopedic surgeon would administer general anesthesia, which means one is unconscious during operation, or spinal or epidural anesthesia in which a person is awake but cannot feel any pain from the waist down. During the procedure, the knee is in a bent position to fully expose the joint surfaces. An incision of 6 to 10 inches (15-25cm) is made on the front of the knee. The kneecap is moved aside and damaged surfaces are cut away. The femur is cut to match the corresponding surface of the metal femoral component that is placed on the end of the femur and the tibia is prepared with a flat cut on top to fit the metal and plastic tibial component that is inserted into the bone so the femoral component will slide as the knee is bent. If needed, the patella is cut flat and fitted with a plastic patella component and plastic spacers are inserted between the metal components for smooth gliding. Prior to completion, the knee is tested during surgery to ensure correct sizing and then closed with stitches or staples. The procedure would take 1 to 2 hours and recovery would be another 1 to 2 hours and then require a hospital stay of a couple of days. During the hospital stay, encouragement to move the foot and ankle to increase blood flow and prevent swelling or clots and blood thinners, support hoses or compression boots are very important. A nurse should also encourage the patient to cough regularly and take deep breaths to promote the movement of mucus that settles in the...
References: Mayo Clinic Staff (2012, October 30). Knee Replacement.
Retrieved from http://www.mayoclinic.com/health/knee-replacement
Cluett, Jonathan, MD (2012, April 8). Considering Knee Replacement Surgery.
Retrieved form http://orthopedics.about.com/od/hipkneereplacement
Einstein Healthcare Network (2013) Healthsheets
Retrieved from http://www.nlm.gov/medlineplus/ency/patientinstructions
The American Academy of Orthopedic Surgeons (2011, December)
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