Total Joint Replacement: Pathophysiology, Care, and Complications

What is total joint replacement?

Surgical replacement of a diseased joint with a prosthesis, most commonly the hip or knee.

What are common causes leading to total joint replacement?

Degenerative joint disease (osteoarthritis), trauma, or other joint pathology.

How does joint replacement affect pain and function?

It restores function and reduces pain.

Who is most commonly affected by the need for total joint replacement?

Older adults, especially women, due to the prevalence of osteoarthritis.

What are some risk factors for needing a total joint replacement?

Osteoarthritis, rheumatoid arthritis, trauma, avascular necrosis, congenital deformities, obesity, advanced age.

What are clinical manifestations of joint issues that may lead to replacement?

Severe joint pain, stiffness, decreased range of motion, impaired mobility, functional limitations, reduced quality of life.

What diagnostic tools are used for assessing joint conditions?

X-rays show joint space narrowing and bone changes; MRI/CT may be used for surgical planning.

What preoperative care is important for patients undergoing joint replacement?

Pre-op education, pain management, and assessment of surgical risk through labs.

What are key nursing care considerations post-total joint replacement?

Monitor for complications (DVT, infection, dislocation), encourage early ambulation, maintain joint alignment, and monitor neurovascular status.

What pharmacological treatments are commonly used in total joint replacement?

Analgesics (opioids initially, then NSAIDs/acetaminophen), antibiotics perioperatively, and anticoagulants for DVT prophylaxis.

What dietary considerations should be made for patients post-joint replacement?

A balanced diet to promote healing, adequate protein intake, and weight reduction if obese to reduce joint stress.

What client education is important after total joint replacement?

Post-op activity restrictions, use of assistive devices, importance of physical therapy, and recognition of infection or DVT signs.

What are common therapeutic procedures related to joint replacement?

Total hip replacement, total knee replacement, and less common shoulder or elbow replacement.

Who are the key members of the interprofessional management team for joint replacement?

Nursing, orthopedic surgeon, physical therapy, occupational therapy, dietitian, and case management.

What are potential complications of total joint replacement?

Infection, prosthesis dislocation, DVT/PE, neurovascular compromise, and prosthesis loosening or failure.