...Mandatory Pre-op for Total Knee Replacement The decision to undergo elective knee surgery can be very stressful for many patients. It is important for patients to be well prepared. Total knee arthroplasty has increased by eighty-four percent from 1997 to 2009 (Fawzi, 2012, para. 1). By making the Pre-op Total knee Arthroplasty class mandatory patients and their family members will be more educated and prepared for surgery and recovery. During the class patients will be able to ask any questions they may have, learn how to better prepare for surgery and ways to prevent infection during their hospitalization. Physical therapist will also discuss exercises and pain management techniques. By using the John Hopkins evidence based practice model a change can be made in the pre-op process for all total knee replacement patients. Change Model Overview The John Hopkins Nursing Evidence-Based Practice Process is defined as a problem-solving approach to clinical decision-making within a health care organization (Dearholt, & Dang, 2012, p. 4). Nurses often use this model to facilitate change within their organization....
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...technique for evaluation of a CT based navigation system for total knee replacement (TKR) Praemer et al30reported that in 1996, 245,000 total knee replacements (TKRs) were done in the United States. They estimated that the projected increase in TKRs in the United States will be 209,000 between 1996 and 2030. Most of the early failures of TKRs are related to technical flaws. Experimental and clinical data indicate that to achieve optimal midterm and long-term results of a TKR, good alignment in /the frontal plane of the lower limb is mandatory. In an experimental study, Hsu et al 14showed that a femoral component in 7° valgus, with the tibial component placed at 90° to the long axis of the tibia, was the best position for the total condylar knee and produced equal force distribution between the medial and lateral plateaus. For the Kinematic knee, the best position was 9° valgus for the femoral component with 2° varus of the tibial component. A clinical association between failure of TKR and malalignment seems likely. Ritter et al 32 reported that varus knees had a lower survival at 10 years than aligned or valgus knees. Jeffery et al,16 with the first design of the Denham prosthesis, reported that at 12 years the incidence of loosening was 3% when, on long-leg standing radio-graphs, the line joining the center of the femoral head to the center of the body of the talus passed through themiddle1⁄3of the knee prosthesis. The incidence of loosening was 24% when the line was...
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...that prompt smokers to eat less. Smoking also might give food an awkward taste for smokers, causing appetite to vanish. As an appetite suppressant, nicotine works on a part of the brain known as the hypothalamus that gives a person an urge to eat. Secondly, Those who don't smoke cigarettes are more probable to die from a heart attack than a person who has been smoking for an extensive duration of time. The danger of heart attacks is increased in people who smoke cigarettes, but the chances of them dying are lowered. Smokers who survive heart attacks are younger when they are sick, often 10 years younger than smokers just beginning to smoke. Third, Smoking can also lower the risks of needing total knee replacement (TKR). Total knee replacement surgery is for people whose knee joints are damaged either by arthritis and other catastrophic joint diseases. The most common factor for TKR is severe osteoarthritis of the knees. Smoking cigarettes also protect individuals from osteoporosis and the nicotine within them helps prevent joint deterioration and cartilage. Adult males who smoke have lowered the risk of undergoing TKR than those who have never smoked in their lives. Finally, smoking can also offer potential effects when it comes to Alzheimer's. Alzheimer’s is a loss of brain function...
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...Orthopaedic Surgery - Arthroscopic Surgery - Joint Replacement - Sports Medicine - Fracture Care John R. Chance, M.D., David L. Fox, M.D., Jamie L. Lynch, M.D., Brian E. Schulze, M.D., Patrick M. Simon, M.D., Rex E. Wilcox, M.D. Diplomates, American Board of Orthopaedic Surgery Kelly A. Cooper, PA-C Total Knee Arthroplasty (Replacement) Post Operative Instructions IN THE HOSPITAL AFTER SURGERY: You will stay in the hospital for 2-3 days after having knee replacement surgery. During that time you will recover from your anesthesia and the surgery itself. Right after surgery you will spend 1-2 hours in a recovery room (PACU) before going into your room. You will likely wake up very tired and groggy. You will have a large dressing (bandage) over your incision and part of your leg. A small drainage tube may be in place during surgery to help drain fluids that collect in your knee joint after surgery. After being taken back to your room you will continue receiving fluids through your IV (a catheter or tube that is inserted into your vein to give the medical staff access for medications and fluids) until you are able to drink fluids on your own. You will slowly resume a normal diet. After knee replacement, some surgeons recommend using a continuous passive motion machine (CPM) while you are in bed. The CPM bends your knee for you. Over time, the rate and amount of bending will increase. If you are using this machine, always keep your leg in the CPM when you are in bed. It may help speed...
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...share information, please write, “Does not want to disclose.” BIOGRAPHICAL DATA (10 pts) | | Date: | 5/29/15 | Initials: | JS | Age: | 52 | Date of birth: | 6/1/1962 | Birthplace: | Antigua | Gender: | Female | Marital status: | Married | Race: | Black | Religion: | Christian | Occupation: | Housekeeping | Health insurance: | Carpenters Union Health Insurance through her husbands employer | Source of information: | Patient | Reliability of source of information: | Patient is responsive, alert, oriented x3, ability to recall and process information. | PRESENT HEALTH HISTORY/ILLNESS (15 pts) | | Reason for seeking care: | Routine physical, having persistent severe headaches, fluid accumulation in the right knee, and hypertension. | Health patterns: | Usually goes to the...
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...Issue description: “The social organisation of health care, concerns the way a particular society organises. funds, and utilises its health services. A central focus on the dominant role of the medical profession, which has significantly shaped health policy and health funding to benefit its own interests” (Germov 2009, pg 18-19 para 5) Doctors who support the medical profession for private health insurance benefit by maximising their profits with the “No Gap” incentive that private health insurance offers to their clients, Doctors are being encouraged to charge more then the scheduled fee however based on the marxism theory only those who can afford private health insurance benefit from such services. Low income workers are limited to health care options due to the rise in household bills, making private health insurance difficult to afford. In private health doctors are able to charge their patients their own fee for services/medical consultations etc. Medicare will pay 75% which is known as the “schedule fee” , private health insurance will cover the 25% gap. However the AMA actually encourage doctors to charge more then schedule fee, allowing the doctors to make profit by those who can afford to pay for these consultations. Until recently private health insurance companies were restricted by law to cover the “gap” fee making the patient having to pay the 25% out of pocket. Now every health fund must offer at least one “no gap” or “known gap” policy. Gap cover is only...
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...HEALTH HISTORY AND EXAMINATION OF AN OLDER ADULT HEALTH HISTORY AND EXAMINATION OF AN OLDER ADULT On March 1, 2016, with the permission of Mr. P.F. henceforth known as the client, a health history assessment and physical examination was conducted and the detailed results dictated within the appropriate assessment templates which are attached for review. In an effort to summarize the health history assessment and physical examination, the summarized assessment findings will be henceforth reported in SBAR format. Situation The client is a Caucasian 64 year old male, whom is alert and oriented to person, place and time whom presents as a well-groomed, well- rested, and well-nourished man that looks his age. English is spoken fluently by the client and is reported as his first language therefore interpreter services were not required. The client states that he worked and supported his family over forty years as a truck driver however has been retired since 2012. Additionally he reports living alone in a single story home which he has owned for over forty years. His plans are to continue to live in his home as long as he is able to care for himself and continue to maintain the home independently. He further states that he is able to complete all his activities of daily living independently, routinely cooks for himself three cardiac meals per day, and takes walks daily for exercise. Client does not report to currently be in a relationship or sexuality active, however did...
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...My client is Miss Whitney Greaves. She is an upper-class rheumatologist, and wanted a calm and spacious room. She would use the room for relaxation, to practice art, and to sleep. Miss. Greaves has ample free time. She loves to read, paint, and eat; as well as watch Netflix, and surf Pinterest. Miss Greaves room is a calm shade of turquoise, and all of the other colors are shades of blue and green. Whitney Greaves also wanted to be able to freely play piano, so I added a Grand Piano atop of a navy blue rug. For her relaxation there is a large television with a surrounding speaker systems. Her seat is a giant beanbag, or a LoveSac™. The LoveSac ™ is a creamy off white. Also included in this section of Miss. Greaves room is a stainless steel...
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...Name Injury Team Pos Note Dragic, Goran PHO G My First Pick Lin, Jeremy Day to Day - Probable HOU G Gordon, Eric Injured - knee - out indefinitely NOR G Don't draft ealier than 4th round Ginobili, Manu Day to Day - Questionable SAS G Don't draft before round 4 Garnett, Kevin BOS C Nowitzki, Dirk Injured - Back late Nov DAL F Ilyasova, Ersan MIL F Hilario, Nene Day to Day - Questionable WAS F/C Don't draft Thornton, Marcus SAC G Stoudemire, Amare Injured - knee surgery - out through mid-December NYK F/C Don't draft ealier than 4th round Pekovic, Nikola Day to Day - Probable MIN C Wallace, Gerald BKN F Williams, Mo UTA G Bogut, Andrew Day to Day - Questionable GSW C Don't draft Granger, Danny Injured - left knee soreness, out indef IND F Lillard, Damian POR G Brian's guy, don't draft Matthews, Wesley POR G/F Chandler, Tyson Day to Day - Probable NYK C Duncan, Tim SAS F Faried, Kenneth DEN F Kaman, Chris Day to Day - Questionable DAL F/C Stuckey, Rodney DET G Thomas, Isaiah Day to Day - Probable SAC G Nelson, Jameer ORL G Brand, Elton DAL F Hayward, Gordon UTA G/F Evans, Tyreke SAC G/F Beasley, Michael PHO F West, David IND F Martin, Kevin OKC G Crawford, Jamal LAC G Humphries, Kris BKN F Smith, JR Day to Day - Questionable NYK G Hill, George Day to Day - Probable IND G Kirilenko, Andrei MIN F Don't draft Felton, Raymond NYK G Vasquez, Greivis NOR G I like Greivis Williams, Lou ATL G Deng...
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...preservation of the both cruciate ligaments.19 In 1973, Marmor designed a modular knee for unicompartment & bicompartment replacement .20 The Total Condylar Prosthesis (TCP) designed by Insall and others, its introduction in 1973 marked the beginning of the modern era of total knee arthroplasty. (Fig. 20) This prosthesis design allowed mechanical considerations to outweigh the desire to reproduce anatomically the kinematics of normal knee motion. Influenced largely by the previous ICLH (Imperial College London Hospital) design, both cruciate ligaments were sacrificed, with sagittal plane stability maintained by the articular surface geometry. The original cemented total condylar prosthesis dramatically reset the standard for survivorship...
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...Review Article Knee Surg Relat Res 2012;24(4):193-200 http://dx.doi.org/10.5792/ksrr.2012.24.4.193 pISSN 2234-0726 · eISSN 2234-2451 Knee Surgery & Related Research Patellofemoral Osteoarthritis Young-Mo Kim, MD, PhD and Yong-Bum Joo, MD, PhD Department of Orthopedic Surgery, Research Institue for Medical Sciences, Chungnam National University School of Medicine, Daejeon, Korea Patellofemoral arthritis is a fairly common disease, and it has been gaining interest with increasing number of studies due to its diverse treatment methods. Patellofemoral arthritis has a broad range of management options according to the characteristics of individual diseases. Identifying whether patellofemoral arthritis is the primary cause of knee pain and is compartment arthritis is necessary for establishing an adequate treatment method. rough investigation of the literature, the issues of recent knowledge of femoropatella arthritis and the diagnosis and treatment of which were studied. Key words: Patellofemoral arthritis, Diagnosis, Treatment. Introduction Unicompartmental arthritis of the knee generally refers to not only tibiofemoral arthritis but also to disorders of the patella and the cartilage. In particular, isolated patellofemoral arthritis is a relatively common disorder for which there has been increasing research regarding its treatment methods. Patellofemoral arthritis occurs due to the loss of the cartilage of the patella and the trochlear groove in approximately half...
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...inpatient surgical cohorts. Methods: A retrospective analysis was conducted using Premier’s Perspective™ hospital database. Patients who had an inpatient procedure within a specialty of interest (cardiac, vascular, non-cardiac thoracic, solid organ, general, reproductive organ, knee/hip replacement, or spinal surgery) during 2006-2007 were identified. For each specialty, the rate of bleeding-related complications (including bleeding event, intervention to control for bleeding, and blood product transfusions) was examined, and hospital costs and length of stay (LOS) were compared between surgeries with and without bleeding-related complications. Incremental costs and ratios of average total hospital costs for patients with bleeding-related complications vs. those without complications were estimated using ordinary least squares (OLS) regression, adjusting for demographics, hospital characteristics, and other baseline characteristics. Models using generalized estimating equations (GEE) were also used to measure the impact of bleeding-related complications on costs while accounting for the effects related to the clustering of patients receiving care from the same hospitals. Results: A total of...
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...According to a study conducted at the Lahey Clinic in Massechuesetts,the importance of the control of the knee implant pricing affects a healthcare organizations pricing strategies and revenues (Healy et al. 2011). Huntsville Hospital Health System developed relationships with specific, surgeon approved vendors that provide a contracted price for the prosthetic knee joints. According to Thomas Fender, negotiating the individual price of the prosthetic joint has been removed by contractual agreements with two prominent suppliers, benefitting the hospital and the surgeons with cost discounts. Importantly, the support of surgeons of the medical device and reasonable transparency with vendors in costs and pricing continue to be advantageous to HHHS in establishing cost value on medical devices (Fender...
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...Patient history Summary Patient is a 65-year-old, housewife, presented to Prince of Wales Hospital (POWH) for an elective right total knee replacement (TKR) on the background of osteoarthritis in the right knee, exertive right knee pain of 3 years associated with knee stiffness. Notable patient’s medical history are Type II Diabetes Mellitus (insulin treated), proliferative diabetic retinopathy with macular oedema, microalbuminuria, hypertension and hyperlipidaemia. Patient’s parents both had diabetes. Initial examination presented with reduced range of motion and a fixed flexion deformity. Presenting Complaint Patient has come into POWH for an elective TKR of the right knee after an initial diagnosis of osteoarthritis of the right knee...
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...Hip arthroplasty is the replacement of the hip joint with a prosthesis, and is one of the most common reconstructive operations (Huo et al 2008). Hip arthroplasty may be performed when irreversible damage has occurred to the joint; this damage often causes pain, dysfunction and reduced quality of life. The pre-operative nursing considerations begin with patient education. This should begin at the time the decision is made to have the surgical procedure performed. It is important that the patient understand the preoperative requirements, the surgical procedure, postoperative care and the necessary home/activity modification. The patient should be instructed in self-preparation, including mental and emotion readiness and having a positive attitude about the surgical outcome. There is a great deal of evidence that a patient’s psychological state before the surgery impacts on their recovery afterwards. Studies have shown that patients who report lower levels of general or mental health before surgery have worse physical health outcomes, such as pain levels, after surgery (Long et al, 2005). Like all surgeries, the patient will be assed for their ability to tolerate the procedure and anesthesia. Of particular concern is their cardiovascular and respiratory status, and the presence of any comorbidities. The patient should also be evaluated for the presence of any infection, as it could spread to the hip prosthesis. The teaching of postoperative exercise before surgery allows the...
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