a. Definitive treatment for advanced, irreversibly damaged
joints with loss of function and unremitting pain
b. Commom conditions: degenerative and rheumatoid arthritis
(RA); selected fractures, such as with hip and femoral neck;
joint instability; congenital hip disorders; avascular necrosis
a. Performed on any joint except the spine, with hip and knee
replacements the most common procedures
b. Prosthesis may be metallic, polyethylene, or ceramic, or a
c. Implanted with methylmethacrylate cement or may be a
porous, coated implant that encourages bony ingrowth
a. Morbidity: In 2004, there were more than 1 million primary
and revision procedures performed; females accounted
for 62% of all procedures, with a mean age (at time of
procedure) of 66 to 68 years (U.S. Bone and Joint
b. Mortality: Rate is very low, 0.29% in 2004, related to
advanced age and comorbidities (Liu et al, 2008).
c. Cost: In 2004, annual hospital cost estimated at over
$44 billion (U.S. Bone and Joint Decade, 2008).
Client is treated in inpatient acute surgical unit and subacute
or rehabilitation unit.
Psychosocial aspects of care
Rheumatoid arthritis (RA)
Thrombophlebitis: deep vein thrombosis
1. Alleviate pain.
2. Prevent complications.
3. Promote optimal mobility.
4. Provide information about diagnosis, prognosis, and treatment
1. Mobility increased.
2. Complications prevented or minimized.
3. Pain relieved or controlled.
4. Diagnosis, prognosis, and therapeutic regimen understood.
5. Plan in place to meet needs after discharge.