Introduction
Total knee replacement (TKR) is considered as an effective and successful end-stage surgical procedure for the relief of chronic knee pain and functional disability (Wylde et al. 2007). There should be radiographic evidence of joint damage, moderate to severe persistent pain that is not relieved by a course of non-surgical management and clinically significant functional limitation resulting in diminished quality of life (Gabr et al. 2011). In Singapore, there is no prevalence data on knee replacements (Leung et al. 2013), but Xu et al. (2008) reviewed the data of 1663 total knee replacements in a tertiary institute of Singapore, and revealed that 96% of the knee replacements were due to osteoarthritis. Osteoarthritis is a multifactorial
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Besides those advantages, it was mentioned that the advantages of a simultaneous bilateral TKR are that it ensures a single anaesthetic exposure, single postoperative course, a single rehabilitation period and enables a more efficient use of resources and increased patient satisfaction (Gurunathan, 2013).
Setting the Context
In setting a clear direction and structure to the essay, some assumptions has to be made to provide a realistic picture of the subject. A review by Stubbs et al. (2015) found that the factors associated with knee osteoarthritis were low physical activity, the non-white ethnicity, being female and increasing age. Thus, it is assumed that the lady is a Singaporean lady with bilateral osteoarthritic knees who lead a sedentary lifestyle. She was experiencing pain and limitation in function, and difficulty in carrying out her activities of daily living (ADLs). Hence, this led to her bilateral total knee replacement surgery done in order to relief her pain, improve her functional mobility and quality of life. Considering the time frame and considerations mentioned, it is highly likely that she underwent a simultaneous bilateral TKR.
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It is advised to follow up with the lady for 6 months as it is well known that maximum functional gain is achieved in the first 6 month following total knee replacement surgery (Unver et al. 2005, Kennedy et al. 2005). In managing the lady, any reversible risk factors that predisposed her to osteoarthritis such as obesity, smoking and physical inactivity must be managed and lifestyle modifications must be made accordingly, along with self-efficacy of her condition.
It is also important to assess and review her functional outcomes as well as performance outcomes from rehab using outcome measures such as Six Minute Walk test, Berg balance test, Functional Independent Measure, Modified Barthel Index and Dynamic Gait Index (Artz et al, 2015).
Non
If Arthroscopic Surgery is possible three incision are made in the knee under short general anesthetic, the patient can return home the same day and begin rehabilitation
States I have bone disease, I had bilateral hip replacement. I need knee replacement. I can’t walk.” The record goes on to state “patient walked out prior to MSE with steady gait on
Strength is 4/5 with knee extension on the right compared to the left. Patient is able to raise from a seated position with mild difficulty. Gait is antalgic. Current medications include Atenolol, Norco 10-325 mg 1 tablet every 6 hours as needed and Cyclobenzaprine 10 mg 1 tablet 3 times daily. IW was diagnosed with knee pain.
The pain that patients report is out of proportion to the severity of the injury. The pain gets worse, rather than better, over time. Eventually the joints become
As per medical report dated 4/26/16, patient’s presenting problem started 14 days ago. Pain is still present in her right knee. Movement worsens symptoms.
Clinical Orthopaedics and Related Research®, 471(4),
Total Hip Resurfacing With the evolution in advancement in the medical field, the old practiced of hip resurfacing is no longer active. The process is lined in such manner that the hip bone is capped and reframed through metal prosthesis. This surgery has an advantage over traditional means as the hip socket is secured by means of metal cup. It also helps in lasting longer and little discharge of metal ions during surface rubbing.
He is currently complaining of recurrence of the pain. In regards to his left knee, he states that pain is much better compared to prior to surgery. His main complaint is weakness and difficulties going up and down the stairs. He had his recent physical therapy approved and he has done 2 sessions and he has additional 10 sessions left. Physical examination revealed healed surgical scar left knee.
With the increase in age, it is normal to find older people with reduced range in motion of the joints (Kruse). But again, candidates for the anterior approach must have flexible joints. Even if patients were younger, many would still be rejected because of their weight. In the United States, “68.8% of adults are either obese or overweight” (Overweight and Obesity Statistics). The current society demands a procedure to fulfil their needs, and the anterior approach hip replacement is just not the
In same studies it showed that among the subjects between 25 and 74 years of age, the prevalence of knee symptoms such as pain, swelling and morning stiffness increased with age and knee pain was slightly higher among women compared to men (Hannan et al, 2000). Knee pain is very likely a health problem with tremendous health care costs, despite the lack of direct cost estimates. In 1996–1997, more than 6 million Americans sought medical care for knee problems (Peat et al
4. Based on the subjective and objective data S.T.’s health care provider orders an x-ray of the right knee and after reading the x-ray, recommends S.T. have a right knee arthroscopy with possible debridement in order to visualize the contents of the knee to determine the cause of the pain and identify treatment options. What should you explain to S.T. about these procedures? A knee arthroscopy is a surgical procedure so the doctor can view the inside of your knee to see what needs to be done to fix the problem.
The preceptor is good at orthopedics and physical therapy. She uses knee and ankle braces to correct patients’ alignment. Some of the patients are elderly and do not want have any surgeries. She also provides physical therapy for a short period of time at the clinic to relieve patients’ pain. The pain can be in the shoulder, neck, hip, back, knee, or ankle.
Once the patient was asleep, he started by making a small incision on the kneed and inserting the scope which showed a full picture on the camera screens. One of his tools vacuum sucked all the torn ligament pieces away to make it easier to see the part that needed fixed. I got to see the ACL ligament and the meniscus. The doctor stated that it wasn’t as bad as many cases he had seen. When he was done taking out all the torn parts he left, and the assistant sewed her up, the patient was then taken back to get ready for discharge.
Athletic training and sports medicine has always been a passion of mine. Second semester, my freshman year in high school was when I first began to work with the varsity softball team and tryout for the high school team. While participating on this team, I was also working with a travel team for the summer. At practice for my summer team, the day before the season started for my high school team, was one of the most traumatic experiences I 've every gone through in my whole life. Half way through the scrimmage at practice, I was running the bases when I felt a “pop” in my leg and immediately collapsed and screamed for help.
Mrs Jones physical shows she had a hip operation thereby causing her pain, reducing her mobility and access to her occupation and engagement. Additionally she has difficulty in weight bearing on her right leg due to her operation and experiencing muscle weakness causing her limited endurance and strength when walking and transferring. Cognition: It was documented the patient experienced post-operative confusion, memory loss, difficulty following and understanding post hip surgery caution. Affective (mood): Patient experienced low mood and lacks confidence walking due to her illness, this has impacted on her emotion.