Standardized nursing care plan for patients with personalized knee replacement PDF

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Summary

Osteoarthritis (OA) is a disease that affects the cartilage that lines the ends of the bones that make up the joints. It is degenerative, progressive, chronic, benign, it can be disabling and controllable...

Description

Standardized nursing care plan for patients with personalized knee replacement. Osteoarthritis (OA) is a disease that affects the cartilage that lines the ends of the bones that make up the joints. It is degenerative, progressive, chronic, benign, it can be disabling and controllable.1 OA is a rheumatic disease in which the degradation of articular cartilage is the consequence of a progressive loss of function in the synovial joint, this process that gives rise to said pathology is caused by the imbalance between the synthesis and degradation of cartilage. 2 It is the most prevalent arthritic disease that affects the joints. It is associated with various risk factors, mainly with aging, but also with a genetic predisposition, obesity, gender, exercise or work-related injuries and trauma. These factors will act on the chondrocyte (type of cells that are responsible for maintaining the cartilaginous matrix) causing an imbalance causing the catabolic phase to predominate and triggering pro-inflammatory mediators

(IL-1,

cytokines,

nitric

oxide,

prostaglandins

and

metal

proteases) that originate the degradation of cartilage and will alter the synovial tissue.2-3 To understand the pathogenic process, it can be summarized in an evolutionary way in four phases: first, it focuses on the etiological factors; second, the degradation of the matrix, inflammation and reparative changes; third, in this phase, changes in the synovium and cartilage will be visible; and fourth, the clinical manifestations will appear, where pain, functional impotence and joint destruction will be found.4 According to the World Health Organization (WHO), it is estimated that osteoarthritis will become the fourth cause of disability in 2020.4 In the United States, it affects 10% in men and 13% in women aged 60 years and over. Due to the aging of the population and the obesity epidemic, the number of people affected is likely to increase., More

1

50% of the population over 65 years of age has some type of osteoarthritis, the knee being the most affected joint, with an incidence of 240 / 100,000 people / year.3-5 Knee arthroplasty is probably the most frequent orthopedic surgery in our society and with the highest success rate. Its main indication is osteoarthritis, which affects around 13.83% of the population in the knee.6 The classic presentation of this condition is in patients of approximately 65 years, predominantly female, presenting with chronic pain of mechanical characteristics, which increases with movement and associated with joint stiffness greater than 30 ', joint deformity, crepitus and effusion. 4 (See Table 1. Diagnostic criteria for knee osteoarthritis.) Clinic history

Coxalgia,>

50

years,

stiffness...