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Front Page » April 23, 2009 » Focus » CNS helps recovery after total joint replacement
Published 2,040 days ago

CNS helps recovery after total joint replacement


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Joint problems can begin as a slow creeping problem and then result in some substantial surgical correction.

"It all started with the inability to do the things that I once used to do with ease, bending, squatting down to get my cooking utensils out of bottom drawers. I could no longer walk and do my shopping like I once did. Before, I could spend several hours browsing for deals and find groceries and household items that my family would need for the next couple of weeks", states Grace Olsen, from Castle Dale.

She had both knees surgically corrected by undergoing total knee arthroplasty within the past year. In Grace's situation both of her knees were very painful due to degenerative effects of crippling arthritis.

Generally, the orthopedic surgeon makes an eight inch incision on the anterior portion of the knee. The damaged joint surfaces are removed from all three bones that make up the knee joint. Sometimes, upon the discretion of the surgeon, the back of the knee cap is left intact if not greatly affected by the arthritis. The surrounding muscles and most of the ligaments are preserved. The lower end of the thigh bone, femur is resurfaced with a metal cap. Then, the upper leg bone, or tibia is replaced with a metal and plastic implant with surgical cement and screws. The back of the knee cap or patella is also resurfaced with an all-plastic implant.

Highly specialized instruments are used that allow precision cutting of the bone so that the new joint fits perfectly. The type of implant used depends on the surgeon's preference and the patient's requirements.

"I know that some people have both knees replaced at the same time," said Olsen. "But my doctor recommended that I have one knee surgically corrected, wait and determine when I felt the best for the last joint to be replaced."

Life with the replacements is not the same as it was when she was young, but it is much better than the pain she had.

"I'm not superwoman any more," she said as she paused and laughed. "I have lots of children and grandchildren, I stayed at home, and had plenty of time to have my surgeries a year apart. I literally would not have had a good leg to stand on if I would have had them done at the same time."

She loves to kid around, especially now that both the surgeries are over. But Olsen does admit that she had heard many "war stories" of joint replacement and that she was somewhat reluctant.

"It just had gotten to the point that the pain was so overwhelming and I could not do the everyday, routine things that I loved to do so much," she said. "I knew that it had to be done, and I was not getting any younger."

Even without complications, Olsen was apprehensive about leaving the hospital after only five days, although at the same time, she knew she would rest better and recover faster at home. She learned the importance of having a supportive spouse to help her through the difficulties.

"Everyone that I spoke to told me how important home health services would be after being discharged from the hospital," she stated. "I chose Community Nursing Services because I had heard they were a great company and had an excellent reputation for their nursing and rehabilitative services. I had previously had home health services due to wound care and knew how instrumental home health would be in facilitating a quicker recovery. I felt like I played a vital role in my recovery by requesting my physician to order the needed home health services."

According to Olsen, the certified nurse's aide that Community Nursing Services provided was excellent.

"There is no way I could have made it in and out of my bathroom, the area is so confining and it really took someone, thinking outside of the box to make it happen," she said with a smile. "Saralee Kemple really took the time and made what seemed impossible happen."

The registered nurse assigned to her assessed her Protein/INR levels with an accurate, portable, blood-screening device.

"This allowed immediate results of the viscosity of my blood, really to see how thin or thick it was running, which allowed immediate results so the RN could adjust my medication, with the orders and supervision of my attending surgeon," she said. "I was so scared of blood clots with this surgery and my history, it made all the difference in the world to have this information available at a moments notice."

The registered nurse also assessed her wound and provided dressing changes when needed. After 10 days, the staples were removed very easily and painlessly.

" I knew one of the most important aspects of my post operative recovery would be the physical therapy and the appropriate exercises," she said. "My physician instructed me that the post operative rehabilitation exercises would be at the top of his priority list for a successful outcome. Initially, Lee Nielsen, a physical therapist, came to my home and provided and taught me all of the information about the needed exercises."

These at-home exercises were key in the proper healing and strengthening of the muscles around the newly implanted joint.

"Lee really made me feel at ease," she stated. "He had a very clear and concise program that someone in elementary school could understand. He even drew the exercises in a stick figure format. Although, the exercises caused pain, I repeated them as scheduled for about a month at home. Afterwards, I went only two blocks to the Castle Dale Clinic at Castleview Rehab. With my progression, I was ready for the exercise equipment. Lee taught me how to use the equipment safely and I had a flexible schedule at the clinic over the next couple of months. I could tell that I was being taught by a state award winning service award recipient. I assume any physical therapist knows what to do, but Lee really treats you like a real person. I have only the best of words and would recommend him to anyone. On a 0-10 scale I have to rate the success of my new joints as an eight, with exceptionally warm weather a nine. That isn't bad considering the complexity of the surgery and also the many other procedures that I've had completed over my lifetime."

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