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Diagnosis Specific Programs: Total Knee Arthroplasty (TKA)

Compassionate Care’s next diagnosis specific program is Total Knee Arthroplasty (TKA)

Considering a TKA and Understanding the Procedure

Total Knee Arthroplasty may be recommended when:

  • Severe knee pain to stiffness makes it very painful or very difficult to perform simple everyday activities such as walking, climbing stairs, getting in and out of a chair.
  • Needing to use a cane or walker due to severe knee pain.
  • Moderate or severe knee pain is present even when the client is resting
  • Chronic knee inflammation and swelling are not relieved with anti-inflammatory medication and rest.
  • The knee joint is bowing in or out
  • Less invasive procedures have not been successful. These can include cortisone injections, lubricating injections, and physical therapy

Individuals considering TKA are not held to strict ages or weight limits. Recommendations for TKA will be based on the patient’s pain and degree of disability. Most TKA patients are between the ages of 50 and 80.

There are four basic steps to a knee replacement procedure:

  • Prepare the bone – The damaged cartilage at the ends of the femur and tibia are surgically removed. A small amount of the underlying bone is also surgically removed.
  • Position the metal implants – The portions of cartilage and bone that were surgically removed are replaced with metal components to essentially build a new surface for the knee joint. These metal parts may be cemented or “press-fit” into the ends of the bones.
  • Resurface the patella – The underside surface of the patella (knee cap) is trimmed and replaced with a plastic button if needed. Not all patients will need to have the patella resurfaced.
  • Insertion of a spacer – A plastic spacer is positioned between the metal components to create a smooth gliding surface.

Empowering You and Your Loved One

Home modifications and considerations should be made prior to Total Knee Arthroplasty. These include: safety bars or a secure handrail in the shower area and along stairs, a stable chair to sit in while recovering, toilet seat risers with arms, and a stable shower bench or chair for bathing. TKA clients should use firm seat cushions that are about 18-20 inches off the floor and footstools for periodically elevating the legs.

Always follow your physician’s orders when returning home after any surgery. Compassionate Care believes every individual has the right to understand their plan of care, make decisions about services they receive and live as independently as possible.

Client Goals:

  • Avoid falls
  • Prevent blood clots
  • Prevent pneumonia
  • Keep wound clean and dry
  • Manage pain

Plan:

  • Medications
    • Use medications exactly as ordered by your physician and contact your physician if medications are not effectively controlling your pain.
  • Wound Care
    • Keep the wound clean and dry. Avoid soaking the wound until it has thoroughly sealed closed and gently pat the area dry after showering.
  • Prevention
    • Prevent blood clots by following your physician’s orders for:
      • Use of support hose (i.e. TED hose)
      • Compression boots (inflatable leg wraps)
      • Anticoagulant medications (blood thinners)
      • Exercise/movement of the leg, foot, and ankle
    • Prevent pneumonia by taking frequent deep breaths
  • Activity
    • Follow your physician’s instructions for activity. A typical activity program will include:
      • A walking program that gradually increases to include greater walking distances.
      • Resuming normal daily activities
      • Specific exercises to restore movement to the hip joint
      • Do not drive until approved by your physician
  • Avoid falls
    • Stairs can be especially hazardous within the first few weeks
    • Use a walking aid (cane or walker) if your physician or physical therapist recommends it
    • Have someone walk with you until you are able to walk alone safely

Compassionate Care’s Goals

Compassionate Care is implementing these diagnosis specific programs for several reasons:

  • Empower clients and their families to successfully manage care in the home setting
  • Educate our office staff to better understand each of these diagnoses and the care needs
  • Educate our caregivers to better understand each of these diagnoses and the care needs
  • Promote successful transition back into the community for clients leaving hospital/skilled nursing facility
  • Reduce the number of avoidable readmissions to the hospital for our clients

Download the Joint Replacement diagnosis program.

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