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Hip Replacement
Osteoporosis
OSTEOARTHRITIS
Degenerative joint disease
Pathophysiology:
Deterioration of the articular cartilage
Cartilage becomes stiff and loses elasticity
Bone spurs joint deformity, pain, and
disability
OSTEOARTHRITIS
Degenerative joint disease
Whos at risk?
Obese - wt stress on the joints
Repetitive trauma bending, lifting, repetitive
motions
Age incidence greatly increased after age 60,
but it can develop in any age
Genetics
Other options:
- Use of braces
- Oral glucosamine
and chondroitin
supplements
- Capsaicin cream
- Steroids
- Acupuncture
- Surgical procedures
Pre-op Prep:
Lab results: CBC,
WBC, PT, PTT, UA,
CXR
Temp
Skin prep
Pre-op prophylactic
antibiotics
Assess for risk of
DVT
Anti-emboli measures
- Sequential pneumatic
stockings
- IV Heparin or sub q
Lovenox Coumadin
- Exercises
Position:
- OOB to chair w/in 24 hrs
- Turn to unaffected side
Administer antibiotics
OSTEOPOROSIS
Pathophysiology
There is a in bone density due to an in bone
reabsorption.
- Calcitonin and Estrogen promotes bone
formation
- Both w/age bone loss
- Parathyroid hormone w/ age in serum Ca
- As Ca is lost from the bone brittle & porous
bones
OSTEOPOROSIS
Primary Osteoporosis:
Postmenopausal women
Dietary
Lack of weight
Actual Calcium need for adults
bearing exercises
Women
Men
25-50 yrs 1,000 mg
25-65 yrs
Older age
1,000 mg
50-65 yrs
> 65 yrs
1,500 mg
Preg/lactating 1,200-1,500
mg
OSTEOPOROSIS
Secondary Osteoporosis:
2nd to renal failure, liver failure
2nd to medications affects the bodys use of
calcium
- corticosteroids, heparin, INH, diuretics
2nd to ETOH abuse
2nd to malignancy, DM
2nd to immobility
OSTEOPOROSIS
Risk Factors:
Small-framed, non-obese (< 127 lbs) Caucasian
or Asian women
Age
Menopause
Family history
Diets low in Ca and Vit D
Sedentary lifestyle
Excessive ETOH, caffeine, & tobacco use
Nursing
Interventions for
Osteoporosis
Prevention!!!
Diet
Weight bearing exercises
Resistance training
Medications
1. Stabilizes bone loss
- Ca carbonate/ Ca citrate
- Estrogen replacement
therapy
2. Build bone mass
- Fosamax, Actonel
- Evista: Selective
Estrogen Receptor
Modulators (SERMs)
- Effective in preventing
40% of spinal fx only
- Calcitonin
- Forteo: parathyroid
hormone