Total Hip Arthroplasty (Nursing)

00:01 I want you to take a look at this picture.

00:03 Look at it really closely.

00:05 What is the difference between the patient's right side and the patient's left side? Yeah, look at that right side.

00:14 That is pretty significant hardware that they're supporting there, right? This patient has had a total hip arthroplasty.

00:23 So when you have a patient that you're caring for, and you see they have this in their history, this is what I want you to visualize.

00:30 This is what orthopedic surgeons do. They're incredible.

00:34 But there's, I told you a lot of power tools involved and strength and helping this patient regain mobility.

00:41 But let's take a closer look at that new kind of hip there.

00:45 Now take a look at that is what it actually looks like.

00:49 Like that's metal. That's what gets placed in a patient's body.

00:53 Now at the top, that's a funny word, but it's acetabular component, right? It's got that round or spherical surface.

01:00 So that's what's gonna go right into that former socket.

01:04 Now also, there's the femoral stem.

01:07 Yeah, here's where it gets real personal.

01:09 Take a look at our drawing.

01:12 Where is that femoral stem placed? Yeah, boom, boom, boom, right into the bone.

01:21 That helps the patient have stability, keeps that hip replacement in the socket, right, where we want it to be, and allows them to control that leg.

01:31 Now you see on the patient's left side, those are the original parts, right? That's what the patient came with, and that is still intact.

01:38 But because of the fracture that they experienced, when they have a total hip arthroplasty, this is the procedure that's done.

01:46 So you've got that heading into the socket, right? That is a tabular component.

01:50 It's a rounded spherical surface, then you've got the femoral stem that goes down into the patient's bone.

01:58 Wow, this is why it's a lot to come back from.

02:01 So you have this component, that surface, there's a little liner on the inside, there's a plastic liner, and then there's what you call the femoral head.

02:08 Now the patient's femoral head on the left is the one they were born with.

02:13 The one that we have here on the right is metal.

02:15 That's what's being replaced.

02:17 So that gives you kind of a close up version, we've broken it down for you.

02:21 So you see the components of the hardware that's used in a total hip arthroplasty.

02:28 One of the things that fascinates me is the amount of range of motion the client has after this procedure.

02:35 I mean, look at how science has figured out how to restore this patient's ability to walk.

02:40 So even though the range of motion for an artificial hip is a little less than normal, it still lets the client have a very wide range of motion.

02:49 See their leg muscles will help keep that artificial leg in position, so it won't dislocate.

02:55 Now, here's the deal.

02:57 When we say dislocate, we don't want that brand new hip, that implant to pop out of its new socket.

03:03 So there's very specific care that you'll need to watch over and monitor after hip surgery.

03:10 We'll get into that in another series.

03:12 But now that you have this visual of what the patient has experienced, what their new hip socket looks like, it's going to make caring for this patient much more straightforward for you.

03:25 So one of you wrote in a question.

03:27 Can the client with an osteoporosis have a total hip arthroplasty? Well, let's think that through.

03:34 We know what osteoporosis is, right? It's a porous bone.

03:38 And a total hip arthroplasty is putting that big implant in there, like we talked about replacing the joint, putting the liner on, then pounding that into the femur.

03:48 Ah, pounding that into the femur.

03:52 I want you to predict, do you think if a patient can or cannot have this procedure, if they have osteoporosis? So pause, commit to your answer.

04:02 Write it down, and then we'll come back, and talk about it.

04:09 Oh, hopefully you said it depends, because that's really what the answer is.

04:14 Now, this wasn't a trick question.

04:16 But thinking about that going into the femoral head, right, going all the way down into that bone, if someone has minor osteoporosis, it likely can be done.

04:26 But the surgeon might have to make some adjustments. Why? Because now you're not putting it into solid bone.

04:32 You're putting it into porous bone.

04:34 So if they have minor osteoporosis, the surgeon may do things like use a longer implant so it's more stable.

04:41 They also might make some other adjustments, but they're going to be very aware of the patient's bone strength and adjust their strategies according to what they see.

04:51 Now, in severe osteoporosis, now you've got a real concern.

04:55 That bone may not be able to support the new joint, and then we have a significant problem.

05:00 that requiring nursing interventions and problem solving with the whole healthcare team.