Chapter 46: Concepts of Care for Patients With Arthritis and Total Joint Arthroplasty

Osteoarthritis represents a noninflammatory degenerative joint disease characterized by progressive cartilage breakdown, resulting in chronic pain and functional limitations that affect patient mobility and quality of life. In contrast, rheumatoid arthritis is a systemic autoimmune condition in which the immune system attacks synovial tissues, causing persistent inflammation, joint damage, and potential deformities; patients with rheumatoid arthritis often experience significant fatigue that necessitates energy conservation strategies and psychosocial support addressing body image concerns. The chapter emphasizes multimodal management approaches for osteoarthritis, combining pharmacologic interventions such as nonsteroidal anti-inflammatory drugs with nonpharmacologic strategies including regenerative therapies and rehabilitation. Rheumatoid arthritis treatment prioritizes disease modification through disease-modifying antirheumatic drugs and biological response modifiers, which require careful monitoring for infection risk and tuberculosis screening given their immunosuppressive effects. For patients undergoing total joint arthroplasty procedures such as total hip arthroplasty or total knee arthroplasty, nursing care focuses on preventing serious postoperative complications including joint dislocation, venous thromboembolism, and surgical site infections. The chapter stresses the importance of preoperative rehabilitation to optimize functional outcomes and describes postoperative pain management strategies utilizing multimodal protocols and peripheral nerve blocks. Throughout the continuum of care, nurses must address both physiological needs related to joint function and psychosocial concerns associated with chronic musculoskeletal disease, supporting patients through rehabilitation and adaptation to activity modifications or prosthetic joints.