Total joint replacement in patients with dementia syndromes: a report of thirteen cases.

Abstract

The hospital course and clinical outcomes of 14 joint replacement surgeries in 13 patients with dementia syndromes were evaluated. Eight patients were disoriented postoperatively. Complications included slow progress in physical therapy, getting out of bed unattended, aggressive behavior, pulling out an intravenous or Foley catheter, and falling out of bed. Three patients were unable to comprehend their movement restrictions, resulting in one dislocated hip from bending and twisting. Eleven of twelve joints available for follow-up were believed to be painless and functional. One patient was inactive due to fractures secondary to osteoporosis. Although complications arise from patients' disoriented status, total joint replacement relieves pain, and the patients' relatives indicated satisfaction with the results of the surgery. The family of a patient with dementia syndrome must be actively involved in all aspects of care after total joint replacement.