You could be reading the full-text of this article now if you...

If you have access to this article through your institution,
you can view this article in

The Cycle of Comorbidities: Potential Risks With Delayed Joint Replacement

Camillo, Patricia; Thompson, Patricia; Goodman, Stuart B.; Jiang, Yanli

Orthopaedic Nursing:
doi: 10.1097/NOR.0b013e31827d96be
Original Articles

Joint replacement is an option that has demonstrated significant improvement in the quality of life for individuals with severe arthritis. However, it is often delayed either in an attempt to avoid future revision surgeries or for other personal reasons. Increasing disability leads to inactivity, chronic pain, and sleep disruption, each of which cycles into significant comorbid risks, many of which are life-threatening. A beginning conceptual framework identified as the cycle of comorbidities is presented to identify these risks and help guide both the patient and the provider in the decision-making process associated with joint replacement surgery.

Author Information

Patricia Camillo, PhD, RNC, GNP/WHNP-BC, NCMP, Founder of

Patricia Thompson, MSN, RN, FNP-BC, Nurse Practitioner, Stanford University Medical Center, Boswell Joint Replacement Clinic, Palo Alto, CA.

Stuart B. Goodman, MD, PhD, FRCSC, FACS, FBSE, Professor, Department of Orthopedic Surgery, Stanford University Medical Center, Boswell Joint Replacement Clinic, Palo Alto, CA.

Yanli Jiang, BSN, RN, ONC, Orthopedic Staff Nurse, Stanford University Medical Center, Joint Replacement Center, Palo Alto, CA.

The authors have disclosed that they have no financial interests to any commercial company related to this educational activity.

© 2013 National Association of Orthopaedic Nurses