Total Hip Replacement and the Middle-Aged Adult
             "Indications for THR include (1) failure of conservative treatments, (2) severe compromise of the client's functional ability, and (3) significant pain (Black, Hawks, Keene,2001).
             "Total hip replacement may also be performed for complications of femoral neck fractures, congenital disease or deformity, and failure of previous fixations or arthroplasties (Black, Hawks, Keene,2001). Total hip replacement was the first successful total joint replacement to be performed in 1958. Most patients attain 90% of their functional ability by 1 year after surgery. THR usually results in an immediate reduction of the patient's pain. The most common concern of most patients is hip dislocation which actually only occurs in 2% of patients that have undergone surgery. Other serious complications include venous thromboembolism and infection.
             The Affects of THR on the Five Dimensions of Wellness
             THR affects the musculoskeletal system by decreasing the activity level which may cause the patient's muscles to cause atrophy. " The most frequently cited problem for patients with hip involvement was lower back pain..." (Johnston, Jones, Suarez-Almazor, Voaklander, 2001). " Since prolonged bed rest can cause joint contractures, muscle weakness, and demineralization, exercise is an important part of the postop routine" ( Dunajcik, 1989). Neuro/Sensory. Immediately post-op, in the recovery room all of the patient's senses would be less reactive and their balance and sense of orientation would not be as if they would normally be. This should be taken into consideration when assessing the neuro/sensory systems of the patient. The patient may be dosing off into sleep and may not be able to articulate what he or
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