DR. ANINDANSU BASU
MBBS , D. Ortho (Gold Medalist) DNB, MNAMS,
F.I.C.S. , MS(Ortho), M.Ch.(Cambridge UK)
Senior Orthopaedic Consultant, FORTIS HOSPITAL
Fellow ADDENBROOKE'S HOSPITAL, England
CALL US AT
94772 90220
WHATSAPP US AT
94772 90220
KNEE REPLACEMENT GUIDELINES
YOUR PATHWAY TO RECOVERY
-
After consultation the patient will undergo OT counselling.
-
Surgeon will suggest a Surgery date.
-
Before the date of admission, patient will be required to complete the pre-surgery orthopaedic tests as instructed by the surgeon.
DAY BEFORE SURGERY
-
Patient will have to take admission for surgery.
-
Patient will go through a check up from our anaesthetist team.
-
Our medical team will guide Patient with regular medications when there are other co-morbid conditions (like uncontrolled Diabetes, Blood pressure, Cardiac issues etc) .
-
Take a good sleep at night. If required anti anxiety or sleeping pills will be prescribed.
SPECIAL DAY OF SURGERY
-
Patient will have breakfast within 8 am in the morning (4 - 6 hours before surgery).
-
After 8 am patient will have to follow the fasting instructions (no food and water by mouth, for 4-6 hours before surgery).
-
Then the patient will be taken to the operation theatre for surgery.
-
Family members presence is compulsory for the signature in the consent form and also for moral support of the patient.
-
1 to 2 hours is generally required for surgery and 30 minutes extra is required for anaesthesia to complete the OT procedure, depending on patient's condition.
-
For the surgery combined analgesia (as per the best standard practice all over the world) is used mostly spinal anaesthesia and regional block or adductor canal block is used, which makes the post operative pain almost nil (if the patient has not done analgesic abuse before).
-
Then patient will be shifted to bed according to the patient's medical condition.
-
Based on medical comorbidities if required the patient may be shifted to a specially monitored bed or ICU.
-
Patient will be under customised pain control medication based on kidney, lung and heart condition..
-
Depending on the condition of the patient if required additional medication will be provided if there is any severe break-through pain.
-
VAS Score will be monitored every day after surgery to alleviate the pain.
DAY AFTER SURGERY
-
Our dedicated team of physiotherapists and rehab consultants will attend the patient, on the very next day of the surgery.
-
Under supervised guidance the patient will walk with the assistance of a walker or walking stick (from day - 1.after surgery).
-
Patient will undergo physiotherapeutic sessions twice a day as per standard guidelines under supervision.
-
We use advance state of art equipment like CPM machine for knee bending exercises as per pain tolerance level of the patient.
-
Then the patient will be under medical monitoring for the next 2 to 3 days based on vital parameters and blood report.
-
Patient will be mobilised with walking frame under supervision from day-1 within 6-12 hours after surgery, (accelerated rehab). From day-2 patient will be given bed to bathroom training, so that the patient can go to the toilet independently (based on patient's spine and upper limb power).
-
Patient will be discharged from the hospital on the 3rd or 4th day after surgery depending on medical conditions of the patient.
-
For bilateral procedure, on the 4th day the patient will undergo 2nd surgery and follow the above mentioned instructions.
AFTER DISCHARGE
-
Our home care professionals will take care of your dressing and physiotherapy sessions at your home.
-
Every patient is different, the overall physiotherapy session may generally require 2 - 6 weeks after surgery. Depending upon the recovery progress of the patient the physiotherapy sessions will be reduced (initially every day, then twice/thrice a week, then once a week and so on) and may extend up to 8 weeks .
-
Cold compress with ice gel pack is a must for initial 4 - 6 weeks.
-
After 15 to 20 days of surgery the patient will have to take an appointment for post surgery follow up and evaluation.
-
For long distance patients, if the patient is unable to come, post surgery follow up appointment through tele-consultation is must on 15 - 20 days after surgery, with the surgeon and the professional rehab team.
-
It is advisable to adhere to the post-surgery instructions for overall patient's well-being and to avoid any further complications.If any complication arises due to negligence in following the instructions given by the surgeon and our expert team, patient will be solely liable for such circumstances. This is for your own interest to completely avoid any undue complications.
-
If things go unplanned during this period then the patient is suppose to contact our care team
CALL US AT 94772 02020
DOs
Follow surgeon's instructions : Adhere to specific guidelines provided by your surgeon, for faster recovery.
Disclose all medical history : Inform your surgeon about any medical conditions, allergies, or medications.
Stop smoking : Quit smoking to reduce surgical risks and promote healing.
Maintain a healthy diet : Eat nutritious food to support recovery.
Stay hydrated : Drink plenty of water to ensure optimal hydration.
Stop Blood thinners : Stop blood thinners 5days before surgery under medical supervision. Patient may require switchover therapy as per instruction of the surgeon.
Prepare your home : Arrange for post-operative care and modify your home for safe and accelerated recovery.
Attend pre-operative appointments : Keep scheduled appointments for pre-operative testing and evaluation and consult specialised doctors for any pre-existing comorbid assessments.
Follow post-surgery instructions : It is advisable to adhere to the post-surgery instructions for overall patient's well-being and to avoid any further complications.
DON'Ts
Don't take certain medications : Avoid taking medications that may increase bleeding risk, such as aspirin or NSAIDs, without consulting your surgeon.
Don't eat or drink : Follow fasting instructions provided by your surgeon or anaesthesiologist.
Don't wear makeup or jewellery : Remove makeup (including nail-polish), jewellery, and contact lenses before surgery.
Don't wear dentures : Remove all teeth dentures (partial or complete) before surgery.
Don't drive yourself : Arrange for someone to drive you home before and after surgery.
Don't lift heavy objects : Avoid heavy lifting, bending, or strenuous activities before and after surgery.
Don't ignore instructions : Follow surgeon's instructions carefully to ensure a smooth recovery.
GENERAL
1. Keep your walker, cane, or other assistive walking device within reach at all times.
2. Use chairs with straight backs and sturdy arm rests which make it easier to stand.
3. Raise the seat height of a low chair by adding a cushion.
4. Clear clutter from pathways so you do not fall.
5. Ask someone to help clean up spills.
6. Keep your phone, medication, water bottle, and watch on the side of your bed
7. Tape down electric cords or tuck them behind furniture
8. Use a night-light or have a light source in every room.
9. Keep the bathroom lights within hand reach and always keep switched on at night.
10. Move the items you use most often to counter height to avoid excess bending or reaching.
11. Maintain health hygiene and keep the surgical site dry.
BEDROOM (GUIDANCE)
1. Sleep on a bed that you can get in and out of easily.
2. Post surgery keep the bedsheet plain (preferably light single coloured or white) and not Floral printed.
3. Drying and dusting of the bedsheet is a must
4. Music therapy is helpful with patient experiencing insomnia post surgery.
5. Keep an emergency bell beside the bed ai ways.
6. Use bedroom with attached bathrooms for night sleep.
7. Keep pillow behind ankle, not under calf muscle at any cost for initial 2-3 weeks.
BATHROOM (TIPS)
1. Prevent slips and falls by installing railings and non-slip surfaces.
2. Check existing and install a handrail for support during defecation and taking shower for stability.
3. You and your therapist may discuss ways to raise the height of your toilet seats (with commode elevator) as per patient's comfort.
4. Watch out for hazards, such as wet floors. Always keep bathroom dry and ventilated.
5. Dry off in the shower to prevent bringing water out onto the floor.
6. Stock up on toiletries and other items you will need during recovery
STAIRS CASE CLIMBING
1. Arrange things so you do not have to use the stairs often in initial 2 to 3 weeks.
2. Make sure stairs have handrails that are securely fastened to the wall.
3. Fix loose or uneven steps.
4. Cover bare wood stairs with non-skid strips. If there is carpet, be sure it is firmly attached.
RULE OF THUMB
while going up use the better knee & while going down use the relatively bad knee.
OUTDOORS
1. Try not to walk on uneven sidewalks or ground.
2. When stepping off a curb, be aware of its height.
3. One should use cane/walker support for case during initial 2-4 weeks.
4. Use your cane/walker during rainy days or if the weather is bad.
4. Add more outdoor lighting if needed.
5. Watch for pets that could trip your feet, jump on you, or lie in your walking path.
6. Use well cushioned shoes with firm grip and lace, for outdoor activities.
CAR TRANSPORT
1. One can travel on a car within 10-14 days with adequate leg space.
2. Driving is mostly allowable after 6 weeks
MUST REQUIRED THINGS POST SURGERY
WALKER
COLD PACKS
(GEL) -NOT SOLID ICE PACKS
COMMODE ELEVATOR 4"/6"
PULSE OXYMETER
DIGITAL BLOOD PRESSURE MONITOR
GLUCOMETER
TED STOCKINGS
POST SURGERY RED FLAG SIGNS
WHEN YOU MUST VISIT DOCTOR
SEVERE PAIN (VAS>=8)
SURGICAL SIGHT SOAKAGE
FEVER (>100 ⁰ F)
SHORTNESS OF BREATH (SPO2<90%)
CHEST PAIN AND/OR PALPITATION
CALF TIGHTNESS AND PAIN
SURGICAL SIGHT REDNESS
FOR EMERGENCY CONTACT US AT
CALL US AT
94772 02020 | 90880 67373
WHATSAPP US AT
90880 90220