Once considered a high risk, joint replacements are now very common. It is termed as ‘a life-changing procedure’.
INFECTION :If there is any existing infection in the body
OBESITY :If the patient is overweight
NEUROPATHY:In case of any nerve damage
Medical evaluation - Good cardiopulmonary function can withstand anesthesia and to cope with a blood loss of 1000-1500 ml
Antibiotics and antithrombotic prophylaxis are administered approximately 30 minutes before the incision is made.
Mechanical anti-thromboembolic devices like struva, stockings and foot pumps are used intra-operatively to prevent thrombosis.
Adequate Hydration & Analgesia :The patient undergoes recovery & is usually observed for a 24-hours period in a High-Dependency Unit. Adequate hydration and analgesia are essential at this time of high physical stress. Analgesia is provided through continuation of the intraoperative epidural, patient-controlled intravenous analgesia or oral analgesia. Cryotherapy is used to reduce post-operative swelling and pain.
Beginning of Knee Movement :At this early stage, the patient begins knee movement, sometimes using a Continuous Passive Motion (CPM), machine & exercises. These are continued under the supervision of a physiotherapist until discharge. Drains are usually removed within 24 hours, and the patient is encouraged to walk on the 2nd postoperative day. Continual improvement is generally observed & discharge occurs in 5-14 days depending on speed of recovery.
Discharge :Discharge is recommended only once wound healing is satisfactory, knee flexion of 90 degrees has been achieved, the patient is considered to be safe and supported in the home environment & no complications are present. Thromboembolism prophylaxis is often continued at home for a period of time. The first outpatient review generally is in 6 weeks to 3 months