Recovery after Knee Joint Knee Replacement Surgery

About 10 years ago a Joint Knee Replacement Surgery meant at least 7 days of hospitalization. Now a days hospital stay is restricted to 48 to 73 hours and the operated patients are sent home with instructions. Your surgeon will let you know when it’s best to leave the hospital. This is based on the results of the surgery and your condition. He gives clear discharge instructions. Back at home there are a few diehards in ensuring quick and proper recovery. In India more than 50% of operated patients do not enjoy 100% benefit of Joint Knee Replacement as they did not focus on their recovery. They complain about incomplete range motion and pain. Some of the common problems encountered by a patient recovering in Home settings which come in the way of full recovery from Joint Knee Replacement Surgeries are given below-

  1. Reduced Physiotherapy: Many hospitals begin physical therapy the day after surgery to promote blood flow to the tissues around the new knee. Back home after surgery, you will still feel stiff at the knee joint. The joint must be moved as much as possible to prevent stiffness.
    1. Usually a physiotherapist is sent to the residence of the patient by the Surgeon at additional costs for a week or two and the Physiotherapist will provide physiotherapy for 20 to 30 minutes a day. In the remaining time of the day the patient has to do exercises on their own.
    2. There are instruments to ensure proper movement of knee joint. They are bulky and not carried by the physiotherapists to homes. Whatever exercise done by the physiotherapist is limited to 30 minutes of physical exercises without the aid of any device.
    3. After initial few sessions of physiotherapy, the recovering patient has to go physiotherapy centre for further physiotherapy. Such movement requires, help in mobilization, vehicle for movement apart from waiting at the physiotherapy centre and paying cost. At this stage regular exercises and physiotherapy is discontinued and such patients complain of pain despite the surgery.
  1. Physical help in lifting the patient: Though discharged from the hospital, the operated persons will not be in a position to move by themselves for at least 4 to 6 weeks.  In a joint family, help may be available at home. In most of the urban small families, however, such a help is not always available. For   proper recovery it is essential to have help of able-bodied persons at home who can help lifting the patient safely from the bed. The operated person needs help in using toilet, changing dress, getting up from bed etc. In cases where the level of support given by the family members is less, the recovering patients will be bed ridden for most part of the day. Such sedentary position on bed delays recovery.
  1. Problem of Accidental fall: Some recovering patients who do not have adequate help may experience fall complicating the recovery process. This should be avoided at any coat.
  2. Improper and inadequate facilities at home: Home is never a hospital which is more equipped to take care of a patient. There are many shortfalls at home viz.
    • Bed is usually a flat bed with foam mattress. What the recovering patient needs a Fowlers’ bed.
    • There may not be a wheel chair to mobilise a patient.
    • Commode may not be a western commode.
    • Toilet may not be at floor level. Etc.
  1. Assistance of patient attendant: Most of the recovering patients obtain the help of a patient attendant provided by man power supply agencies. These attendants are expected to help the patient in ambulation, bathing, feeding etc. There are problems in hiring such an attendant in home settings
    • The patient attendants are usually untrained in handling patients. They can not recognise any medical complication.
    • Usually Patient attendants do not stick in a place and function for a few months.
    • Some one other than the patient must be at home to provide food for both the patient and the attendant.
    • A continuous vigil has to be kept on the patient attendant.
    • Above all, nurses are required for wound dressing and maintenance of hygiene of the patient and this work can not done by the patient attendant.
  1. Issues relating to improper Clinical care at home:
    • While at the hospital you would have received which would have helped you to endure the pain. You may receive possibly a nerve block to help with postoperative pain. Yet at the time of discharge You’ll have pain. Untrained patient attendants cannot ensure compliance to prescribed medication.
    • Clotting of blood can cause problems. Home attendants cannot ensure freedom from blood clots during the recovery process.
    • A recovering patient with comorbidities like diabetes or hypertension will have to monitored very closely by trained personnel.
    • There are some complications associated with knee Joint Knee Replacement and most of them are related to improper handling of the patient during the recovery period. Therefore, one has to watch for the following symptoms and take remedial action.
      • Bleeding from the wound
      • Breathing problems if any felt by the recovering patient.
      • Continuing knee stiffness
      • Experiencing chills
      • Possible drainage from the point of surgery.
      • Patient having fever over 100°F (37.8°C)
      • Patient experiencing pain, redness, swelling, and tenderness in the knee
      • Possibility of infection of the wound. Infection is an ongoing concern for people who receive artificial joints and also if they have diabetes.