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Patient guide

Consultation with Dr Raj Kanna - Orthopedic Specialist Chennai

Consultation is done either at Doctor’s Clinic (Dr Raj Kanna Knee & Ortho Clinic) or at one of our tie-up centers (Westminster Healthcare, Apollo Spectra Hospital) depending on the date and patients priority. Prior appointment is necessary. For the appointment, you can contact the following numbers

Phone                          : 0091 96262 62945

Whatsapp                    : 0091 96262 62952

Srilanka Patients        : 0 75525 0963

Email                           : rajkannas@yahoo.com

We will confirm you the appointments within 24 to 48 hours.

Patient safety

The surgical treatment will be planned in one of our tie-up hospitals based on the patient’s choice. Our tie- up hospitals are NABH ( National Accreditation Board for Hospitals) accredited for maximum patient safety and care.

 

Getting ready for Surgery

This can be done in one of the following two ways depending on the patient’s choice.

  • The patient gets all the tests and opinions prior to hospital admission. The patient gets admitted to the hospital on the evening before the surgery date.
  • The patient gets admitted to the hospital 24 hours before the planned surgery date. All investigations and opinions are obtained thereafter. .

Caution: Patients who are on blood thinners (agents used to prevent clotting of blood such as Aspirin, Clopidogrel etc) are supposed to stop it 5 to 7 days before the planned surgery date. We generally get cardiologist opinion for all patients who are aged greater than 40 years prior to undergoing surgery. It is advisable to discuss with the cardiologist before stopping such medications.

The evening before surgery

The evening before surgery patient will be seen by the anesthetist. Type of anesthesia (Reginal or general) and other anesthesia-related queries can be sorted out with the anesthetist at this point. The patient will also be seen by a physician to manage comorbid conditions such as Blood pressure, Diabetes, etc… The ward nursing staff will prepare the leg planned for surgery. Also, they will do some sensitivity tests for medications which are to be given during and after surgery.

Type of anesthesia

We as a routine prefer to give spinal + epidural anaesthesia to anesthetise the leg. Patient will be completely conscious during the procedure. But if the patient does not want to be awake a gentle sedation will be given, putting the patient to sleep till the end of the procedure. On few occasions we have to choose general anaesthesia where the patient becomes unconscious throughout the procedure. The choice of anaesthesia will be decided by the anaesthetist after having a complete discussion with the patient.

Duration of the surgery

Generally for a single knee replacement the time taken will be 70 to 90 minutes depending on the complexity of the case. We do all our cases with computer assistance which helps the surgeon to do every step of the surgery accurately without error.

After the surgery

After the surgical procedure patient is observed in the recovery room for two to three hours and then they are shifted to their rooms. Aged patients (more than 75 years) or those with medical risks are observed in intensive care unit. Such patients are usually observed for 24 hours and then they are shifted to their rooms.

Pain Management

We follow a specialized protocol which was co-published by Dr Rajkanna in an American journal, “Journal of Arthroplasty” in the year 2010. As a part of the protocol pain controlling medications are started 12 to 24 hours before surgery which prepares the central nervous system well in advance and closes the pain gate, so that the brain does not feel the pain at the time or after the surgery. Secondly the medications are carefully and rationally combines for maximum action with minimum or no side effects. Finally using cryo (ice) therapy and pain controlling pumps have revolutionized the pain management after such major surgeries.

The patient will be allowed to take fluid orally in about 5 to 6 hours after surgery. Normal diet is usually given the day after surgery. Diet for the patient will be provided by the hospital.

Recovery after surgery - Physiotherapy

Bed exercises are commenced soon after surgery. The patient will be made ambulate in the following days after surgery as per the below-mentioned schedule. Recovery time vary between patients depending on multiple factors including their general health condition.

Day 1 – Standing and walking a few steps with the assistance of a walker. Knee bending as tolerated.

Day 2 – Little more walking with the assistance of a walker, chair sitting and more knee bending.

Day 3 – Walking in assistance with the walking stick. Toilet training.

Day 4 – Stair climbing and discharge to home.

In the case of both knee replacements on the same day, the above rehabilitation will take place in 5 or 6 days duration and the patient will usually be discharged home by day 6.

The rehab protocol varies slightly for cases undergoing Key Hole surgery depending on the procedure. Physiotherapy support can be extended after discharge if the patient needs it. In that case, we have our network physiotherapists who will take care of the patient by visiting them at the place where they stay.

Medications to be taken after hospital discharge

A clear and detailed treatment summary will be provided to the patient at the time of discharge. Medications to be taken after discharge will be summarised and explained to patient and their attenders to the point.

Follow up after discharge

The patients are followed up in the outpatient clinic every 3 to 4 days and sutures are usually removed by day 12 or 13.

Accommodation and Food for Attenders

Usually one or two attenders will be allowed to stay with the patient depending on the room category and the hospital policy. Food to the attenders can be provided at special request.

Flight Travel after Surgery

Patients are usually fit to travel by flight one or two weeks after surgery depending on the surgical procedure. Fitness letter to travel by flight will be provided at request.

VISA support

Overseas patients are advised to come in Medical VISA if they are planning for surgical procedure. We will be able to provide you the VISA support letter after going through your medical reports.

 

Authored By Dr. Raj Kanna - Orthopaedic and Knee surgeon, Chennai

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