At present the number of people required placed a knee prosthesis is increasing an unstoppable, and lengthening life expectancy, so continue to grow increasingly important. The knee prosthesis is the usual treatment of knee osteoarthritis when conservative treatments (infiltrations, templates, recovery) are no longer effective.
One of the problems that most scares people is, apart from the fact undergo surgery, distress related to pain the days and weeks subsequent to the intervention and shall specify whether or not transfusion.
In Traumatology Institute associats J Tuneu i put the knee with two basic premises:
Very significantly decrease pain in the whole process and systematically avoid blood transfusions.
For the treatment of pain let's break down the immediate postoperative pain the pain of recovery or rehabilitation.
For the immediate post-operative pain, a protocol intraoperative infiltration of local anesthetics in different internal points of the knee while operating is seeing that is highly effective. Along with the anesthesia department we have a protocol epidural catheter for 48 hours and pump intraspinal pain so we get most often minimal pain in the first two days which is when the wounds are more tender and so both when the process is more painful.
For the third day we turn to conventional medication and began the soft functional recovery in the Room. To lessen the pain we have suppressed the motorized type ferrules Kenetec and spent the minimum and gentle mobilization with physiotherapist, and walk twice a day.
We have the patient between 6 or 7 days at the clinic to finish in the last two days teaching up and down stairs and getting high flexion to 90 °.
At the end of the clinical team Traumatology Institute Tuneu J i associats we have taught the exercises to follow a smooth work program in your own home without having to go to a physiotherapy center.
With this pattern of exercise we have deleted the pain of recovery and we have realized that the mobility of the knee is the same as we were getting before with long recovery sessions forcing the knee with the consequent suffering of the patient.
As for transfusions, equipment Institut Traumatology J Tuneu i associats have practiced over 300 consecutive surgeries prosthesis primary knee without transfuse simply with new protocols applied treatment Local intravenous tranexamic acid or, or the combination of both. To this it has been very useful collaboration of bloodless surgery unit of Teknon Medical Center.
We use tranexamic acid intravenously, where there is no pathology that contraindicated, or as a local product diluted in the washing liquid of the surgical field that are regularly used to irrigate the operative site.
A careful review of the bleeding, the corresponding clotting, at the end of surgery and tourniquet release, is enough to close the wound with the tranquility of having a postoperative with little pain and minimal blood loss and consequent security will not transfuse our patient.
All this makes us a postoperative much easier without having the impression of having suffered.