DIAGNOSIS: Bilateral knee osteoarthritis

COMPLAINTS ON ADMISSION:
This

pleasant

gentlemen

was

admitted

with

complaints

of

bilateral knee pain since few years. Pain was insidious in

onset, localized over knees, non-radiating and progressive in
nature. Pain was aggravated by walking and partially relieved
by

rest

and

analgesic

medications.

Overtime

the

pain

has

worsened and patient has developed difficulty in walking and

sitting with crossed legs. At present, he has severe pain and
is unable to walk and carry out activities of daily living.

PAST HISTORY:
History of Hypertension - on medication

ON EXAMINATION:
Conscious, alert, oriented
General condition - Fair
Vitals - Stable
Systemic examination - No abnormality detected

LOCAL EXAMINATION OF RIGHT KNEE:

Tenderness - Present
Swelling - Present
Valrus Deformity - Present
Flexion = 20 degree
ROM- painful = 20-100 degree

LOCAL EXAMINATION OF LEFT KNEE:

Tenderness - Present
Swelling - Present
Valrus Deformity - Present
Flexion = 20 degree
ROM- painful = 20-100 degree

TREATMENT GIVEN:
Patient was evaluated and advised surgery. After cardiology,
PAC clearance and informed consent he was taken up in OT on
08/09/2016

wherein

left

total

knee

replacement

and

on

10/09/2016 right total knee replacement was done under general

anesthesia.

Postoperatively

patient

was

taken

to

ICU

and

stabilized then shifted to ward. Drain was removed on second

postoperative day. Wound was inspected and found to be dry and
healing well. Physiotherapy exercises were started and patient
was taught hip and knee strengthening exercises. Cardiologist
advice was taken in view of hypertension

and was accordingly.

He was mobilized with the aid of walker. He is now being

discharged in stable condition.

At the time of discharge patient is comfortable, afebrile and

pain free. Surgical wound is dry and healthy and patient is
comfortably ambulant with the help of walker.

IMPLANTS USED:

ADVICE ON DISCHARGE:

Walker aided ambulation with short knee immobiliser over

right knee.

Use of high commode chair.

Continue physiotherapy as taught-Q-drill/Ankle pump/SLR

Limb elevation over pillow during night.

Avoid sitting on low chairs and Indian toilet.

Ice packs application locally for 10 minutes thrice daily.

Tab.

Crocin

Pain

Relief

breakfast, lunch and dinner) x

tab

thrice

daily

(after

9 days.

Tab. Gabapin NT 1 tab once daily after dinner x 9 days

Tab. Pantocid 40 mg 1 tab twice daily ( before breakfast

and dinner) x 9 days

Cap. Nutrolin-B 1 cap once daily (after lunch) x 9 days

Tab. Xarelto 10mg 1 tab once daily (after lunch) x 9 days

Tab. Atarax 25 mg 1 tab twice daily (after breakfast, lunch

and dinner)x 9 days

Syp. Mucaine gel 2sf thrice daily (after breakfast,lunch and

dinner)9 days

Tab. Emset 8mg 1 tab to be taken in case of vomiting

Tab. Dolonex-DT 1 tab to be taken in case of severe pain

Syrup. Looz 30 ml to be taken in case of constipation

Infen

patch

applied

on

medial

aspect

of

both

knees

to

be

changed daily.
Fentanyl patch applied on

left thigh on 14/09/2016

to be

changed on 17/09/2016 next to be changed on 20/09/2016 and

next to be changed on 23/09/2016

AS ADVISED BY CARDIOLOGIST (DR. A. DHALL)

Tab. Metolar 50 mg 1 tab twice daily (after breakfast,lunch
and dinner)
Tab. Minipress 5 mg 1 tab twice daily (after breakfast,lunch
and dinner)
Tab. Amtas 5 mg 1 tab twice daliy (after breakfast,lunch and
dinner)

Review on 24/09/2016 (Saturday) for suture removal in

OPD with Dr. Bhushan Nariani after prior appointment or
SOS in emergency.
In

case

of

9818063869.

emergency

contact

Dr.

Bhushan

Nariani