Mrs. A is a 66 year old female with k/c/o diabetes and hypertension presented with c/o on and off pain over the both knee since 1-2 years with no h/o injury or trauma. Patient was initially managed with physiotherapy. Patient now c/o increasing pain over right knee more then left knee since 2-3 months. On examination pain and swelling present over right knee, crepitus present. X-ray was taken and showed severe tricompartmental osteoarthritis of both knee. Patient was diagnosed TRICOMPARTMENTAL OSTEOARTHRITIS BOTH KNEE. Hence patient was advised admission and surgery.
Pre-operatively: CXR, ECG, ECHO, USG and basic blood profile was done to assess the fitness for surgery along with a physician, anesthetist and a cardiologist opinion . And was given fit for intermediate surgery under intermediate risk.
Procedure:Under spinal anesthesia with the patient in supine position.After thorough skin preparation and under tourniquet control. The right knee exposed by midline skin incision and medial parapatellar approach.The synovium was found thickend osteophytosis were excised and soft tissue were adequately released.Tibia was found grossly deformed with bone loss on medial side. Femoral cuts were then done and sized to size 3. Tibial was then sized to size 2.The selected prosthesis was cemented and driven home and joint was reduced with insert size 13 mm and found to be stable. Thorough wound wash was. Hemostasis was obtained and wound was closed in layers with DT. compression bandage and knee brace was given.
Post-operatively patient was put on observation for a day in SICU to monitor vitals and other parameters after the surgery. During 1st post operative day patient was shifted back to the room and mobilized few steps with walker support under the assistance of physiotherapist. During 7th post operative day patient was discharged.