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Knee Pain Treatment
Spinal Surgery Disorders
Treatment of Neurological Problems
Treatment of Joint And Muscle Problems
Treatment of Nerve And Muscle Disorders
Acl Reconstruction Procedure
Joint Dislocation Treatment
Knee Care Procedures
Joint Replacement Surgery
Ankle Pain Treatment
Treatment of Spondylosis
Arthritis And Pain Management Treatment
Treatment of Joint Dislocation
Treatment Of Disk Slip
Treatment Of Herniated Disc
Knee Injury Treatment
Treatment of Spine Injuries
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Patient Review Highlights
Multimodal pain management has become an important part of the perioperative care of patients undergoing total joint replacement. The principle of multimodal therapy is to use interventions that target several different steps of the pain pathway, allowing more effective pain control with fewer side effects. Many different protocols have shown clinical benefit. The goal of this review is to provide a concise overview of the principles and results of multimodal pain management regimens as a practical guide for the management of joint arthroplasty patients.
Multimodal denotes administering two or more than two types of medications that work with different mechanisms. The following are the techniques used:
Pre-operative Femoral Nerve Block: Prior to the surgery, a catheter is placed beside the femoral nerve for blocking it. This nerve is located in the upper thigh. Medication is delivered through the catheter for the nerve to be numbed for 24 hours. Thus, pain signals to the brain are blocked. This method reduces the use of narcotics and the consequent side effects.
Patient Controlled Analgesia (PCA): This method is also known as ‘Pain Pump’. An intravenous pump is used to administer pain relief medications, such as oxymorphone or morphine, after the surgery. The control button of the machine could be pressed, by the patient for 6 to 10 times per hour. The machine is used for two post-operative days.
Oral Medications: The oral medications include Non-Steroidal Anti-Inflammatory drugs or NSAID; such as Celebrex which is similar to aspirin, structurally. Alternatively, acetaminophen, such as Tylenol or its equivalent composition, can also be used.
Acetaminophen: It acts on the Central Prostaglandin Synthesis and relieves the patient of pain through multiple mechanisms.
Epidural Analgesia: It produces lower pain scores and involves less time for achieving physical therapy goals. However, this is subject to side effects such as dizziness, urinary retention and itchiness.
The objective of multimodal treatments is to provide quick relief to the patient and immediately so. Earlier the rehabilitation, more successful will be the knee replacement surgery.
My mother is suffering from arthritis and she is having swelling on hands and feet and it increases with almost everything she eats. Can you please suggest the doctor for the treatment.
Joint replacement surgery is a procedure where the damaged surface of the advanced arthritic joints are removed and replaced by artificial joints, such as metallic, plastic and ceramic joints.
These surfaces closely replicate the original anatomy.
When do you need a knee replacement?
When you suffer from severe pain or deformity in the joint (knee in this case), the pain or stiffness and deformity makes it difficult to perform simple tasks. Severe grade iv osteoarthritic knees of people over 50 years when have pain, swelling and deformity fail to respond to medicines, physiotherapy, injections and rest.
Aim of the surgery
Correct the deformity: relieve the pain and give near full movements almost immediately after the procedure. Details including techniques and safety, it is a safe, rewarding surgery with a success rate of as high as 99.5% when done by an able and experienced professional.
Anaesthesia: usually it is the spinal cord epidural where one is rendered numb for 3 to 4 hours waist down. Sometimes a general anaesthesia is given. A 4 to 5 inches cut is made in front of the knee and all the damaged cartilages, bones, loose bodies are removed from the lower end of the thigh, upper end of the tibia (usually of few millimetres) and the surface re-crafted to match the size and shape of the artificial joint (it is usually imported). They are fixed with bone cement. The ligaments and muscles are reattached and the parts closed.
Recovery: stand up and walk a few steps with a walker the day after the procedure i. E. In 24 hours. Physiotherapy in hospital for 5 to 7 days and/or walking. Progressively longer walks and exercises over the following 15 days. Stitches are removed in 15 days. The patient can return back to normal activity in 4 to 8 weeks the surgery.
Activities: normal walks of 3 to 5 km per day climbing stairs, cycling, swimming, and driving can be performed with the new implant (s) now.
Avoid: squatting/kneeling prohibited: contact sports like football, cricket, tennis; jumping; adventure sports longevity of joints: 15-35 years depending on the materials used.