Operative preparation of the knee prosthesis operation
Since the knee prosthesis operation is performed under anesthesia, either the general practitioner or an internist must determine the patient’s suitability for anesthesia (anesthetic capability). This is done by checking the general state of health. If necessary, various measures must then be taken to establish the ability to anaesthetize.
This can mean, for example.
- The discontinuation of certain blood-thinning medications, such as Marcumar or Aspirin mean (usually at least 10 days before the surgical procedure) But also certain medications for pathologically elevated blood sugar (diabetes mellitus), e.g. metformin, must be discontinued 2 days before the operation, whereas most blood pressure medications may continue to be taken. Ultimately, these decisions about which medications to discontinue and when should be made together with the family doctor and the operating clinic.
- Or the treatment of a heart failure
- Adjusting the blood pressure in case of high blood pressure
- Or a possibly existing blood sugar increase in diabetes
The clarification of the ability to anaesthetize and thus the general state of health is essential for the postoperative prognosis of the knee prosthesis operation and thus for the entire wound healing process.
However, various other measures can also be taken, either during the operation itself or during the rehabilitation phase, and thus also influence the outcome. Some of these measures are listed below: Autologous blood donation: Since increased blood loss cannot be ruled out during a knee prosthesis operation and since it is usually an elective procedure, the date of which is fixed in advance, it is possible for the patient to donate his or her own blood in advance. This prevents foreign blood from entering the patient’s own body in the event of a necessary blood transfusion, which ultimately also eliminates the risk of disease transmission through foreign blood.
An autologous blood donation is usually done on an outpatient basis about two to four weeks before the planned procedure. During this procedure, 500 ml of blood is then taken. Cellsaver: If cellsaver systems are used in the operating clinic, an autologous blood donation can often be avoided.
These systems purify the blood lost during the knee prosthesis operation, which can then be returned to the patient. This minimizes the blood loss for the patient. The donation of foreign blood becomes rare.
Physiotherapeutic measures:If there is already a severe impairment of movement before the operation, physiotherapeutic measures should be taken before the knee prosthesis operation. This can strengthen the muscles, but also improve mobility, which should enable the patient to achieve faster and better rehabilitation after the prosthesis is fitted. The patient should be admitted to hospital at least one day before the operation.
During the inpatient admission a detailed discussion of all planned measures, all possible complications and risks takes place. The surgeon or the assistant physician examines the patient once again thoroughly with regard to the extent of movement and ligament stability of the knee joint. X-rays are taken for preoperative planning and to determine the expected prosthesis model.
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