SURGERY


   
Care after SHOULDER Surgery Surgery --- Day 1, Day 2, Day 3, Day 4, Day 5 & 6, Day 7

DAY 1

Exercises done by the CPM:

This exercise helps in regaining early range of movements ( ROM ). The machine works on electricity. It helps in bending and straightening your knee without your active efforts. It has a feature of pre-setting the angle of flexion and time delay at the end of flexion and extension. On the first day the angle of flexion is set from 10-30 degrees and delay time is set at 5 seconds. The CPM is given for 1 to 2 hours in the morning and in the afternoon.

Exercises to be done by you:

On the day after the surgery, knee exercises, which were taught to you prior to the surgery are begun. All these exercises help in improving body circulation and the circulation of the operated limb thereby reducing the swelling. It also prepares you for early walking. These exercises also help in reducing the incidence of calf clots (deep vein thrombosis and lung complications pulmonary embolism) secondary to calf clots.

  • Static Quadriceps Exercise: In this exercise, you tighten your knee cap till the count of 3 seconds and loosen it for another count of 3 seconds. On the first day , it is done in the set of 5, every hour.
  • Calf pumps: Moving the foot up and down, at the ankle joint to its maximum. This exercise reduces the incidence of calf vein clots. On the first day it is done in set of 5 every hour.
  • Upper limb exercises: Done either in sitting or propped up in bed.
    • Raising the arms by the side.
    • Spreading the arms by the side.
    • Bringing the arms together in front
    • Elbow bending and straightening.
    • Spring dumbell.
  • Deep breathing exercises: This is done with a machine called triflometer. To be done in set of 10, twice a day.

DAY 2

  • Dressing will be done and drainage tube will be removed: The dressing will become smaller , so that you can exercise your knee better.
  • The same set of exercises you did yesterday will be done today.
  • The epidural will continue in reduced dosage: You will be given mild pain relieving tablets.
  • For the patients operated on single knee, today is the last day of antibiotic course. After the last dose, your intravenous line will be removed.

DAY 3

  • The epidural tube will be removed.
  • The urinary catheter will be removed.
  • Your exercise programme will continue.
  • The CPM angle will be increased to 40 degrees.
  • You will be made to stand up with the help of a walker and may be allowed to walk few steps if your condition permits.

DAY 4

  • Today will be last day of antibiotic injections for patients operated on both knee joints.
  • Your exercise programme will continue.
  • The CPM angle will be increased to 50 degrees.
  • You will be made to sit at the edge of the bed and knee bending and straightening will be started today. To be done twice a day.

DAY 5 & 6

Today those who have only one knee operated are ready for discharge after learing the following exercises.

Those operated on both the knees together will go continue the exercise program and will go home on 7th or 10th day.

  • Sitting on an office chair, you move the chair by pushing the chair with your operated leg.
  • Stationary bicycling.
  • Climbing stairs, small steps.
  • Straight leg raising. The exercises will concentrate on getting more knee bending and getting more power in the operated leg.

DAY 7

The goals before discharge are:

  • Ability to stand and walk few steps with support.
  • Ability to bend knee > 75 degrees.
  • Ability to lift leg straight up in lying down position.
  • To be able to sit on a commode.
  • To be able to get up from sitting position.
  • Good balance while walking.