DATE: 11-02-2018

DISCHARGE- SUMMARY
Name of the Patient: Mrs.B.Jayamma Age: 59 Y/F
Room Type: A.C (Single) D.O.A:01/02/2018
Address: Pandillapalli(V), D.O.S: 02/02/2018
Prakasam(Dt) D.O.D:11/02/2018
Consultant Name: Dr G.Sudhir Bhargav Reddy M.S., M.Ch (Ortho)
_________________________________________________________________________________
SUMMARY
PRINCIPAL DIAGNOSIS: GRADE IV OSTEO ARTHRITIS RIGHT KNEE WITH
OSTEOPOROSIS.
HISTORY:
Patient presented with the complaints of
 Pain
 Deformity
 Inability to sit cross legged and squat.
Pain more over medial joint line.
Pain increases on walking rest and decreases on taking rest and medications.
Patient was on symptomatic treatment for all these days and came here for further follow up.
Examination of both knees: Fullness in the suprapatellar region.
Tenderness in the medial joint line
Patellar grinding test positive
Lachmannstest negative
Anterior and posterior drawer test negative
Mc Murray test for menisci negative.
HOSPITAL COURSE:
Patient was admitted in the ward, necessary blood investigations were done, and anaesthetist opinion was
taken for surgical fitness. After fitness from the anaesthetist was obtained, patient was taken up for surgery
for Right knee on: 02-02-2018.
SURGERY:
TOTAL KNEE REPLACEMENT FOR RIGHT KNEE done on: 02/02/2018.
Procedure:
Under combined spinal and epidural anaesthesia, under tourniquet control parts were
prepared and draped sterile.
Through subvastus approach knee joint reached.
Synovium was found to be hypertrphied, Extensive chondral damage was present.
Calcific deposits were seen extensively over the menisci, synovium and ACL sites.
Tibial and femoral cuts were made, prosthesis of femur and tibia size were measured:
Medial and Lateral instability were checked
Prosthesis were inserted using cement and movements checked.
Wound washed and closed in layers over negative suction drain.
POST OPERATIVE PERIOD:
Patient recovered well from the surgery hence shifted to S.I.C.U, patient was observed in S.I.C.U.
She responded well hence shifted to the wards.
In the ward IV antibiotics, analgesics were given, wound inspection was done on the second postoperative
day, and wounds were healthy.
Sterile dressing done drain tip was sent for culture and sensitivity
Patient was made to walk with walker support,
Physiotherapy was taught.
Patient recovered well hence being discharged on: 11-02-2018.
Physiotherapy:
Active ankle and toe movements
Quadriceps exercises
SLR up to 20 degrees
Active knee ROM
Full weight bearing walking with walker support.
AVOID SQUATTING AND SITTING CROSS LEGGED.

MEDICATIONS:
1. Tab. Hifenac P 1 Tab BD for 30 days.
2. Tab. Pantop 40 mg 1 Tab OD for 30 days.
3. Cap. Cisbone 1 Cap OD for 30 days.
4. Powder Once in a day for one month.
5. Tab.Zincovit 1 Tab OD for 15 days.
6. Tab. Calnus TR 1 Tab OD for 30 days.
7.Review after one week days for suture removal.

Dr. G.SUDHIR BHARGAV REDDY.

M.S (Ortho)