Before Travelling

Preparing for Your Knee Replacement Journey

Embarking on a journey towards improved health through a knee replacement surgery requires a seamless process to ensure your comfort and well-being. Here’s a step-by-step guide to help you navigate the stages before your travel:

1. Identification of Treatment Need -Your first step is to consult with your General Practitioner (GP) or consultant who will assess and identify the necessity for a hip replacement surgery.

2. Initiate Contact with Healthcare Abroad – Once the need for treatment is established, either you or your GP can initiate contact with Healthcare Abroad. Our dedicated team is ready to guide you through the process of receiving surgery in an EU country under the cross border directive.

3. Referral and Diagnostic Coordination -The Healthcare Abroad team will collaborate with your GP to arrange a referral letter and any essential diagnostic tests. We streamline this process by providing the results directly to the chosen hospital.

4. Hospital and Surgeon Matching – Our team, with a vast network of hospitals and skilled surgeons, will carefully match your requirements to ensure you receive personalized care.

5. Financial Assistance – If needed, we can assist you in organizing your finances through Irish credit unions, making the financial aspect of your healthcare journey hassle-free.

6. Surgery Planning and Documentation – Coordinating with the selected hospital, we facilitate the arrangement of surgery dates and ensure all necessary files are sent for review.

7. Confirmation of Travel Dates – Once your healthcare plan is confirmed, we liaise with the hospital team to finalize your travel dates and healthcare schedule.

8. Arrival and Out-Patient Appointment – Upon arrival at the hospital, you’ll have an out-patient appointment with your consultant the day before the scheduled treatment, ensuring all pre-operative concerns are addressed.

9. Post-Surgery Paperwork – After your surgery, we take care of finalizing all paperwork, submitting it to the Health Service Executive (HSE) on your behalf, and ensuring a prompt refund process.

10. Report to Local GP – To maintain continuity of care, your GP will receive a comprehensive report from the hospital regarding the treatment received, updating your local medical records accordingly.

With these meticulous steps, you can embark on your healthcare journey with confidence, knowing that Healthcare Abroad is dedicated to ensuring a smooth and supportive process for your knee replacement surgery abroad.

Surgery Information

Knee replacement surgery, also known as arthroplasty, is generally regarded as an effective treatment for end-stage knee arthritis. It results in an improved knee function and significantly relieves severe pain caused by degenerative joint diseases.

All knee replacement procedures are generally divided into 2 major groups, depending on whether the knee is replaced totally or partially. A knee joint is often compared to a hinge which allows to flex, extend and limitedly rotate the lower leg.

Structurally it resembles three separate joints: slightly rounded end of the thigh bone forms 2 separate articulations with a slightly hollow end of the shinbone which has a mobile kneecap on top. The most common indication for total knee replacement is severe osteoarthritis that affects all surfaces of these synergic joints and causes pain which is unresponsive to medical management.

During the Procedure

• During the procedure, the patella is laterally subluxed and the knee is exposed in flexion.
• The affected joint tissue is surgically removed and replaced by a knee prosthesis which consists of three separate components.
• The end of a thigh bone is replaced with a femoral component made out of metal plate which corresponds to the natural shape of the bone.
• The tibial component, which consists of a metal tray covered with a layer of special plastic that moves against the surface of the femoral segment, replaces the top surface of the lower leg bone.
• Patellar component covers the back part of the kneecap and is made out of special plastic for it to glide over the front of the knee. Due to this reason the patients are advised not to kneel on the operated knee as the plastic covering of the patella may resurface.

These significant structural changes are directly responsible for the main complaint after knee replacement surgery, which is stiffness and a lingering sensation of a foreign body placed inside the joint. All in all, a total knee replacement is one of the most successful examples of innovative surgery and has resulted in substantial quality-of-life gains for people with severe joint problems. During your surgery in Spain a modern prosthesis is used and the sense of a foreign body is almost completely absent as it almost reproduces the native knee.

We use a modern prothesis design that almost replicates the native knee

What is a partial knee replacement?

In comparison to a total knee arthroplasty, partial knee replacement may be defined as a less invasive surgical approach for patients with only moderate knee joint diseases. A great majority of degenerative joint diseases primarily affect the medial compartment of the knee joint. This is because a fibrous cartilage between the surfaces of the medial tibiofemoral articulation, also known as a medial meniscus, is relatively thinner and experience greater pressure while walking etc.

This occurs because the medial compartment is the largest and because the most people have a little varus in their knees which causes the leg to turn inwards. The goal of the surgery is to replicate as much as possible the native knee.

The damaged component of the knee is replaced using the same method as in the total knee arthroplasty but without affecting the healthy parts of the joint. However, as flawless as partial knee replacement may sound, its biggest potential drawback is incomplete pain relief. The success of the surgery depends entirely on choosing the right candidate and carefully evaluating the extent of disease.

Preparation for surgery

Careful preparation for knee replacement surgery is an important part of the procedure itself as it determines the success of the surgery and the quality of post-op recovery.

Is there an age or BMI limit for the surgery?

Increased body weight would, intuitively, be expected to lead to a poorer outcome after joint replacement as the knees are directly strained by overweight. A significant positive correlation has been observed between the wear damage seen on the components of knee prosthesis and the BMI of the postoperative patients. However, some recently published studies have proven that the perioperative complication rate in patients with BMI over 40 wasn’t dramatically higher than the rate in patients with lower BMIs.

Moreover, it is now known that obese patients have relatively good pain relief and positive functional outcomes after the surgery. Therefore, a simple answer to the question about BMI limit is negative. Looking from a medical point of view, obesity is associated with many other comorbidities that affect one’s everyday life and well-being. That is why overweight should not be tolerated, and if a patient is able to lose weight they most definitely should do that.

The age limit for knee replacement patients is also of a debatable significance. Although the older patients require a relatively longer hospitalisation time and have higher complication rates, the improvements in their quality of life are very similar to those of younger patients.

Hospitalisation and what to expect during the first days after surgery

After the surgery a patient is expected to stay in the clinic for 3 to 5 days. If a patient underwent general anaesthesia, it is absolutely normal to experience some mild side effects on the first day after the procedure.

On the following day a postoperative patient is encouraged to start moving and walking with a walker or crutches. In the beginning, it requires a lot of will and effort to start walking again, but it will pay off in the form of faster recovery. Upon discharge from the hospital, a patient should be able to take short walks, bend one’s knee up to 90 degrees and climb up and down a few steps with some extra help.

The Importance of Physiotherapy

It could be said that half of the success of a knee replacement surgery depends on the post-op physical therapy. Physiotherapy exercise routine may be either home-based or monitored by the health professionals in rehabilitation facilities.

Studies have shown that light to moderate regular exercises show short-term improvements in patients’ physical function, whereas more intensive ones have positive long-term outcomes. In order for a certain therapeutic approach to give good results the right combination of physiotherapy methods should be selected for each patient individually.

At Healthcare Abroad, we understand that your journey to optimal health extends beyond the operating room. Following your surgery, we provide a comprehensive post-operative care plan, including a series of 10 specialized physiotherapy sessions. Tailored to meet individual needs, these sessions are designed to accelerate your recovery and enhance the effectiveness of your surgical intervention. All physio sessions are reimbursed by the HSE.

Physical activity after the surgery

The positive effects of physical activity are particularly important for patients undergoing knee replacement, as osteoarthritis predisposes them to metabolic and functional decline. Light physical activity such as walking, climbing the stairs, jogging etc. is an attractive and convenient form of exercise as it can be self-managed and performed on a daily basis with low cost and minimal equipment. In addition to that, there are several types of exercises which target specific muscle groups of the lower body and may be performed every day. These include:

• Stretches – Exercising muscles of the thigh improves knee flexion. This may be achieved by light stretches of hamstrings.
• Tension Creating Exercises – Muscles in the front of the thigh are responsible for knee extension. In order to strengthen them any light tension creating exercises, such as half squats done while holding on to a handrail or straightening the leg while sitting on a chair in highly advised.

Exercise

In the early-operation period there is a great variety of light exercises that should be performed while lying down. This includes bending the knees by sliding the heel towards the buttocks, repeatedly adducting the operated leg.

Wound care and Staple removal

• Dressing – After the knee is totally or partially replaced, the midline incision across the front of a knee is closed and tightened up with staples or stitches. In order to prevent the wound from getting infected, a dressing is applied. It is highly recommended to keep the dressing for up to 7 days after the procedure unless it moves out of place or becomes fully saturated. If so, please contact healthcare abroad or your GP as it should be changed by a qualified nurse, if possible, or a patient may do it by themselves.
• Showering – When it comes to showering, it is allowed as long as the dressing is kept as dry as possible, for it may fall off if the skin becomes too moist.
• Stitches – The stitches or staples are usually removed in 10 to 21 days after the surgery. If during the postoperative period a leakage, bruise or swelling is observed and the incision site becomes painful, you should consult a doctor immediately as the wound might get infected. There is an agreement between Healthcare Abroad and your GP to remove stitches free for the patients.

Driving after surgery

The candidate for knee replacement are often hesitant about the surgery as there is a common misconception that driving is prohibited once the surgery is performed. In fact, the postoperative patients may already resume driving 4 weeks post-operation or when they feel comfortable and confident about the flexibility of the knee.

Sports after a knee replacement

Based on a general opinion among the medical society low-impact sports, such as hiking, swimming, running, and cycling etc. after knee replacement are most certainly welcome and encouraged. However, strenuous activities that put a lot of pressure om the knees are a topic of discussion. It is observed that the patient who played sports before their surgery are more likely to return to sports because of the willingness and motivation.

All in all, due to the improvements in surgical technique and the growing knowledge about post-operative management of knee prosthesis, knee replacement surgery has even less impact on the activity level of post operative patients.

When you return home

Continuing Care at Home: Your Path to Lasting Recovery

Your journey towards improved mobility and well-being doesn’t conclude when you return home after your knee replacement surgery. Proper care during the post-surgery period is crucial for ensuring a smooth and lasting recovery. Follow these guidelines to make the most of your rehabilitation and enjoy the benefits of your new knee:

1. Follow Your Rehabilitation Plan: Adherence to the prescribed rehabilitation plan is paramount. Your healthcare team, both in the hospital and at home, will provide you with specific exercises and activities to support your recovery. Consistency is key, so make these exercises a regular part of your routine.
2. Pain Management: It’s normal to experience some discomfort during the initial stages of recovery. Follow the prescribed pain management plan, taking medications as directed by your healthcare provider. Communicate any concerns or changes in pain levels to your healthcare team promptly.
3. Monitor Surgical Site: Keep a close eye on the incision site for any signs of infection or unusual changes. Follow the care instructions provided by your healthcare team, including proper wound cleaning and dressing changes. Report any redness, swelling, or increased pain to your healthcare provider.
4. Gradual Return to Daily Activities: While it’s essential to rest and allow your body to heal, gradually reintroduce daily activities as advised by your healthcare team. Start with light tasks and progress at a pace that feels comfortable for you.
5. Physical Therapy at Home: Continue the exercises prescribed by your physiotherapist at home. These exercises are designed to enhance your strength, flexibility, and overall joint function. Regular physical therapy at home will contribute significantly to your ongoing recovery.
6. Healthy Lifestyle Choices: Support your recovery by maintaining a healthy lifestyle. Eat a balanced diet, stay hydrated, and engage in activities that promote overall well-being. A healthy lifestyle can positively impact your joint health and contribute to long-term success.
7. Communication with Healthcare Providers: You are still under the care of the state when travelling with Healthcare Abroad. Stay connected with your local healthcare providers. Inform your General Practitioner (GP) about your surgery, and share any relevant information from your healthcare abroad experience. Regular check-ups with your GP will help monitor your overall health and address any concerns.
8. Patient Support Groups: Consider joining local or online support groups for individuals who have undergone knee replacement surgery. Sharing experiences, tips, and encouragement with others who have faced similar challenges can be immensely beneficial. For example: There is a post operative Healthcare Abroad Facebook group for past patients.
9. Long-Term Monitoring:Your healthcare team will provide guidance on long-term monitoring and follow-up appointments. Attend these appointments as scheduled to ensure that your progress is continually assessed, and any potential issues are addressed promptly.
10. Enjoy Your Improved Quality of Life:Embrace the positive changes that come with your new knee. With proper care and dedication to your recovery plan, you can look forward to a more active and pain-free lifestyle.
11. If needed you can contact with our surgeons via teleconference. Please contact Healthcare Abroad if you feel like this is necessary.

Remember, the journey to lasting recovery is a partnership between you and your healthcare team. By following these guidelines and staying engaged in your post-operative care, you’re laying the foundation for a future filled with improved mobility and enhanced well-being.

For any post-operative questions or concerns, do not hesitate to reach out to your local healthcare providers or contact Healthcare Abroad for ongoing support.