How is it Possible to Travel Further Yet Heal Faster?

The surgeons experience, uninterrupted healing and generous professional staffing ratios are the key to India's quick surgical recoveries.

The surgical experience of a two patients, one in the US and one in India, is nearly identical. Experienced surgical team, state of the art instruments and identical orthopedic implants.

Day of Surgery

The day of hip replacement surgery is mostly a day to recover from the procedures. But it is not just about rest. Depending on the time of day of surgery, the patient may be asked to sit in a chair or on the side of the bed.

Patients in India and in the US will begin simple activities including ankle pumps, leg lifts and heel slides. Both nursing staffs will make sure that the patients take sufficient pain medication to allow them to participate in their rehabilitation exercises.

Hospitalization

During hospitalization, the patient will meet with the physical and occupational therapists. The physical therapist will work on mobility, strengthening, and walking. The occupational therapist will work on preparing for tasks such as washing, dressing, and other daily activities.

Therapy progresses at a different pace for each patient in India and the US. Factors that will affect the rate of the patient's progression include strength before surgery, body weight, and ability to manage painful symptoms. The type and extent of surgery can also affect the patient's ability to participate in physical therapy.

Discharge/Rehabilitation

In the US, the patient will be discharged from the hospital in 3-5 days. In India, the patient will be discharged in 14-17 days. This is the point of healing divergence between the two healthcare systems. For reasons outlined previously in this blog, there is no way for a US hospital to indulge a patient in 14 days of therapy. So while the Indian patient is working daily on mobility, strengthening and walking...the US patient is making plans to return home, set up appointments for rehabilitation in another location and trying arrange for transportation.

Post-surgical rehabilitation hurts. It is a rare patient that is able to muster the fortitude needed to maintain a rigorous schedule of physical therapy, and self-manage pain medication. So, the US patient, due to both human nature and sporadic exposure to healing professionals, begins to slow down on his journey to recovery, when compared to his Indian counterpart.

Complications can arise

After hip replacement surgery, patients must restrict certain activities to prevent problems with the hip replacement implant. The concern is that hip replacement implants are not as stable as a normal hip joint. This means that it is possible for the ball of the ball-and-socket hip replacement to dislocate.

The Indian patient has had 17 days of practice in learning the limitations of their new hip replacement...their US counterpart only received a few instructions after surgery.

What are some of the life-long practices that a patient will need to 'unlearn?'

• Crossing the legs
  Patients should not cross their legs after hip replacement surgery. When putting on socks and shoes,they should not cross their legs to bring the foot towards the body. The therapist will instruct the patient on how to safely get dressed. The patient should not sleep on their side until instructed by the surgeon. Some surgeons may have patients sleep with a pillow between their legs to prevent them from crossing.

• Forward bending
  It is important not to bend a hip up more than 90 degrees. In general, if the knee is below the hip joint, you are in a safe position. Problems occur with deep cushioned seats or low seats (such as toilets).

It is important to work with the physical therapist and occupational therapist to learn the proper ways to get dressed, sit down, walk, and perform other routine activities.

Why is it so important that these limitations be learned?

As mentioned above, a hip replacement implant is not as stable as a normal hip joint. If a dislocation of the hip replacement occurs, the hip implant must be put back in place. This can usually be done in the emergency room, but may require additional surgery. Furthermore, hip replacement dislocations can damage the implant and decrease the chances of success after hip replacement surgery.

So, after 17 days, the Indian patient has had continuous therapy, no distractions, continuous practice with the new limitations of the implant, and is now far ahead of their US counterpart on their healing journey.