Rehabilitation of Arthroplasty Patient During Covid-19
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LETTER TO THE EDITOR
Rehabilitation of Arthroplasty Patient During Covid‑19 Gaurav Govil1,2 · Lavindra Tomar1,3 · Pawan Dhawan1,4 Received: 10 May 2020 / Accepted: 18 May 2020 / Published online: 24 May 2020 © Indian Orthopaedics Association 2020
Sir, Commentary on guidelines regarding the management of orthopaedic patients during Covid-19 in India is thoughtprovoking and an evolving process [1]. Protocol for immediate orthopaedic management has been well emphasized [1, 2]. Post-operative care and physiotherapy have been briefed but without any elaborate guidelines [1]. There is no denying the fact that rehabilitation protocol is important for recovery from orthopaedic procedures especially arthroplasty [3]. In the present pandemic, healthcare workers have been incapacitated in the conduction of their wishful activities. We feel guidelines for rehabilitation are necessary for attaining desired functional outcomes during Covid-19.
Rehabilitation of Orthopaedics and Arthroplasty Patient Initially, in the confusion of the first few days of lockdown, there was utter chaos. The established protocols were sidelined and patients asked to care on their own with dictum being “stay home and stay safe”. Patients faced additional challenges to their recovery path on discharges. Limited health care services in adjoining native areas, including no * Gaurav Govil [email protected] Lavindra Tomar [email protected] Pawan Dhawan [email protected] 1
Department of Orthopaedics, Max Super Speciality Hospital, 108 A, I.P. Extension, Patparganj, Delhi 110092, India
2
D‑101, Sunshine Helios, Sector 78, Noida, Uttar Pradesh 201305, India
3
A‑702 Vardhman Apartment, Mayur Vihar Phase 1 Extension, Delhi 110091, India
4
House No 37, Sukh Vihar, Delhi 110051, India
rehabilitation services available compound the scenario [3]. The majority may respond well to the rehabilitation protocols adopted in pre-Covid era [4]. However, the fear of an uncertain period of restrictions, additional measures to safeguard from an evolving medical emergency in an elderly population will have a profound psychological impact on recovery [5]. Recurrent episodes depending on the disease load may require lockdown restrictions for the next two years. Safety comes first even when the endeavour is to provide a reasonable outcome. The induction of patient into an orthopaedic or arthroplasty programme should be a systematic team approach with the inclusion of established patient-specific home-based rehabilitation protocol. Plans that need consideration [3] are: (a) Preoperative identification of patient home caregivers. (b) Training them in the basic rehabilitation protocols and exercise programmes through simulation exercises, pictorial and video study material preoperatively and during hospitalization. (c) Educate them regarding danger or red flags of orthopaedic or arthroplasty management for early and rapid response. (d) Devices of utility required in immediate post-operative rehabilitation at home (walker, toilet chair, heat sensor
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