Table 4 Examples of concomitant interventions accompanying a surgical intervention: knee replacement
From: Interventions in randomised controlled trials in surgery: issues to consider during trial design
Pre-, peri- or post-operative | Concomitant interventions | Description |
|---|---|---|
Pre-operative | Magnetic resonance imaging | Pre-operative imaging to plan the exact type of implant required |
Investigations within the pre-operative assessment clinic | Pre-operative blood tests, electrocardiogram, X-rays and other interventions (such as echocardiogram) as required | |
Physiotherapy | Muscle strengthening exercises | |
Peri-operative | Application of pulse oximeter, oxygen mask and blood pressure cuff | Intra-operative monitoring devices |
Application of continuous pump devices and compression stockings | Preventative measures for deep vein thrombosis | |
Insertion of a urinary catheter | To prevent urinary retention (potential consequence of spinal anaesthesia) | |
Insertion of a peripheral cannula | To allow delivery of intravenous analgesia | |
Administration of spinal anaesthesia | Injection of a local anaesthetic into the subarachnoid space, through a fine needle | |
Administration of intravenous analgesia | To minimise intra-operative pain | |
Application of a knee bandage | To provide pressure and minimise swelling | |
Post-operative | Administration of subcutaneous clexane | Preventative measures for deep vein thrombosis |
Application of continuous pump devices and compression stockings | Preventative measures for deep vein thrombosis | |
Administration of oral analgesia | To minimise post-operative pain | |
Physiotherapy | Muscle strengthening exercises and learning to walk with crutches or a frame | |
Use of a continuous passive movement machine | Provide passive motion in a specific plane of movement, and protect the healing repair or tissue |