Ms Jennifer smith
Nurse- in- Charge
Grant Transition Care Home
42 Greenwell Avenue
Leeds
23 January 2018
Dear Ms Smith,
Re: Mrs Evelyn Brown, DOB: 9 August 1939
Mrs Evelyn Brown, who underwent a right knee viscosupplementation procedure, requires continuing
care and appropriate management from your facility following the discharge today.
Mrs Brown has been treated for moderate bilateral right knee osteoarthritis since 2013, for which she has
been taking oral medications and performing physiotherapy.
21 January 2018, Mrs Brown presented with the complaints of excessive pain in the same knee and
difficulty in mobility despite walking with an assistive device followed by hyaluronic acid was
administered for lubricating the knee.
Postoperatively, Mrs Brown was observed for a 48- hour in the ward. Bruises were noticed in relation to
the accumulation of fluids on the site and the pain was managed with tramadol fifty milligrams four times
a day.
In today’s review, Mrs Brown’s overall progression was stable and ambulation is possible with a walkingstick
for backup. If the pain is persisting, tramadol one or two tablets can be given as needed along with
acetaminophen 325 mg thrice a day. Presently, she is overweight; nonetheless, weight reduction up to 77
kg as well as reframing from squatting and stairs to ease loading on the patella have been advised. In
addition to that, using a toilet seat raiser would be profitable. Physiotherapy, including ROM, water
aerobics and isokinetic exercises for strengthening the knee need to be reviewed each fortnight time.
Based on the aforementioned circumstances, ongoing care and necessary assistance to improve Mrs
Brown’s health condition would be extremely beneficial. It is noted that, the follow- up with injections on
28 January, 4 February and General practitioner to review reduction of weight in a month’s time have
been scheduled.
If any additional information is required, please do not hesitate to contact me.
Yours sincerely,
Nurse
St. James Hospital
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