Planning Knee Surgery Around Ramadan

Choosing when to have elective surgery

Many knee operations, such as knee replacement, cartilage procedures or reconstruction of an older ligament injury, are planned rather than urgent. That gives you room to choose a date that suits your family, work and religious life.

The first weeks after surgery are when the body most needs regular fluids, nutrition, medicines on schedule and daily exercises. For many patients in Qatar, it is simpler to have surgery several weeks before Ramadan, so that the early recovery is complete, or to wait until after Eid.

Some injuries should not wait. A locked knee, a displaced meniscus tear that may be repairable, a fracture or a dislocated kneecap may need treatment soon, whatever the time of year. Your surgeon will tell you if timing matters for your knee.

Fasting before anaesthesia is a different kind of fast

Before any anaesthetic you will be asked to stop eating and drinking for a set number of hours. This is a medical fast with specific rules, and it is different from the Ramadan fast. Your anaesthetist will give you exact instructions about when to stop food, when to stop clear fluids and which tablets to take with a small sip of water.

If surgery happens during Ramadan, tell the team that you are fasting. Arriving already dehydrated after a long day without water can make anaesthesia and recovery harder, so the team may plan the timing of the operation and intravenous fluids with this in mind.

Medicines and blood thinners

After knee surgery you may be prescribed pain relief, antibiotics and, after some operations such as knee replacement, a blood-thinning medicine to lower the risk of blood clots. These work as intended when taken at regular times.

• Never stop or skip a blood thinner without speaking to your surgeon first.
• Ask whether your medicines can be given once or twice a day so that they fit around iftar and suhoor, and whether any injection forms are suitable.
• If you have diabetes, high blood pressure or another long-term condition, your regular medicines and insulin may need adjusting. Discuss this with your physician as well as your surgeon.
• Some anti-inflammatory painkillers can irritate the stomach, especially when taken without food, so follow the instructions on when to take them.

Hydration, nutrition and wound healing

Wounds heal better when the body has enough fluid, protein and calories. Long fasting hours, particularly in warm weather in Doha, can lead to dehydration, dizziness and constipation, which are already common after surgery and with some painkillers.

If you are recovering during Ramadan, spread fluids through the evening and night, include protein at iftar and suhoor, and watch for signs of dehydration such as dark urine or light-headedness. Contact your surgical team if the wound becomes red, hot, swollen or starts to leak, or if you develop a fever.

Physiotherapy around iftar and suhoor

Daily exercises are a large part of the result after knee surgery. During Ramadan, many patients find it easier to do their home exercises and attend physiotherapy sessions after iftar, once they have eaten and had fluids.

Exercising hard while fasting in the afternoon can bring on fatigue and dizziness. Ask your physiotherapist to adjust the programme and appointment times, and keep the gentle exercises, such as ankle pumps and straightening the knee, going through the day as advised.

Religious exemptions and your own decision

Islam provides allowances for people who are ill or recovering, and many patients ask whether they should fast after surgery. This is a religious question, and it should be answered by a qualified religious scholar who knows your circumstances, together with medical advice from your doctors about how fasting may affect your recovery.

This article does not give religious rulings. At Aman Hospital in Doha, Dr. Gelber and the anaesthetic team respect each patient's wishes and will work with you to build a safe plan. Above all, follow your surgeon's and anaesthetist's instructions for your own situation.