Before surgery, your doctor needs to understand your overall health status. You will be evaluated in several ways.
Complete Medical Evaluation:
Your doctor will take your health history, an inventory of medications you now take and will administer a total physical. X-ray images will be taken of your knee that helps the surgeon plan your surgery. Some patients will also need chest X-rays, ECGs, and other tests to ensure they are strong enough for surgery and recovery.
Preliminary lab work:
As part of your pre-admission process, you will need to undergo routine lab work. Your physician’s nurse can explain what each test is and why you need it.
Donate your own blood:
You may be asked to donate some blood to have on hand in case you need it during surgery. Some patients cannot donate their own blood. In these cases, using pre-screened blood bank blood is recommended.
Packing for the Hospital
When packing your hospital bag, bring your list of medications and the telephone numbers of your relatives or designated “help” person. Bring walking shoes, loose, comfortable clothes, underwear, books, personal care items and cash for sundries. Please don’t bring jewellery, large amounts of cash, credit cards or other valuable items to the hospital with you.
A note about medications
It is very important to tell your doctor about every single medication you are taking, even aspirin or ibuprofen. Some medications are not compatible with anesthetic, and others could increase bleeding or cause other problems. Your physician will determine which medications you can continue up until your surgery, and which ones you must discontinue.
What to expect on the Day of Surgery?
When you are admitted to the hospital you will change into a hospital gown. Your vital signs are taken by a nurse. An intravenous line containing medications and fluids will be inserted comfortably into a vein on your arm or neck. At this point, your anesthesiologist will arrive to begin the administration of your anesthetic for surgery. Once you are transferred to the operating table where the surgery will take place. This is often the last thing you remember before waking up in the recovery room. You may have general anesthesia or spinal anesthesia with sedation.
What to expect right after surgery?
In the recovery room, you will recover from surgery until you are awake and alert. You could experience chills or nausea these are normal side effects of anesthesia. You may notice:
Drainage tubes and catheters:
A drainage tube and catheter may be in place.
To manage the pain you may feel right after surgery, you will be given medication.
You may be fitted with elastic surgical stockings that help prevent blood clots and improve circulation. You may wear these stockings every day for six to eight weeks following surgery.
Your operated leg may be connected to a CPM (Continuous Passive Motion) machine, which slowly bends it up and down to improve range of motion.
You are returned to your regular hospital room once you are completely awake. Your family members may then visit you in your room.
Two Days after surgery
IV tubes and lines are usually removed within the first few days following surgery. If a drain was placed in your knee, then it will probably be removed a day or two after surgery.
The start of physical therapy:
Physical therapy usually begins for most patients within the first few days following surgery. The therapist focuses on helping to increase the knee’s range of motion with bending exercises. You will also be building strength in the knee and muscles of the leg. Often the CPM machine is continued at a higher degree of bend.
It is imperative that you get up and begin moving as soon as possible. This ambulatory activity helps prevent clots and speed your therapist and nurses; you should be able to get from the bed to a chair (transfer) at least once or twice a day. You will eventually be able to transfer with your crutches or walker.
Three to Four Days after surgery
Your physical therapy will continue, except you will practice becoming more independent in your exercises, transfers from bed to chair, stair climbing and other activities your therapist has designed for you. Your dressings will be changed, as well as your blood tested for coagulation. Before you are discharged from the hospital, your physician and physical therapist will review instructions for your continuing care and exercises at home. You will be given prescriptions for medication you need.
Getting your Home Ready
To make your life easier post-operatively, it pays to think ahead about how to adapt your home environment for safety and greater efficiency. Here are some tips that can help:
Arrange for help now:
You won’t be able to drive immediately after surgery. This means you will need the assistance of some who can drive you to your follow-up doctor’s appointments, as well as help you with shopping and errands. Try to line up this person’s assistance now.
Reorganize your home:
Bending, kneeling and squatting will be impossible immediately following your surgery. Also, remember you will be on crutches or a walker for a while. Place everyday essentials in top drawers or easy-access places. Remove electrical cords and clutter that pose a hazard. Don’t wax floors.
Obtain assistance items:
It makes sense to have certain assistance items ready when you return home. Some suggested items might be a cordless phone, large apron with pockets, reaching aids and bathing aids. Check with your surgeon and hospital to identify which items will be provided to you at discharge.
Long Term Care of Your Knee
Your Knee replacement should give you years of service. You can protect it by taking a few simple steps:
Watch for and prevent infection:
Because your new knee is sensitive to infections, you must be diligent about preventing them. You may need to take antibiotics before seeing the dentist. If you suspect a bacterial infection of any kind, notify your physician right away.
When you leave the hospital, you will be given a schedule of follow-up visits. These visits will ensure the long-term success of your operation. Your physician may want to check you several times during the first year and annually thereafter. Often, follow-up X-rays will confirm proper placement and alignment of the implant.
Keeping your weight under control will reduce the amount of pressure and stress on your new knee. Avoid high-impact sports and participate regularly in low-impact activities such as walking, swimming, golfing or cycling. These are excellent ways to strengthen your new knee and get the exercise you need to stay fit.