About your total knee surgery

Questions About Surgery, Casts, Emergencies, Etc.
About your total knee surgery


QUESTIONS AND ANSWERS ABOUT TOTAL KNEE REPLACEMENT….WHAT HAPPENS NOW ??

Once you and the doctor have decided on surgery, we will have someone from our scheduling office talk to you, usually right then in person, or sometimes on the phone.

They will tell you what day your surgery is scheduled for. We will try to do this at the time that is most convenient for you, within the limitations of hospital regulations and our existing surgical schedule.

They will tell you what day your surgery is scheduled for. We will try to do this at the time that is most convenient for you, within the limitations of hospital regulations and our existing surgical schedule.

Some patients are able to donate their own blood for surgery, and we make arrangements for that also. A blood transfusion is sometimes needed after surgery. If you can't donate your own blood, please be assured that the blood bank is very concerned about the safety of blood, and will not even take a donation from someone with a cold !!

One of the doctors or nurses from the anesthesia department might talk to you at that time also. You can discuss with them whether you will have general anesthesia [go to sleep] or spinal anesthesia [an injection in the back that temporarily numbs your legs].

The anesthesia department might also talk to you about an epidural. This is the same anesthesia that is used during childbirth. The advantage to this is that not only does it numb your legs during surgery, but a tiny tube also stays in your back for a few days after surgery. The nurses can give you medicine in this tube that relieves your pain without making you sleepy.

Be sure to bring a list of your medicines to the hospital. The nurse at the hospital will tell you which of your medicines to take on the day of surgery, If you are on blood thinners like Coumadin or Plavix, they can also tell you how many days before surgery to stop taking these.

Usually, we have you stop arthritis medicine three [3] days before surgery. For example, if your surgery is on a Monday, then take your last dose of arthritis medicine on the Thursday before.

Likewise, if you take Plavix, stop the Plavix seven [7] days before surgery. For example, if your surgery is scheduled on a Monday, take your last dose of Plavix on the Sunday of the week before surgery [not on the Sunday just before surgery!]

If you take Coumadin, your surgeon will coordinate this with your regular doctor [internal medicine or family practice]. We will run a blood test before surgery to make sure that your blood will clot properly after the surgery.

If you shave your armpits or legs, please use an electric razor or Nair for the week before surgery. Small cuts from a razor can be a source of infections after surgery!

On the night before your surgery, remember not to eat or drink anything after midnight. It is okay to brush your teeth on the morning of surgery, but please try not to swallow any water.

When you arrive at the hospital on the day of surgery, the nurses will check you in, have you change into a hospital gown, and will start your IV. If necessary, your leg will be shaved with an electric razor.

The doctor will see you right before surgery. You will find that a lot of people ask you which leg is getting the surgery. This is to make sure that you get the correct operation on the correct place on your body.

You then will be moved from your room into the actual operating room. The operating rooms can tend to be a little cold, so please don't be afraid to tell someone if you are cold. We can cover you with warm blankets.

Right before surgery, we put in a bladder catheter. You won't feel this. This is so that you don't have to get up to urinate right after surgery. It is removed in 2 or 3 days. You also will get antibiotics in the IV tube, right before surgery and for one day afterward.

The surgery takes about 1 to 2 hours. However, longer surgery time does not necessarily mean that there are problems. Orthopaedic surgeons use a lot of different equipment during surgery, and we have to make sure that the equipment is just right.

Once surgery is over, you will find yourself in the recovery room. You will stay there for about an hour, so we can make sure that your blood pressure and breathing are okay, and that you have awakened from surgery without problems.

While you are in the hospital, we also notify your regular doctor [family practice or internal medicine] so that they can watch your blood pressure, diabetes, etc. You will get antibiotics, and medicine to prevent blood clots in your legs. We also use a special device that gently squeezes your legs the first few days after surgery, to keep the blood flowing.

We make sure that you have pain medication after surgery, so that pain is kept to a minimum. This is usually through the epidural tube in your back, or through the IV tube in your vein, if you don't have an epidural.  You might have a machine called a "CPM"...this is a device that is to help you bend your knee.

You get to rest on the day of surgery, but on the next day, you get to start physical therapy. The idea behind the surgery is to get you up and around right away. Some patients are able to walk well enough to leave the hospital after a few days, but most patients need extra help. We often have the nurses and doctors from the rehabilitation unit [6th floor] talk to you about staying a week or two longer in the hospital.

The rehabilitation unit is sort of like summer camp for adults. You are still in the hospital, but your main job every day is to improve your walking after surgery. You will probably be using a walker for about 2 to 3 months after surgery.

The advantage to the rehabilitation unit [called the "rehab unit"] is that you go to physical therapy every day, but a family member doesn't have to drive you back and forth, and doesn't have to wait while you have the therapy.

After you are discharged from the hospital, the rehab unit staff sets up home health nurses to see you, and arranges for the equipment you will need at home, like a walker, for example. The nurses check you once or twice a week, to let the doctor know if there are any problems. The rehab staff will also set up the appointment time for you to see your surgeon in his office after your hospital discharge.

Your stitches or staples will stay in for 2 to 3 weeks. After the first week, you can leave the wound open to the air.

Of course, when you are at home, be sure to watch out for the danger signs of [1] increased pain in the knee or lower leg [2] swelling in the knee or lower leg, [3] drainage from the knee wound, or [4] redness around the knee wound, or [5] fever over 101 degrees. If you notice these, tell the home health nurse or call the doctor's office.

Always try to sit in a chair with arms, so that you can help yourself up with arm power as well as with leg power.

The question that everyone asks is : "when can I drive ?". You probably should not drive for 8 weeks after surgery. It takes about that much time for your legs to regain the fast reflexes that you need in driving.

After total hip or knee replacement, you can go back to sedentary [seated] work about 6 weeks after surgery, but at work you really should never again do any heavy lifting [lifting where you have to strain], and no bending, stooping, or squatting.

Also, after total hip or knee replacement, you will need to take antibiotics before any dental work or teeth cleaning, and before any surgery by a urologist [kidney doctor] in the hospital or office. Please call us and we can prescribe these for you.

Total hip and total knee replacements can be expected to last 15 to 20 years, sometimes longer, before they wear out. Of course, if you are overweight or very active, the new joint will not last as long. Please remember..this surgery is done to relieve your pain, not to make you into an athlete again! The new joint is made of plastic and metal and was made on earth, not in Heaven.

Always try to sit in a chair with arms, so that you can help yourself up with arm power as well as with leg power.

The question that everyone asks is : "when can I drive ?"  You probably should not drive for 8 weeks after surgery.  It takes about that much time for your legs to regain the fast reflexes that you need in driving.

After total hip or knee replacement, you can go back to sedentary [seated] work about 6 weeks after surgery, but at work you really should never again do any heavy lifting [lifting where you have to strain], and no bending, stooping, or squatting.

Also, after total hip or knee replacement, you will need to take antibiotics before any dental work or teeth cleaning, and before any surgery by a urologist [kidney doctor] in the hospital or office. Please call us and we can prescribe these for you.

Total hip and total knee replacements can be expected to last 15 to 20 years, sometimes longer, before they wear out.  Of course, if you are overweight or very active, the new joint will not last as long.  Please remember..this surgery is done to relieve your pain, not to make you into an athlete again !  Your new joint is made of plastic and metal and was made on earth, not in Heaven.

We usually ask you to not drive until 8 weeks after your surgery.  It takes you that long to get your reflexes back.  Also, if you drive before that and have an accident, the other driver could say that you were "impaired" and were an "unsafe driver".  Believe it or not, it has happened!

Your doctor can tell you more about when you can return to work, sports, and sexual activity - but be sure to ask, because each patient is different.  The doctor can also tell you when you can stop using a walker, high commode seat, etc.

 

BUT WHAT ABOUT WHEN I GET HOME ???!!

Here are a few handy tips for when you get home :

If you have scatter rugs or throw rugs, remove them so you don't trip

Sit on a high stool or high chair instead of standing for long tasks

Plan easy meals in advance so you don't have to go the store so often

Wear low heeled slip-on shoes,  or shoes with velcro closures

Don't try to carry a lot of stuff and use your walker...it can't be done !

Always sit in chairs that have arms

While you are awake, get up and walk around every hour to keep your legs limber and so they don't swell

Use handicapped restrooms at public facilities, even after everything heals

Always use hand rails with steps or stairs.

Wear loose-fitting clothing..elastic waists are lots easier

Elevate the operated leg above your heart often, to prevent swelling.

Most importantly, don't ever get in a hurry...you have "run the race" for years, so take some time to relax.

 

TO KEEP YOUR KNEE REPLACEMENT FROM POPPING OUT OF SOCKET  !!...

Don't cross your legs...ever again !

Keep your toes pointing forward, and don't twist your leg

Don't bend your hip past 90 degrees by bending forward or bringing your leg up...use a reacher stick.

To bathe, put a tub chair in the tub facing the faucet...back up to it and sit down, then bring one leg in at a time.  Take one leg at a time out when finished, and push up on the tub chair rails...don't pull up on your walker

When you stand up, push on the arms of a chair...don't pull on your walker or you and it will fall backwards.

Likewise, when you get into a car, move the car seat back, back up to it, sit, and then help one leg at a time in

To get on a raised toilet seat, back up to it, keep your operated leg straight, and bend your good leg.  To get back up, use your good leg to push.  You can use the same trick to get in and out of any chair, but don't get into low chairs, and don't get into chairs that do not have arms.

To get into bed, sit on the edge of the bed, then help one leg at a time into bed. 

A good general rule is that the operated leg goes in first, and comes out last, whenever you sit or lay down.

Take small steps with walkers, and make sure that all 4 feet of the walker are on the ground.  If the ground looks too slick or too steep, don't go there !

 

antibiotics after joint replacement

PLEASE DON'T BE AFRAID TO ASK QUESTIONS!