Frequently Asked Question
Total knee replacement is a surgical procedure where the worn out surfaces of the knee are resurfaced with metal and plastic components. Over time, the cartilage that cushions the bones can wear away, cause pain and discomfort, and make simple pleasures like walking and shopping unbearable. Knee replacement can reduce or eliminate pain, allow easier movement and get you back to normal life.
Knee replacement surgery may be considered for those suffering from arthritic knee pain that severely limits the activities of daily living. It is only recommended after careful examination and diagnosis of your particular joint problem, and only after more conservative measures such as exercise, physical therapy, and medications have proven ineffective.
There are many kinds and designs of knee implants available today, and no one design or type is best for every patient or their particular situation. Each surgeon selects the implant that they believe is best for their patient’s needs based on a number of factors including age, activity level, the implant’s track record, and his or her comfort with the instruments associated with the particular implant. If you have specific questions regarding implants, we will be happy to answer.
With improvements in surgical techniques and postop care, it is now common for many patients to be able to go home from the hospital after two or three days. If you have both knees replaced at the same time, the stay can be a day or two longer. Of course, each patient is different, but the goal should be for you to recover in the comfort and privacy of your own home as soon as possible.
Once again, this can vary from person to person, but most people will need to use an ambulation aid such as a walker or single stick support for 2 to 3 weeks or so. Driving may be possible in 2 to 3 weeks, and activities such as brisk walking and light cardio activities can be resumed in as few as 10 to 12 weeks. Some activities such as singles tennis and contact sports are not recommended after knee replacement. Most people will be able to go straight home from the hospital, though some patients, particularly those who live alone, may need to spend a few days at a rehab center or nursing home. Keep in mind that healing and recovery times can vary.
Knee replacement is recognized as one of the most successful procedures in all of medicine. In India, over 10,00,000 people have their knees replaced each year, and a recent panel of independent experts determined that ninety percent of those opting for knee replacement reported “fast pain relief, improved mobility, and better quality of life.
You will experience some discomfort after surgery, but be assured we will be doing everything we can to keep you as comfortable as possible. Pain after surgery is quite variable from person to person, and not entirely predictable, but modern medications and improved anesthetic techniques greatly enhance our ability to control pain and discomfort after surgery. Some amount of swelling off and on and intermittent pain episodes can happen for 10 to 12 weeks.
Even though knee replacement surgery is considered a very successful procedure, it is major surgery, and as with any surgery, there are risks you need to be aware of. Overall rate of complications are less then 1% but Possible complications include:
- Blood clots in your leg veins (DVT)
- Infection
- Implant loosening
- Fractures
- Nerve or blood vessel damage
- Knee stiffness
We and our healthcare team will be taking great care to minimize the risk of these and other complications. Keep in mind that complications are relatively rare, but they need to be understood by you and your family.
Further, we will be happy to answer any questions that you may have.
If you have any problems with your teeth or gums please see your dentist before surgery. Please also see your family doctor if you have any urinary infections or sores on your skin that are not healing.
The healthier and fitter you are before your surgery, the quicker you will recover after your operation. Daily exercise strengthens the muscles that support your joints. You should work towards exercising at least four times a week, for up to 20 minutes per session.
Patients that are well nourished recover better after surgery. At the pre-assessment clinic, a nurse will assess your nutritional state, and may arrange an appointment with a dietician. Eat a healthy well-balanced diet and keep alcohol to within sensible limits. If you are overweight, reduce the fat in your diet, cut down on sugary foods, and eat more whole grains, fruit and vegetables.
Practice the exercises that you will be doing after your surgery. Please practice these twice a day. By practicing these exercises before surgery, you will find them easier to do after your operation.
Smoking increases the risk of lung complications after an anaesthetic and can delay wound healing.
If you have diabetes, high blood pressure, or may be anaemic, please ask you family doctor to review your health. When you are healthy before your operation, you are more likely to recover well. If you have diabetes we encourage you to use your own equipment, including your insulin pen and blood glucose monitor, so you can continue to manage your diabetes
You must not eat or drink for six hours before surgery – this includes chewing gum.
If you have been given special instructions about your medication before surgery please follow them carefully. Otherwise, take all of your usual medications within the time you are allowed to drink water. Before your operation you will be asked by medical or nursing staff to take some tablets to help prepare you for your anaesthetic.
Your hair must be dry when you come into hospital as this will help you stay warm and help with your recovery. Please do not put on make-up, talcum powder, body moisturiser or nail polish.
A religious medal or Taonga that you do not want to leave at home can be given to your support person for safe keeping, or you can ask for it to be taped close to you during surgery. When you arrive at the Day of Surgery Unit you will be shown to a waiting area. Your reporting time is to allow us to prepare you for theatre. This is not the actual time of your operation. While you are waiting, several people will do safety checks, including asking your name and date of birth. This is to make sure that you are the right person having the right operation. You will be asked to wear a gown to theatre.
You will be taken to the recovery room, where you will stay until you are awake and comfortable. At this point you may be aware of:
An oxygen mask
Drip (this provides fluids until you can drink)
Cuff around your arm recording blood pressure
Peg on your finger measuring oxygen
Dressings over the wound
Drain collecting blood from the wound
When you are awake enough you will be taken to the ward. It can take up to 5-6 hours from when you enter the operating theatre until you arrive on the ward.
After your operation, do not be too concerned if you cannot immediately move your operated leg. Some anaesthetics take several hours to wear off.
You should expect to have some pain after your surgery. However, the pain should be manageable with pain relief. Everyone experiences pain differently. It is important that you have regular pain relief so that you can begin to move and regain control of your operated leg. Please let the nursing staff know how you are feeling, so that they can adjust your pain relief and give you drugs for any side effects, such as itching or nausea.
Please do not attempt to get out of bed without a staff member present. You may get out of bed unassisted once your physiotherapist has said it is okay to do so. If you are awake and comfortable you will be helped to sit on the side of your bed or stand on the night you return to the ward. Do not sit or lie with anything rolled under your knee as this may cause your knee to stiffen and prevent it from straightening Please help staff as much as you are able to by moving yourself around the bed.
After your operation your wound will be covered with a dressing and heavily bandaged. You may also have a plastic tube from your knee. The drain draws any bleeding away from your knee joint. The day after your surgery the heavy bandage will be removed, along with the drain. The light plastic dressing will not be changed unless it is extremely bloody or is no longer watertight. Your wound dressing will stay in place until after your stitches/clips have been removed. You will need to go to your family doctor to have your stitches or clips taken out approximately 10-14 days after your surgery.
