Preparing For Knee Replacement



Known as arthroplasty, knee replacement surgery replaces the damaged parts of your knee with artificial parts. Several millions of people live with such implants.

Knee replacement surgery is one of the most common bone surgeries in the country. Whether you need the surgery is a decision that you and your doctor, an orthopedic surgeon, carefully make together. More than 90% of people who have had their knees replaced see a huge improvement in pain and their ability to get around.


Deciding to Have Surgery

You might get surgery for a number of reasons:

  • Severe pain and stiffness makes it hard for you to walk, climb stairs, or get out of a chair.

  • Nagging knee pain bothers you while resting, possibly keeping you from sleeping well.

  • Your knee is often swollen.

  • Your knee is bowed or has other defects.

  • Physical therapy and medication haven’t helped.



Preparing for Surgery

Dr. Vaidya recommends, getting yourself evaluated several days to a few weeks before surgery which usually consisting of:


Blood work/Urine test

A complete blood count may be determined to finalize the "all clear" for surgery. Because there may be a need for blood transfusion during or after the surgery, blood tests will be needed for blood matching.


ECG

Provides information regarding the condition of the heart for surgery.


Chest x-ray

Provides information about the respiratory status of the individual.


Anesthesia consult

An anesthesiologist, who is a medical doctor specializing in anesthesia, will explain what types and options of anesthesia are available for the knee surgery. Total knee replacement is usually performed under a spinal and epidural anesthesia where an injection is given into the spine numbing both legs. The individual is conscious but comfortably sedated.


Assessment by a member of the nursing staff

The nurse will meet with the individual to explain and describe the nursing care prior to and after the surgery.


Assessment by a physical therapist and occupational therapist

This part of the rehabilitative team will provide preoperative education to help prepare for the surgery. The physical and occupational therapist can assist with preoperative programs to include exercises as well as arranging for special equipment that may be needed after the surgery such as walkers, canes and reaching aides.


Other preparations


Dental

Some individuals may be asked to have a dental check up if there has not been one recently. Dental problems that have been previously addressed before knee replacement can prevent infections that might affect the new joint.


Eating and drinking instructions

The person undergoing surgery for total knee replacement will be given specific instructions regarding eating and drinking before surgery following guidelines from the of anesthesia department of that specific hospital.


Current list of prescription and non-prescription medications

The physician, anesthesiologist and nursing staff will need a current list of all prescription and non-prescription medications being taken. Instructions may be given to discontinue aspirin or aspirin containing medications two weeks prior to surgery at the discretion of the surgeon.



During Surgery

Knee replacement surgery has become more advanced. If you are healthy, it can be done as an outpatient procedure without a hospital stay. If done in the hospital, expect to stay in the hospital for at least 1 to 4 days. Just before surgery, nurses might insert an intravenous line (IV) into a vein in your arm or hand to give you fluids and medicines. They also have to shave your skin where the doctor will make the cut.

You might get general anesthesia to put you in a deep sleep during the surgery. Your doctor may decide instead to give you a spinal/epidural anesthesia, which will numb you below the waist but keep you awake. Most people will have general anesthesia.

Surgery can take 1 to 2 hours. Your doctor can do it a couple of ways. They might make an 8- to 10-inch cut in the front of the knee. Then they’ll take out the damaged part of the joint and the surfaces of the thigh bone and shin next to the joint. Once that is done, the surgeon will implant the artificial knee.

You might get what’s called “minimally invasive” surgery. In this case, the surgeon will make a shorter cut, around 4 to 6 inches. This will result in less damage to muscle and tendon. A person who is thin, young, and healthy is usually a good candidate for this technique.



After Surgery

You can expect to be up on your feet within a day. That might be hard to do on your own at first. So you may need parallel bars, crutches, a walker, or a cane for a while to get up.

Usually, you can expect a big improvement in flexibility and much less pain within a month. It’s important to exercise your knee often, to keep down swelling and to strengthen your muscles.

You might need help from a physical therapist, who will go through a series of exercises to strengthen your repaired knee. How long you’ll need physical therapy depends on your health and how motivated you are to recover from your surgery.




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