Resurgens Orthopaedics
Greater Atlanta's Premier Joint Center
Patient Education
Knee Replacement Surgery Overview
INTRODUCTION
Knee replacement surgery (total knee arthroplasty or TKA) was developed in the late 1960’s and since that time, has undergone many changes in surgical technique, implants, and post operative care. It is important to understand that your surgeon can best advise you as to the most appropriate implant and surgical technique for your particular situation.
Realistic expectations in all aspects of the surgical experience are critical to a successful outcome. The information below is presented so that you and your family can have a good general overview of what to expect and what is expected of you prior to embarking on knee replacement. This is not meant to be all inclusive, nor is it specific for every patient. Your Resurgens Joint Replacement surgeon will tailor your care based on your individual needs and general medical condition.
BEFORE THE SURGERY
Stop taking aspirin 7 days before surgery
If you take other blood thinners such as Coumadin (Warfarin) or Plavix, you will need to alert both your surgeon and the doctor who prescribes the blood thinner so that appropriate adjustments can be made. These medications need to be stopped prior to surgery.
Non steroidal anti-inflammatory medicines (NSAIDs) such as Ibuprofen, Aleve, Advil, and Naprosyn should also be stopped 5-7 days prior to surgery.
MEDICAL CLEARANCE
Clearance by your medical doctor is required for most patients undergoing hip replacement. If you see a specialist routinely (such as a cardiologist) or if you have on going disease processes (such as diabetes), you will be asked to obtain surgical clearance from those physicians as well.
DENTAL CLEARANCE
As the mouth harbors many bacteria that can cause a post-operative infection, you must obtain clearance from your dentist prior to surgery. After your surgery, you will need to take antibiotics prior to any dental procedure. This is a lifetime recommendation. Your surgeon can supply the prescription if your dentist prefers.
PRE-OPERATIVE APPOINTMENTS
You will be seen by your surgeon in his/her Resurgens office approximately one week prior to surgery. It will be necessary for you to bring a list of all medicines with dosage to this appointment. Additional x-rays may be made at this time and you will sign your consent form for surgery. You will also have the opportunity to ask any questions you may have.
Following this appointment, you will have a pre-operative appointment at the hospital. Your surgeon’s office will coordinate this visit. Any remaining necessary lab studies and tests will be performed at this time. You may also meet with a representative of the anesthesia department to discuss the anesthetic choices available to you.
Some of the hospitals offer a pre-operative class for patients undergoing joint replacement surgery. You will receive information pertaining to these classes when you schedule your surgery. We hope that you will take the opportunity to attend with your family so that you can learn more about the process involved in total joint surgery at that facility and after-care.
THE NIGHT BEFORE SURGERY
It is critical that you have nothing to eat or drink (no food, water, gum, mints, candy, etc) after midnight the evening before your surgery. The anesthesia provider or surgeon’s office will discuss which, if any, of your daily medications you should take the day of surgery.
POST OPERATIVE CARE
You can anticipate a 1-3 day hospital stay. Your surgeon or his/her assistant will make rounds each day. Some of the care you will receive while in the hospital may include:
PHYSICAL THERAPY (PT)
Your physical therapy will begin either day of surgery or the morning afterward. You can usually put full weight on your operative leg immediately after surgery. In-hospital therapy goals consist of getting in and out of bed with minimal or no assistance; walking in the hall; and going up and down stairs. In addition, you will be taught exercises that are to be done two to three times per day – even after discharge. Attaining these therapy goals quickly will ease your recovery. While therapy can be painful, it is critical to the success of your new knee.
Your therapy may continue at home two to three times per week for approximately three weeks. This will be arranged in advance by your surgeon’s office or by the hospital prior to discharge.
Your surgeon may order a CPM (continuous passive motion) machine for your use both in the hospital and at home. If so, you will be given specific instructions regarding its use.
EXPECTATIONS
It is not unusual to experience some kind of anxiety over the decision to have knee replacement surgery, the operation itself and the post-operative recovery. Some feeling of nervousness is normal. Hopefully, however, these feelings will be tempered by the thought of having a new knee that will likely change your life for the better. Most patients experience a dramatic reduction in pain within a few days after surgery. Naturally, there is pain from the surgery itself, but the kind of pain you experienced prior to surgery will be gone. Swelling and bruising around the knee may occur. Bruising usually resolves in several weeks while swelling may be present for up to six months. Swelling can interfere with rehab and it is important to manage it with ice and elevation from the beginning.
In general, patients are independent in activities of daily living within one to two weeks while the total recovery period may continue for up to one year.
Knee replacement surgery (total knee arthroplasty or TKA) was developed in the late 1960’s and since that time, has undergone many changes in surgical technique, implants, and post operative care. It is important to understand that your surgeon can best advise you as to the most appropriate implant and surgical technique for your particular situation.
Realistic expectations in all aspects of the surgical experience are critical to a successful outcome. The information below is presented so that you and your family can have a good general overview of what to expect and what is expected of you prior to embarking on knee replacement. This is not meant to be all inclusive, nor is it specific for every patient. Your Resurgens Joint Replacement surgeon will tailor your care based on your individual needs and general medical condition.
BEFORE THE SURGERY
Stop taking aspirin 7 days before surgery
If you take other blood thinners such as Coumadin (Warfarin) or Plavix, you will need to alert both your surgeon and the doctor who prescribes the blood thinner so that appropriate adjustments can be made. These medications need to be stopped prior to surgery.
Non steroidal anti-inflammatory medicines (NSAIDs) such as Ibuprofen, Aleve, Advil, and Naprosyn should also be stopped 5-7 days prior to surgery.
MEDICAL CLEARANCE
Clearance by your medical doctor is required for most patients undergoing hip replacement. If you see a specialist routinely (such as a cardiologist) or if you have on going disease processes (such as diabetes), you will be asked to obtain surgical clearance from those physicians as well.
DENTAL CLEARANCE
As the mouth harbors many bacteria that can cause a post-operative infection, you must obtain clearance from your dentist prior to surgery. After your surgery, you will need to take antibiotics prior to any dental procedure. This is a lifetime recommendation. Your surgeon can supply the prescription if your dentist prefers.
PRE-OPERATIVE APPOINTMENTS
You will be seen by your surgeon in his/her Resurgens office approximately one week prior to surgery. It will be necessary for you to bring a list of all medicines with dosage to this appointment. Additional x-rays may be made at this time and you will sign your consent form for surgery. You will also have the opportunity to ask any questions you may have.
Following this appointment, you will have a pre-operative appointment at the hospital. Your surgeon’s office will coordinate this visit. Any remaining necessary lab studies and tests will be performed at this time. You may also meet with a representative of the anesthesia department to discuss the anesthetic choices available to you.
Some of the hospitals offer a pre-operative class for patients undergoing joint replacement surgery. You will receive information pertaining to these classes when you schedule your surgery. We hope that you will take the opportunity to attend with your family so that you can learn more about the process involved in total joint surgery at that facility and after-care.
THE NIGHT BEFORE SURGERY
It is critical that you have nothing to eat or drink (no food, water, gum, mints, candy, etc) after midnight the evening before your surgery. The anesthesia provider or surgeon’s office will discuss which, if any, of your daily medications you should take the day of surgery.
POST OPERATIVE CARE
You can anticipate a 1-3 day hospital stay. Your surgeon or his/her assistant will make rounds each day. Some of the care you will receive while in the hospital may include:
- Pain control with intravenous and oral pain medications, some surgeons use nerve blocks
- Blood thinning medication to reduce the risk of blood clots
- Compression pumps on your feet or legs to reduce the risk of blood clots
- Antibiotics to help prevent infections
- Lab studies including a blood count
- Managing your pre-existing medical conditions (often with the assistance of medical doctors)
- Intravenous fluids to help prevent dehydration
- Oxygen if needed to maintain your oxygen level
- A catheter in your bladder for one to two days until your mobility improves
- A drain in your knee (if needed) to reduce the risk of blood accumulation in the wound
- Breathing exercises to keep your lungs clear and reduce the risk of pneumonia
PHYSICAL THERAPY (PT)
Your physical therapy will begin either day of surgery or the morning afterward. You can usually put full weight on your operative leg immediately after surgery. In-hospital therapy goals consist of getting in and out of bed with minimal or no assistance; walking in the hall; and going up and down stairs. In addition, you will be taught exercises that are to be done two to three times per day – even after discharge. Attaining these therapy goals quickly will ease your recovery. While therapy can be painful, it is critical to the success of your new knee.
Your therapy may continue at home two to three times per week for approximately three weeks. This will be arranged in advance by your surgeon’s office or by the hospital prior to discharge.
Your surgeon may order a CPM (continuous passive motion) machine for your use both in the hospital and at home. If so, you will be given specific instructions regarding its use.
EXPECTATIONS
It is not unusual to experience some kind of anxiety over the decision to have knee replacement surgery, the operation itself and the post-operative recovery. Some feeling of nervousness is normal. Hopefully, however, these feelings will be tempered by the thought of having a new knee that will likely change your life for the better. Most patients experience a dramatic reduction in pain within a few days after surgery. Naturally, there is pain from the surgery itself, but the kind of pain you experienced prior to surgery will be gone. Swelling and bruising around the knee may occur. Bruising usually resolves in several weeks while swelling may be present for up to six months. Swelling can interfere with rehab and it is important to manage it with ice and elevation from the beginning.
In general, patients are independent in activities of daily living within one to two weeks while the total recovery period may continue for up to one year.