Knee Replacement Surgery

________________________________________________________________________

KEY POINTS

• Knee replacement surgery is a procedure done to remove a painful, broken, or arthritic knee joint and replace it with an artificial knee joint.
• Ask your provider how long it will take to recover and how to take care of yourself at home.
• Make sure you know what symptoms or problems you should watch for and what to do if you have them.

________________________________________________________________________

What is knee replacement surgery?

Knee replacement surgery is a procedure done to remove a painful, broken, or arthritic knee joint and replace it with an artificial knee joint.

When is it used?

Conditions such as arthritis or damage caused by a fracture, dislocation, or injury to the tissues around the joint may cause knee problems. This surgery may be done when your knee joint is very painful or is not working well and other treatments have not helped.

Knee replacement should relieve the problems of a painful knee. After surgery you should be able to move your knee more easily and with less pain. It will be easier for you to walk and do other activities. Most people get back to a more normal life.

This surgery may not be recommended if you have certain health problems. Ask your healthcare provider about your choices for treatment and the risks.

How do I prepare for this procedure?

• Talk to your healthcare provider and to other people who have had the surgery. Knowing what to expect can help lessen anxiety about the operation.
• You may meet with a physical therapist before surgery to learn exercises that will help you after surgery. If you can, increase your leg motions and general exercise before surgery. The more fit you are, the easier it will be to recover from the surgery. Getting yourself into an exercise habit helps you continue good exercise habits after surgery.
• Because you may need blood transfusions during the operation or during recovery, you may want to donate some of your own blood before the procedure. Ask your healthcare provider about this.
• Make plans for your care and recovery after you have the procedure. Find someone to give you a ride home after the procedure. Allow for time to rest and try to find other people to help with your day-to-day tasks while you recover.
• Your healthcare provider will tell you when to stop eating and drinking before the procedure. This helps to keep you from vomiting during the procedure.
• Tell your healthcare provider if you have any food, medicine, or other allergies such as latex.
• Follow your provider's instructions about not smoking before and after the procedure. Smokers may have more breathing problems during the procedure and heal more slowly. It’s best to quit 6 to 8 weeks before surgery.
• You may or may not need to take your regular medicines the day of the procedure. Tell your healthcare provider about all medicines and supplements that you take. Some products may increase your risk of side effects. Ask your healthcare provider if you need to avoid taking any medicine or supplements before the procedure.
• Follow any other instructions your healthcare provider gives you.
• Ask any questions you have before the procedure. You should understand what your healthcare provider is going to do. You have the right to make decisions about your healthcare and to give permission for any tests or procedures.

What happens during the procedure?

You will be given a regional or general anesthetic to keep you from feeling pain. A regional anesthetic numbs the lower part of your body. If you have regional anesthesia, you will also be given medicine to help you relax. The medicine can make you drowsy or you may fall asleep before the procedure. A general anesthetic relaxes your muscles and puts you into a deep sleep.

Your healthcare provider will make a cut from above the kneecap to below it and remove damaged bone. A metal or plastic artificial joint will be attached to the healthy bone. Your provider will close the cut with stitches or staples and put a bandage and a splint around your knee.

You may need a blood transfusion. The hospital will use either blood you have donated or blood from a donor that matches your blood.

What happens after the procedure?

You will be helped to get out of bed as soon as the day after surgery. For a few days you may have a catheter, which is a small tube used to drain urine from your bladder. Special boots or stockings will be put on your feet or legs to help prevent blood clots. You may also need medicine to help prevent blood clots. You will be given medicine to help control pain.

You will start walking with a walker, crutches, or cane as soon as possible. You may use a continuous passive motion machine (CPM) while resting in bed to keep your knee moving and prevent stiffness.

You may be able to go home after a few days in the hospital. If you and your healthcare provider think you might need extra help with recovery, you may first go to a rehabilitation center before returning to your home. Deciding if a rehab center is needed depends on your fitness, your general health, your ability to do the exercises recommended, and whether or not you have help at home.

Constipation is common after joint replacement surgery. It is often caused by narcotic pain killers as well as inactivity. You may be given a stool softener and a laxative after surgery to avoid this. When you are home again, be sure to eat a high-fiber diet and drink plenty of liquids according to your provider’s recommendations.

The replacement knee is designed for usual day-to-day activities. You will need physical therapy for weeks to months after your surgery. You will not be able to participate in some sports or activities that involve squatting or jumping. Ask your healthcare provider to suggest physical activities that are safe for you.

Ask your healthcare provider:

• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup.

Let all of your healthcare providers, including your dentist, know that you have an artificial joint. If you get an infection, such as a gum, sinus, bladder, or skin infection, the infection should be treated right away. If you have a procedure, like deep cleaning for tooth and gum problems, or sinus surgery for infections, talk to your provider about taking preventive antibiotics to protect your new joint.

What are the risks of this procedure?

Every procedure or treatment has risks. Some possible risks of this procedure include:

• You may have problems with anesthesia.
• You may have infection, bleeding, or blood clots.
• Other parts of your body may be injured during the procedure.
• Your legs may not be the same length after the operation.

Ask your healthcare provider how these risks apply to you. Be sure to discuss any other questions or concerns that you may have.