A PATIENT’S GUIDE TO TOTAL KNEE REPLACEMENT

Why do I need total knee replacement(TKR)?

There are many conditions which require a knee replacement. The most common is osteoarthritis,also referred as ‘’degenerative joint disease’’. Over time, the cartilage on the surface of the joint starts to get damaged and wear away and this causes pain and stiffness in the joint.

It may be causing you to cut back or stop doing your normal daily activities, such as working, going for a walk, going up and down stairs, gardening and shopping. In TKR, the portions of the knee joint that contain the damaged surfaces are replaced with biocompatible devices that provide a smooth and painless range of motion.

Are there risks associated with TKR surgery?

There are some risk associated with this surgery and although rare, it is import and that you understand them.

Deep Vein Thrombosis(DVT):

A DVT is a blood clot in the deep vein of the calf or top of inner thigh. To reduce the risk, you will be given stockings to help with your circulation and medications that thins your blood. The physiotherapist will show you how to exercise your legs and ensure that you start to move about quickly after your operation.

Knee stiffness:

It is important to do your exercises to prevent this.

  • Infection: There is a small chance of infection and all possible precautions are taken to avoid infection during your operation.
  • Loosening: Over a period of time your artificial knee joint may become loose and further surgery may be required to correct this. An average TKR is expected to last between 10-20 years.

PREPARING FOR YOUR SURGERY

Preparations for your TKR begins several weeks before the date of the surgery itself. To begin with you will be asked to keep the following appointments.

  • Pre-admission testing: This includes physical examination test and series of tests such as X-rays, blood work, etc. that will be performed in preparation for your surgery.
  • Medical clearance for surgery: Approval for you to undergo surgery is required and its necessary to review your overall health and identify any medical conditions that could interfere with your surgery and recovery.
  • Stay active: Continue to do all your regular activities. Exercises to increase your upper body strength will help you use a walker or stick in the early days after surgery and exercises that strengthen your legs can reduce recovery time.
  • If you are overweight, losing weight will help reduce stress on your new joints.
  • Cease smoking before surgery to prevent risk of post operative lung problems and improve healing.
  • Have a dental examination: Although infections in joint replacements are not common,one can occur if bacteria enter the bloodstream somewhere else in your body.therefore,you should arrange to have dental procedures such as extractions and periodontal work completed before surgery.

THE DAY OF YOUR SURGERY

Do not eat or drink anything after midnight before your surgery.
You will be asked to fill out an operative consent form.
Before you go into the operating room, an intravenous(IV),will be put into a vein of your arm or hand. medications and fluid will be given to you through the IV during and after surgery.
The anesthesiologist will come to see you before your operation. if you are on regular medications please ask the anesthetist what you can take on the day of surgery.

IN THE OPERATING ROOM

You will be given something to make you drowsy and help you relax.
You will be given medication called an anesthetic to control pain.
Surgery involves opening up your skin and muscles to get to the knee joint,removing the damaged parts and replacing them with the metal and plastic parts(prosthetic implant).
The muscles are then reattached and the incisions,or cut in the skin is closed. A bandage is put on the area to protect it.
A plastic tube,called a catheter,may be placed in your bladder to drain urine without having to go to toilet.
You may not have any feeling in your legs for awhile after surgery because of the anesthetic which is normal.The feeling in your legs will return slowly.

AFTER THE SURGERY

After the operation you will feel some pain and discomfort,which will be helped by medications.

You may have the following:

  • A bulky bandage on your knee
  • Small drainage tubes coming from your wound
  • A drip to replace lost fluids
  • A urine catheter
  • An oxygen mask

All will be removed as soon as possible after surgery.

REHABILITATION

Following your surgery,you will have many weeks of physical therapy to help ease your operated knee back into activity. Physiotherapy is an integral part of your recovery and is very important in determining the success of your surgery