What is total joint replacement?
When a joint has worn to the point it no longer does its job, an artificial joint, or prosthesis, made of metal and plastic or ceramics can take its place. Total joint replacement surgery tries to reproduce the normal function of the joint – relieving discomfort and increasing activity and mobility.
Why do knees need replacement?
The knee is a “hinge” that joins the shin to the thigh. The knee joints are lined with cartilage, a layer of smooth, tough tissue that cushions the bones where they touch each other. With age and stress, the cartilage wears away and the bones rub against each other, causing friction, swelling, stiffness, pain and sometimes deformity. When this happens, knee replacement may relieve pain and restore mobility and quality of life.
Is joint replacement surgery safe?
Joint replacement is a safe and common procedure. However, any surgical procedure involves risk. Your surgeon and the hospital staff will review the risks with you and explain how your post-surgical program can help reduce risk and aid in more rapid recovery.
What kinds of tests will I need before surgery?
All patients are usually required to have routine blood work and urinalysis at least 14 days before surgery. You should probably also have a physical examination within 30 days of the surgical date. Patients over 50, and those with cardiac or respiratory history, should also have an EKG and chest x-ray within days of surgery. Most pre-admission testing can be performed either by your personal physician or at the hospital where the procedure will be performed.
Will I need to donate blood before surgery?
Some surgeries may require bood tranfusions and your surgeon may ask that you to donate blood if possible. This can be done any time within 35 days of surgery. If you can’t donate your own blood, a designated donor may donate blood on your behalf. You may also receive blood from the hospital Blood Bank if necessary. The Blood Bank follows universal guidelines in screening blood and blood products to ensure safety.
Are there any medications I need to take before surgery?
Perhaps you should take an iron supplement, particularly if you will be donating your own blood. Speak with your surgeon and anaesthesiologist.
Are there any medications I need to stop taking before surgery?
Usually patients can take most medications up until the day of surgery. It is recommendable not to take anti-inflammatory medications containing aspirin, which can act as blood thinners, within two weeks of surgery unless instructed otherwise by your physician. Always ask your surgeon and anaesthesiologist regarding medications.
What should I bring to the hospital?
You may bring all of your personal toiletries and shaving gear, comfortable, loose fitting clothing, slip-on non-skid shoes or slippers with closed backs, a list of current medications including dosages and any paperwork the hospital has requested. If you have a walker, cane or crutches, have someone bring them at discharge so the physical therapist can check them for size and stability. It is recommendable not to bring radios, televisions or large amounts of cash.
When should I arrive at the hospital for surgery?
Your surgeon will tell you when to arrive at the hospital. Normally, it takes about two hours before surgery to go through admissions, change into hospital clothing, meet the anesthesiologist and nursing personnel and address any questions about the procedure. Do not eat or drink after midnight on the day of your surgery. You may be allowed to take pre-approved medication with the least amount of water necessary. Report any medication taken, along with dosage, to your admitting nurse.
Can my family stay with me?
Your family may stay with you until you are taken to the operating room according to the hospital rules
Do I need to be “put to sleep” for this surgery?
You may have a general anesthetic, which most people call being “put to sleep.” Some patients prefer a spinal or epidural anesthetic, which numbs your legs without requiring a deep sleep. You can discuss options with your surgeon and anesthesiologist.
Will the operation hurt?
Many patients only experience mild discomfort in the days and weeks following joint-replacement. However, after years of living with joint pain, for most it is a welcome relief. As with any surgery, individual patient results and experiences vary. Make sure to talk with your doctor before surgery about your pain management options. You may receive pain medicine through your IV, through the epidural or in shots or by pills. Most likely, you should be mobile within 12-18 hours of surgery.
How long will the surgery take?
Depending upon the difficulty of your case, surgery can take approssimatively from one to three hours, with an additional two to three hours in the recovery room.
Who will perform the surgery?
Your orthopaedic surgeon will perform the surgery.
Will the surgeon see my family immediately after surgery is completed?
Whenever possible, the surgeon or one of his assistants will meet with family members immediately after surgery. If for any reason this is not possible, you may contact the doctor’s office to arrange a time to discuss how the surgery went.
What will my hospital stay be like?
You will most likely be “groggy” at first from the medications you receive during surgery. You will be transported from the recovery room to your hospital room once your surgeon and medical team deem it safe for you to be transferred.
Once you are fully awake, you will be able to drink and eat as tolerated. Your vital signs, urinary output and any drainage will be monitored closely by nurses on the orthopaedic surgery floor. Pain medicine will also be monitored closely. Make sure to talk with your doctor before surgery about your pain management options. You may receive pain medicine through your IV, through the epidural or in shots or by pills. It may also be administered intravenously by “pain pump” for the first 24 hours, which allows you to control yourpain medication up to a predetermined dosage. Starting on day one post-operatively you will work two to three times a day with physical and occupational therapists, who will go over exercises and help you adapt daily activities to your post-operative limitations.
How long will I be in the hospital?
Most patients are hospitalized between 1 and 4 days. This may be extended to include treatment at a rehabilitation center or sub-acute facility.
Do I need someone to stay full-time with me when I go home?
It is best for someone to be with you the first 24 to 72 hours after discharge. If you live alone and a friend or relative offers to stay with you, take them up on the offer! If you can’t arrange a full-time helper, perhaps a friend of neighbor can call daily to check on your progress. Home care can also be arranged through your case manager.
When can I go up and down stairs?
Many patients can climb stairs before leaving the rehabilitation facility. Your surgeon and physical therapist will advise you on when you can start using stairs.
Will I need pain medicine after I’m discharged?
Most patients do benefit from a short-term course of pain medication. Expect to take some kind of pain medication for several weeks after discharge, especially at night or before therapy sessions subject to your surgeon’s evaluation. You can call your doctor’s office for prescription renewals.
How long will I need to use my walker or crutches?
Your orthopaedic surgeon will work with your physical therapist to develop a specific ambulation plan for you. Generally, patients use a walker or crutches for the first six weeks after surgery. Then, they can graduate to a cane for about six weeks or more before walking on their own.
When can I go outside?
You may go outside at any time. Start with short trips at first - therapy, church - and increase the number and length of outside activities, as you feel more comfortable. Be very cautious during periods of poor weather, particularly with snow and ice.
When can I drive?
Your surgeon will advise you when you will be able to drive again; most patients must wait for six weeks before driving. However, some physicians may allow the patients to drive earlier if they feel the patients can do so safely. The type of surgery, side of surgery (left leg vs. right leg), and the patient’s overall general condition and your state laws will play a part in that decision. If you wish to drive earlier than recommended, you should discuss this with your surgeon and obtain his/her approval. Consult with your surgeon for further details.
When can I return to work?
Most patients wait until at least six weeks post-surgery to return to work. Some may return earlier if they can do so safely. You should discuss your own situation with your surgeon during a follow-up visit.
How often will I need to see my surgeon?
You will need to schedule your first post-operative visit two to three weeks after discharge according to your surgeon’s rcommendation. The frequency of additional visits will depend on your progress. Many patients are seen at six weeks, 12 weeks and then yearly.
When can I resume sports activities?
Please always ask your surgeon because you have to remember that some activities are not adviseable after you have received an artificial joint replacment. You should be able to try swimming, distance walking, hiking, bicycle riding, golfing and other low impact sports activities after a few weeks of rehabilitation and recovery. Discuss your activity level and abilities with your surgeon.
When will I be able to have sexual intercourse after surgery?
In most cases, you may resume sexual activity when you feel comfortable enough to do so. Make sure to heed any position restrictions recommended by your caregivers. In general, most patients resume normal sexual activities within 4 to 6 weeks after surgery.
Will I notice anything different about my knee?
You may have a small area of numbness on the outside of the scar for a year or more. Kneeling may be uncomfortable for a year or so, and you may notice clicking when you move your knee.