Total Knee Joint Replacement FAQ

A knee replacement is usually a safe and successful way to treat knee arthritis but like any surgery, there are risks involved. When the pain from you knee is so much that it interferes with your leisure activities and normal functions or wakes you at night it is usually time to consider it. You should discuss your options carefully with your surgeon so that together, you can decide on a treatment plan that is right for you.

• Once you and your surgeon have decided that a knee replacement is the right decision for you, a plan will be discussed with you regarding your usual medications as some of these medicines (like blood thinners or blood pressure tablets) may need to be stopped before your surgery
• You will usually need to have a blood test and a tracing of your heart (ECG) before your operation
• For people with other health conditions, we might arrange for the anaesthetist to see you before your surgery to make sure your surgery is as safe as possible
• If you have health insurance that you would like to use to fund your surgery, it is important to speak with them before your operation. We can provide the information that they will require to process your claim
• We know that smoking increases the risks associated with surgery. We recommend that patients stop smoking, both before and after their operation, to reduce the risk of a complication occurring

There are several steps to take to make your operation as safe and smooth as possible.

• You will be given a special soap to wash with before your procedure to minimise the risk of infection
• It is very important not to have anything to eat or drink in the 6 hours before your operation although, you can have small sips of water up until 2 hours beforehand. This is because some of the medicines used during your anaesthetic may cause the stomach to relax and if your stomach is not empty, the contents may move into the lungs and cause serious problems with your breathing
• When you arrive at the hospital, our staff will help you change into a hospital gown and will give you stockings to wear to reduce the risk of blood clot
• Your surgeon and anaesthetist will see you before your surgery to complete your consent form and answer any questions you might have. Your surgeon will also draw an arrow on your leg to confirm the operation and side to be operated on. This is a standard part of our safety checklist for every operation
• At several points before your operation, your identity and surgery will be confirmed along with other important medical information (such as allergies). This is another standard part of our safety checklist for every operation
• When it is time for your surgery, you will be taken through to the operating room. Most people find this a little daunting as there are a lot of people in the room and the specialist equipment required for your procedure. Just remember, everyone in the room is there to look after you, answer your questions and make you as comfortable as possible
• Most patients will require a catheter (a soft, flexible tube inserted into the bladder) and an IV line (drip) to be placed. These are usually removed the day after your operation

• When your surgery is complete, you will spend some time in the recovery room (PACU) where you are looked after by a specialist team before being transferred to the ward
• You will be given regular pain relief medication but it is important to let the staff know if you have pain, nausea or other concerns so that we can keep you safe and comfortable
• The team on the ward will monitor your vital signs and your wound. They will help you stand and walk when you are comfortable
• Ice is usually used (or a cooling bandage) to reduce the swelling and increase the comfort.
• You will be able to leave the hospital when your surgeon is happy with your progress and we can be sure you will manage at home. Your pain must be well controlled with tablet medication and you will need to be ableto walk around safely and care for yourself without assistance from staff. This usually takes 3-4 days for most people
• Before you leave the hospital, you will have information about physiotherapy- a vital part of recovery after your surgery

• Someone should be available to stay with you and provide additional supportwhen you return home from the hospital
• You will have a waterproof dressing on your knee which should stay in place until you see your surgeon, usually two to three weeks after your operation
• It is important to see the physiotherapist and practice the exercises you have been taught. This helps you regain your strength and ensures that you will get the most benefit from your surgery in the long-term

• Most people find that their pain has improved significantly within a week or twoafter their surgery. However, it is normal to need to take simple pain relief for the first 6 weeks or longer. You should need less medication as time goes by. The knee often feels stiff and swollen for many weeks – but you will be able to walk on it and increase its movement as time goes by.
• It is expected that most patients will be able to fully straighten their knee and bend to at least 90 degrees within 6 weeks of your operation. It will take longer than this for your strength to recover. Physiotherapy is very important to achieve these goals
• Many patients are able to return to their normal activities within 6 weeks of surgery however, we expect that patients will continue to notice improvement for up to 2 years after their surgery

• In order to leave the hospital, your surgeon must be happy with your progress and we need to be sure you will manage at home
• Your pain must be well managed with tablet medication and you must be able to walk (with crutches) and care for yourself without assistance from staff

• Provided your pain is well controlled and you have recovered adequately from your anaesthetic, you are able to put weight through your knee and even walk the same day as your operation

• Generally, we advise that patients may not drive in the first 6 weeks after a knee replacement. After this period, it is important to be sure you could make an emergency stop if required before resuming driving. We also recommend checking with your car insurance provider to ensure they do not have rules regarding surgery and driving. If you do not comply with these rules, they may not cover you in the event of an accident

• This depends on the type of work you do. People with a sedentary job may feel they are able to return to work 4-6 weeks after surgery. If your job is very active, it might between 6 weeks and 3 months before return to work is advised.
• You should talk to your surgeon about what is right for you

• Immediately after your surgery, you will have a bandage which is not waterproof. This is usually removed the following day and the dressing underneath is waterproof
• Your waterproof dressing should stay in place until you see your surgeon to check your wound, two to three weeks after your surgery

• You will receive information about your next appointment before you leave the hospital
• You will see your surgeon two to three weeks after your surgery to check your wound and then again 6 weeks after your operation

• If you have chest pain, shortness of breath or other serious problems, you should seek emergency attention without delay
• If there is a problem with your wound or if you have other concerns about your progress, you should contact the hospital or your surgeon who will advise you on the best course of action