I will discuss the pros and cons of surgical vs non-surgical treatment for knee osteoarthritis, and a tailor a treatment plan to your individual needs. Once a mutually agreed decision to have surgery has been made, you will be listed for surgery. You will be taken through the consent process and asked to sign a form.
You will receive an appointment to attend the pre-operative assessment clinic. Your relative/carer is also encouraged to attend with you as they will be an important part of your recovery and timely discharge. During this appointment a detailed medical history will be taken. A blood sample will be required, heart tracing will be taken (ECG), swabs will be taken to check for the presence of bacteria (MRSA). We may need to organise other investigations based on your individual needs to ensure you are optimised and safe prior to having your operation.
Before you come into hospital it is important you are as fit as possible for your operation. You can do this with a healthy balanced diet and regular exercise. We appreciate walking may be painful, but a lot of exercises can be done by sitting in a chair or laying down in bed. It is important that your skin is in good condition, as wounds or rashes on the skin increase the chances of you getting an infection. If you have any concerns regarding your skin in the days leading up to your operation, we strongly advise you to let us know.
Day of Knee Replacement Operation
You will be welcomed on to the ward by one of our friendly healthcare professionals. You will meet the nurse or healthcare assistant who will methodically go through your admission paperwork and carry out a few baseline observations.
You will meet the anaesthetist who will discuss the anaesthetic plan with you. We usually tend to do the operation under a spinal/epidural anaesthetic as this usually leads to the quickest post-operative recovery and allows you the opportunity to mobilise early on your new knee. Sometimes a general anaesthetic may be required.
You will meet me, and I will confirm the operation plan with you and will happily answer any questions that you might have. The operation lasts approximately an hour or hour and a half.
After Your Knee Replacement Operation
You will be transferred from the recovery area to the ward. You might experience some pain which will be different to the pain you were experiencing prior to surgery. You will be given pain killers to help manage this. Depending on how long it takes for the anaesthetic to wear off you may be able to walk on your new knee on the day of surgery or the following day.
The length of stay in hospital is usually a couple of nights, but you may be able go home sooner or later depending on your general condition and safety with mobilisation with the physiotherapists. A small proportion of people may be able to go home within 24 hours of their operation once all the safety requirements are fulfilled.
After you go home, you will need to continue with the exercises you were taught on the ward by the physiotherapist. It is very important for you to attend out-patient physiotherapy appointments; if you cannot attend these appointments kindly let the physiotherapists on the ward know prior to your discharge allowing them to make alternative arrangements.
Depending on your individual needs, you might be provided equipment by the occupational therapist on discharge to maintain your safety and independence once you are home. However, where possible, we would always encourage you to carry out tasks that help you improve your knee bend over time. Most patients continue to improve the amount of knee bend they get up to one year following surgery.
Simple walking with two sticks/ crutches is one of the best exercises for your new knee. Start with frequent short walks and build up the amount you walk slowly as your stamina improves. There is no set walking regimen, rather walk what distance you feel comfortable doing. Discard one crutch or stick when you feel confident or competent to do so. Discard the second crutch or stick only when you feel you no longer need it.
You must not drive till you have be given the go ahead by me. This period is usually 6 weeks from surgery. It is your responsibility to inform your insurance company that you have had a total knee replacement. If you are a passenger, it is advisable to sit in the front seat, with the seat well back and slightly reclined to give you additional leg room.
Most leisure activities may be enjoyed and continued with care after a total knee replacement. Remember to take things gently, not overdo it, and when in doubt seek your surgeon’s advice.
Do not gain excess weight, or take part in activities that involve running, jumping, pulling or twisting. Avoid heavy manual labour, heavy lifting, or activities causing repetitive impacts to your knee.
Take care with heavy manual work and lifting heavy weights. Gardening should be avoided until advised by me. Avoid kneeling on your operated knee. Avoid heavy garden work involving excessive lifting.
If you are planning a holiday after your operation, wait at least 3 months to go on a short haul flight and 6 months for long haul flights and coach holidays. Beware, coach or airline toilet seats may be too low.