13/02/2015
FAQ's - concerning Total Knee Replacement
RATIONALE
Patients are rightfully trying to become more educated about their surgery and recovery. Many a times they obtain (mis)information from various resources. It is always better to get all the answers of their questions before undergoing surgery. It helps in preparing the patient for surgery mentally as well as physically. Because of which after surgery period becomes smooth. These FAQs are designed to give all the answers. Even though, you must contact and ask your surgeon before hand.
CATEGORIES OF QUESTIONS
Questions are divided in three parts.
1. Preoperative-Before surgery
2. Perioperative- During and after hospitalization
3. Postoperative-after surgery
Some symptoms are common after this surgery. If they know before sugery, it does not create anxiety. e.g. Clicking sound from the operated knee, Numbness on outer aspect of the knee, swelling after exercise and at the end of the day, warmth around the knee.
Whenever there is redness around the knee,increased swelling and pain,calf pain,fever, discharge from the operated knee- patient must contact their surgeon.
Preoperative Questions
Q: What is the chance for success?
A:
Success rate depends on answers of the following questions if it is "yes".
Are you glad you had operation?
Did it fulfill you expectations?
Would you undergo for the another knee?
Approximately 98% of patients wil answer "yes" to all three questions at the end of 3-6 months.
Q:
When can i resume my day today activity after surgery?
A:
Every human being has different mental and physical strength. It decides their recovery
period. Usually, patients are allowed to walk with walker from the next day of surgery and
withing 3-4 days with the help of stick. They can move around in house and gradully can walk independtly without support.
Q:
When can I drive car?
A:
If right knee has been replaced then it is advisable not to drive for one month. Then you
can drive as soon as you feel comfortable. If left knee has been replaced then may drive as soon as you feel comfortable if you have an automatic transmission. Some surgerons do not allow until 4 to 6 weeks after surgery. Check with your surgeon.
Q:
Do I require physiotherapy?
A:
Yes, according to literature physiotherapist plays an important role in your recovery. He
guides you how to do exercises helps you to recover faster.
Q:
When can I travel?
A:
As soon as you feel comfortable you can travel. It is important to remember that you should walk at least once an hour to prevent blood clots-deep vein thrombosis(DVT). Ankle pumps is very useful exercise to prevent DVT.
Q:
When can I return to work?
A:
It depends on your profession. If you have table work then you can join after one month. If
you have to move around then it may take longer time. It depends on your work pattern.
Q:
What activities are permitted following surgery?
A:
You can do most of activities like walking, house hold work, gardening and golf. Exercises
like swimming and static cycle would increase strength and movement of the knee. High
impact exercises are advisable to avoid.
Q:
How long this surgery will last?
A:
It varies from patient to patient. Every year there is 1% chance of requiring another surgery. For example, at 10 years there is 90% success rate without further surgery.
Perioperative Questions:
Q:
When can I take bath?
A:
After stitches/Staples are removed and wound has healed nicely, you can take a bath.
Q:
When stitches/staples are removed?
A:
Staples/stitches are removed after 2-3 weeks from the day of surgery.
Q:
How long will I be on pain medication?
A:
Everyone has different pain tolerance. Initially strong pain killers (analgesics) are required.
After a 1-2 months pain killer are discontinued.
Q:
How long will I be on blood thinner medication?
A:
Various options like tablets or injections are available to prevent Deep venous thrombosis
(clotting of blood) after surgery. Depending on your medical history your surgeon decides about the medication and its duration.
Q:
How long I have to wear Knee brace?
A:
After surgery, knee brace is advisable while walking and till you can do straight leg raise. At
the time of sitting exercises brace can be removed. After suture removal, usually knee
brace is discontinued.
Q:
How long should I take iron supplement?
A:
Usually four weeks of iron supplement is given. But it also depends on your preoperative
hemoglobin level. It helps to replenish your body and increase hemoglobin level.
Q:
Which positions are good or bad for my knee after surgery?
A:
Everyday you must spend some time working on both flexion and extension of knee. Always change positions every 15 to 30 minutes. Don’t put pillow under your knee. A pillow or roll under the ankle helps improve extension and prevent contracture.
Q:
Should I apply ice or heat?
A:
Initially, Ice helps in decreasing the swelling and to reduce pain. After few weeks depending upon your comfort, ice or heat can be applied.
Q:
When can I go up and down stairs?
A:
Usually on 3rd or 4th day of surgery, you can start. Initially, you will lead unoperated leg
when going up stairs and operated leg when going down. As muscle strength and
movements improve, more normal fashion can be achieved.
POST OPERATIVE CONCERNS:
Q:
What range of motion should I expect from my knee?
A:
It varies and depends on many individual factors. Your potential will be determined at the
time of your surgery. The average patient achieves approximately 120 degrees of flexion.
Some may achieve less and others much more.
Q:
Has my leg become longer then before operation?
A: When there are "BOW LEGS" before surgery which becomes straight after surgery. Due to
which patient feels the leg has become longer. If only one leg is operated and other limb is
also affected than it is advisasble to use "Shoe lift" in non operated leg.
Q: Can there be any problem passing through security monitors at airport/public places?
A: Whenever you pass through metal detector, immediately alarm would be active. You should
inform at security check so they can do necessary arrangements. Wear clothing that will
allow you to show them your knee incision without difficulty.
Q: Do I need antibiotic/s before any invasive or dental procedure?
A: Yes, any dental procedure or nonurgent procedures are to be avoided for 6 weeks after knee replacement surgery.
Q: When do I need to see my surgeon for follow up?
A: After suture removal, intial 4 to 6 weeks you should consult your surgeon regularly. Then
followed by 1 year,2 year 5 year and 10 years. In between if you have any problem about
knee or any doubt you should consult your surgeon.
