Total Knee Replacement: Before Your Surgery

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What is a total knee replacement?

Knee joint with osteoarthritis

A total knee replacement replaces the worn ends of the bones where they meet at the knee. Those bones are the thigh bone (femur) and the lower leg bone (tibia). Your doctor will remove the damaged bone. Then he or she will replace it with plastic and metal parts. These new parts may be attached to your bones with cement.

Your doctor will make a cut down the centre of your knee. This cut is called an incision. It will be about 20 to 25 centimetres long. Sometimes the surgery can be done with a smaller incision that is 10 to 15 centimetres. Both kinds of incisions leave scars that usually fade with time.

You probably will be able to go home about 3 to 5 days after surgery. If you have both knees done at the same time, you may need to be in the hospital for 1 week. If there is no one to help you at home, you may go to a rehab centre.

Most people go back to normal activities or work in 4 to 16 weeks. This depends on your health. It also depends on how well your knee does in your rehab program. This may take longer if you have both knees done at the same time.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

What happens before surgery?

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

  • Understand exactly what surgery is planned, along with the risks, benefits, and other options.
  • Tell your doctors ALL the medicines and natural health products you take. Some of these can increase the risk of bleeding or interact with anesthesia.
  • If you take blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, be sure to talk to your doctor. He or she will tell you if you should stop taking these medicines before your surgery. Make sure that you understand exactly what your doctor wants you to do.
  • Your doctor will tell you which medicines to take or stop before your surgery. You may need to stop taking certain medicines a week or more before surgery. So talk to your doctor as soon as you can.
  • If you have an advance care plan, let your doctor know. Bring a copy to the hospital. If you don't have one, you may want to prepare one. It lets your doctor and loved ones know your health care wishes. Doctors advise that everyone prepare these papers before any type of surgery or procedure.
  • You may need to shower or bathe with a special soap the night before and the morning of your surgery. The soap contains chlorhexidine. It reduces the amount of bacteria on your skin that could cause an infection after surgery.

What happens on the day of surgery?

  • Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be cancelled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
  • Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
  • Do not shave the surgical site yourself.
  • Take off all jewellery and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery centre

  • Bring a picture ID.
  • The area for surgery is often marked to make sure there are no errors.
  • You will be kept comfortable and safe by your anesthesia provider. The anesthesia may make you sleep. Or it may just numb the area being worked on.
  • You also will get antibiotics through the IV tube before surgery. This lowers the risk of an infection of the incision.
  • The surgery will take about 2 to 3 hours.

Going home

  • Be sure you have someone to drive you home. Anesthesia and pain medicine make it unsafe for you to drive.
  • You will be given more specific instructions about recovering from your surgery. They will cover things like diet, wound care, follow-up care, driving, and getting back to your normal routine.

When should you call your doctor?

  • You have questions or concerns.
  • You don't understand how to prepare for your surgery.
  • You become ill before the surgery (such as fever, flu, or a cold).
  • You need to reschedule or have changed your mind about having the surgery.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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Current as of: May 23, 2016