Knee Joint Replacement

WHAT YOU SHOULD KNOW

Risks

IF YOU'RE HEADING FOR THE HOSPITAL...

Before You Go

• Your doctor will tell you when on the night before surgery you must stop eating and drinking. Follow these directions exactly.
• You may take pills with a sip of water the morning of surgery.
• Follow your doctor's instructions about when to stop taking aspirin or ibuprofen before the operation.
• To assure a good night's rest, you may be given a sleeping pill to take the night before surgery.

When You Arrive

• You will be taught how to cough and breathe deeply to reduce your chances of getting a lung infection after surgery.
• Before surgery, you may be taught special exercises to help make your knee stronger. You will also learn how to roll from side to side after the surgery and how to use a trapeze bar to move yourself around in bed.
• An anesthesiologist (AN-is-THEE-se-OL-o-gist) will put you to sleep just before the operation. This doctor may come and talk to you the day before surgery.
• You may need to have your knee cleaned with a special liquid before going to the operating room. The medication in this liquid may make your skin yellow, but will come off easily.

What to Expect While You're There

• Taking Your Vital Signs: These include your temperature, blood pressure, pulse (counting your heartbeats), and respirations (counting your breaths). A stethoscope is used to listen to your heart and lungs. Your blood pressure is taken by wrapping a cuff around your arm.
• Oxygen: May be given to you during surgery. You may also need extra oxygen as you are waking up after the operation.
• Pulse Oximeter: You may be hooked up to a pulse oximeter (ox-IM-uh-ter). This device is placed on your ear, finger, or toe and is connected to a machine that measures the oxygen in your blood.
• Blood: Usually taken from a vein in your hand or from the bend in your elbow and sent to a laboratory for testing.
• IV: A tube placed in your vein for giving medicine or liquids. It will be capped or have tubing connected to it.
• Chest X-ray: This is a picture of your lungs and heart. The doctors use it to see how your heart and lungs are doing before surgery.
• Before Surgery: You may be given medicine to make you sleepy before you are taken to the operating room.
• ET Tube: During surgery, you may have a tube placed in either your mouth or nose. This tube goes into your trachea (windpipe). The ET tube serves two purposes: It protects your trachea during surgery and it allows your doctor to give you oxygen when you need it. After the tube is taken out, you may have a sore throat for a while.
• After Surgery: You will be taken to a special unit until you wake up. When you wake up or are close to waking up you will be taken back to your room. You will have a bandage and maybe a splint over your knee where the operation was performed.
• Activity: You will need to rest in bed until your doctor says you may get up. Otherwise you may damage your knee.
• ECG: Also called a heart monitor, an electrocardiograph (e-LEC-tro-CAR-dee-o-graf), or EKG. The patches on your chest are hooked up to a TV-type screen or a small portable box (telemetry unit). This screen shows a tracing of each heartbeat. Your heart will be watched to make sure your body is handling your surgery well. It will also be monitored for signs of injury or damage during surgery.
• Turning: You must turn in a special way after surgery and you will need to use pillows between your legs to keep the one that was operated on from moving in the direction of the other leg.
• Physical Therapy: Sometime after surgery, a physical therapist will teach you special exercises to strengthen the knee and improve its movement.
• Pressure Stockings: After the operation, you may need to wear these special stockings on both legs or on just the leg that was operated on. You may be given stockings that tighten first on one leg and then the other, or you may wear a special pair of tight socks. These are needed during long periods of immobility to keep the blood from pooling in the legs and causing clots.
• Medicines:
  • Antibiotics may be prescribed to prevent infection following the surgery. They may be given by IV, in a shot, or by mouth.
  • Blood Thinners such as heparin, warfarin, or aspirin may be given to prevent blood clots, especially if you will be resting in bed for a long time.
  • Pain Medicine may be given in your IV, as a shot, or by mouth. If the pain does not go away or comes back, tell a doctor right away.
  • Anti-Nausea Medicine may be prescribed if your pain medication upsets your stomach or makes you vomit.

After You Leave

• Always take your medicine as directed by your doctor. If you feel it is not helping, call your doctor, but do not stop taking it on your own.
• If your doctor has prescribed antibiotics, finish all the medication even if you feel well. Ask your doctor if you need to take antibiotics before seeing your dentist.
• If you are taking medicine that makes you drowsy, do not drive or use heavy equipment.
• You will need to use crutches for walking for the first 6 to 12 weeks. Then you may slowly start walking without crutches or a cane.
• You may also need to wear a knee brace or splint for a while to protect your knee and keep it from moving too much while it heals. You may take it off to shower or bathe. If your toes feel numb and tingly, loosen it.
• For the next 3 months, you must be careful about how you move or place your leg.
  • Do not cross your legs when you are sitting, lying, or standing.
  • Keep your leg facing forward at all times, even in bed. Never turn your knee outward or inward.
  • Put a pillow between your legs when you lie down on the side opposite the operation.
• Do not sit on low chairs, low stools, or low toilet seats. Do not use reclining chairs. You may need a firm cushion to raise chair seats. You may want to rent or buy a raised toilet seat. This will help to prevent you from putting too much strain on the knee.
• Sit only in chairs that have arms. When you get up from a chair, move to the edge, then hold the chair arms and push yourself up. While getting up, keep the leg that was operated on in front of the other one and push up with the good leg.
• After you've recovered, it is usually alright to swim, play golf, walk, and bicycle; but avoid exercises that repeatedly jar the knee joint, such as tennis and jogging.
• Do not drive until your doctor gives you the go-ahead.
• Until you are completely back on your feet, you may need to wear support socks to help reduce swelling in your legs.

Call Your Doctor If...

• You have fever, swelling, or redness at your surgery site.
• The pain in your knee increases or you have trouble moving around.

Seek Care Immediately If...

• You fall and injure the knee.
• You suddenly have trouble breathing.
• Your leg or toes feel numb, tingly, or cool to the touch, or turn pale or blue.