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Frequently Asked Questions about
Total Knee Replacement
We are glad you have chosen the Joint
Surgery Center to care for your knee. Patients have asked many questions
about total knee replacement. Below is a list of the most frequently
asked questions along with their answers. If there are any other
questions that you need answered, please ask your surgeon or the Joint
Care Coordinator. You can contact the Joint Care Coordinator at 928
214-2812 or by e-mail at
FMCJointSurgeryCenter@nahealth.com. We want you to be completely
informed about this procedure.
What is arthritis and why does my
knee hurt?
In the knee joint there is a layer
of smooth cartilage on the lower end of the femur (thighbone), the upper
end of the tibia (shinbone) and the undersurface of the patella
(kneecap). This cartilage serves as a cushion and allows for smooth
motion of the knee. Arthritis is a wearing away of the smooth cartilage.
Eventually, the cartilage wears down to bone. Rubbing of bone against
bone causes discomfort, swelling and stiffness.
What is a total knee replacement?
A total knee replacement is really
a cartilage replacement with an artificial surface. The knee itself is
not replaced, as is commonly thought, but rather an artificial
substitute for the cartilage is inserted on the end of the bones. This
is done with a metal alloy on the femur and plastic spacer on the tibia
and kneecap (patella). This creates a new, smooth cushion and a
functioning joint that does not hurt.
What are the results of total knee
replacement?
Results will vary depending on the
quality of the surrounding tissue, the severity of the arthritis at the
time of surgery, the patient’s activity level and the patient’s
adherence to the doctor’s orders.
When should I have this type of
surgery?
Your orthopaedic surgeon will
decide if you are a candidate for the surgery. This will be based on
your history, exam, X-rays and response to conservative treatment. The
decision will then be yours.
Am I too old for this surgery?
Age is not a factor if you are in
reasonable health and have the desire to continue living a productive,
active life. You may be asked to see your primary care provider for
his/her opinion about your general health and readiness for surgery.
How long will my new knee last and
can a second replacement be done?
All implants have a limited life
expectancy depending on an individual’s age, weight, activity level and
medical condition(s). A total joint implant’s longevity will vary in
every patient. It is important to remember that an implant is a medical
device subject to wear that may lead to mechanical failure. While it is
important to follow all of your surgeon’s recommendations after surgery,
there is no guarantee that your particular implant will last for any
specific length of time.
Why might I require a revision?
Just as your original joint wears
out, a joint replacement will wear over time as well. The most common
reason for revision is loosening of the artificial surface from the
bone. Wearing of the plastic spacer may also result in the need for a
new spacer. Your surgeon will explain the possible complications
associated with total knee replacement.
What are the major risks?
Most surgeries go well, without
any complications. Infection and blood clots are two serious
complications. To avoid these complications, we use antibiotics and
blood thinners. We also take special precautions in the operating room
to reduce the risk of infections.
Should I exercise before the
surgery?
Yes, consult your surgeon about
the exercises appropriate for you.
Will I need blood?
You may need blood after the
surgery. Bank blood is considered safe, but we understand if you want to
use your own.
How do I donate my own blood?
Most patients will not need to
donate blood. If, however, your physician requests you to donate your
own blood, it will be arranged by your surgeon’s office.
How long will I be incapacitated?
You will probably stay in bed the
day of your surgery. However, the next morning most patients will get
up, sit in a chair or recliner and should be walking with a walker or
crutches later that day.
How long will I be in the
hospital?
Most knee patients will be
hospitalized for three days after their surgery. There are several goals
that you must achieve before you can be discharged.
What if I live alone?
Two options are usually available
to you. You may return home and receive help from a relative or friend.
You can have a home health nurse and physical therapist assist you at
home for two or three weeks. You may also stay at a sub-acute facility
following your hospital stay, depending on your insurance.
Will I need a second opinion prior
to the surgery?
The physician’s office secretary
will contact your insurance company to pre-authorize your surgery. If a
second opinion is required, you will be notified.
How do I make arrangements for
surgery?
After your surgeon has scheduled
your surgery and preadmission appointment, the Joint Care Coordinator
will contact you. The
Joint Care
Coordinator will guide you through the
program and make arrangements for both pre-op and post-op care.
How long does the surgery take?
We reserve approximately 2–2½
hours for surgery. Some of this time is taken by the operating room
staff to prepare for the surgery.
Do I need to be put to sleep for
this surgery?
You may have a general anesthetic,
which most people call “being put to sleep.” Some patients prefer to
have a spinal or epidural anesthetic, which numbs your legs only and
does not require you to be asleep. The choice is between you, your
surgeon and the anesthesiologist.
Will the surgery be painful?
You will have discomfort following
the surgery, but we will try to keep you comfortable with the
appropriate medication. Generally, most patients are able to stop very
strong medication within one day. Most patients control their own
medicine with a special pump that delivers the drug directly into their
IV.
Who will be performing the
surgery?
Your orthopaedic surgeon will
perform the surgery. An assistant often helps during the surgery and
that assistant will bill you separately.
How long, and where, will my scar
be?
The scar will be approximately six
inches long. It will be straight down the center of your knee, unless
you have previous scars, in which case we may use the existing scar.
There may be some lasting numbness around the scar.
Will I need a private nurse?
No, you do not need a private
nurse, but if you want one, we can assist in making these arrangements
for you.
Will I need a walker, crutches, or
a cane?
Yes, for about six weeks we do
recommend that you use a walker, a cane, or crutches. The
Joint Care
Coordinator can arrange for them if necessary. The Joint Care
Coordinator will be working with a case manager to facilitate your
post-op care and equipment needs.
Where will I go after discharge
from the hospital?
Most patients are able to go home
directly after discharge. Some patients may transfer to a sub-acute
facility, where they will stay from 3-5 days. The
Joint Care
Coordinator
will help you with this decision and make the necessary arrangements.
You should check with your insurance company to see if you have
sub-acute rehab benefits.
Will I need help at home?
Yes, for the first several days or
weeks, depending on your progress, you will need someone to assist you
with meal preparation, etc. If you go directly home from the hospital,
the Joint Care Coordinator may arrange for a home health care nurse to
come to your house as needed. Family or friends need to be available to
help if possible.
Preparing ahead of time, before your surgery, can minimize the amount of
help needed. Having the laundry done, house cleaned, yard work
completed, clean linens put on the bed and single portion frozen meals
will help reduce the need for extra help.
Will I need physical therapy at
home?
You may need this service when you
go home. If so, you will have either outpatient or in-home physical
therapy. Patients are encouraged to utilize outpatient physical therapy.
The
Joint Care
Coordinator will help you arrange for an outpatient
physical therapy appointment. If you need home physical therapy, we will
arrange for a physical therapist to provide therapy at your home.
Following this, you may go to an outpatient facility three times a week
to assist in your rehabilitation. The length of time required for this
type of therapy varies with each patient.
How long until I can drive and get
back to normal?
The ability to drive depends on
whether surgery was on your right leg or your left leg and the type of
car you have. If the surgery was on your left leg and you have an
automatic transmission, you could be driving at two weeks. If the
surgery was on your right leg, your driving could be restricted as long
as six weeks. Getting “back to normal” will depend somewhat on your
progress. Consult with your surgeon or therapist for their advice on
your activity.
When will I be able to get back to
work?
We recommend that most people take
at least one month off from work, unless their jobs are quite sedentary
and they can return to work with crutches. An occupational therapist can
make recommendations for joint protection and energy conservation on the
job.
When can I have sexual
intercourse?
The time to resume sexual
intercourse should be discussed with your surgeon.
How often will I need to be seen
by my doctor following the surgery?
Two to three weeks after
discharge, you will be seen for your first postoperative office visit.
The frequency of follow-up visits will depend on your progress. Many
patients are seen at six weeks, 12 weeks and then yearly.
Do you recommend any restrictions
following this surgery?
Yes, high-impact activities, such
as running, singles tennis and basketball are not recommended.
Injury-prone sports such as downhill skiing are also dangerous for the
new joint.
What physical/recreational
activities may I participate in after my recovery?
You are encouraged to participate
in low-impact activities such as walking, dancing, golf, hiking,
swimming, bowling and gardening.
Will I notice anything different
about my knee?
Yes, you may have a small area of
numbness to the outside of the scar, which may last a year or more.
Kneeling may be uncomfortable for a year or more. Some patients notice
some clicking when they move their knee. This is the result of the
artificial surfaces.
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FREQUENTLY
ASKED QUESTIONS
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TOTAL HIP
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TOTAL
KNEE
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PATIENT
ANESTHESIA FAQs
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CONTACT
INFORMATION
You can contact the
Joint Care Coordinator
at 928 214-2812
or by
e-mail.
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