Post Anesthesia Care Unit
- After surgery, you will be taken to the recovery room or Post Anesthesia Care Unit .; Most people stay about 1 to 1 1/2 hours here. Your time in the PACU will depend on your surgery and how fast you recover from the anesthesia.
- A member of your health care team;will monitor your vital signs, help you if you have any side effects from the anesthesia and work with you to make you as comfortable as possible.
- You may have an immobilizer brace on your surgical leg that extends from your thigh to just above your ankle. This will keep your leg straight and provide some support for your leg when you get up.
- An X-ray may be taken of your new joint in the PACU.
What Are The Advantages Of Knee Replacement
Long-term, you may still feel some discomfort and have to limit high-impact activity to protect the replacement joint. But knee replacement can relieve a lot of the pain and help you move much better. More than 90% of people who have a total knee replacement still function well 15 years after surgery.
When Can I Go Home
You will usually be in hospital for 3;to 5;days, depending on what progress you make and what type of knee replacement you have. Patients who have a half knee replacement usually have a shorter hospital stay.
If you are generally fit and well, the surgeon may suggest an enhanced recovery programme where you start walking on the day of the operation and are discharged within 1;to 3;days.
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What Is A Knee Replacement
A knee replacement is carried out to treat knee pain, usually due to knee osteoarthritis, which is gradual wear and tear of the joint. Arthritis accounts for the majority of the 90,000 knee replacements carried out in England and Wales annually.
During the procedure, both sides of the damaged joint are removed and replaced with a prosthesis or implant. If your arthritis is minimal, and youre under 65, you may be able to have a partial knee replacement. With this procedure the surgeon only replaces the damaged compartment, which means that the knee tends to bend better and feel more like a normal knee than after a partial knee replacement than it would with a total knee replacement. Your surgeon will recommend the surgery thats best for you, depending on your symptoms and X-ray results.
Knee Extension Stretches And Exercises
Expect to perform a variation of these knee extension exercises:
- Quad Sets
- Seated calf stretch with towel/belt
- Standing TKE
Some patients will use a continuous passive movement machine that will repeatedly assist bending and straightening your knee slowly for hours each day for a couple weeks until they have reached a desired range of motion.
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What Does Knee Replacement Surgery Involve
Total knee replacement surgery involves replacing the knee joint with an artificial joint made of metal, plastic or ceramic materials. Materials used in making your artificial joints are strong and designed to last a long time inside your body. To work on the knee, your surgeon will make an incision across the front of your knee to gain access to the patella, more commonly referred to as the kneecap. Additional information about knee replacement surgery.
How Long Will It Be Before I Feel Normal
You should be able to stop using your crutches or walking frame and resume normal leisure activities 6 weeks after surgery. However, it may take up to 3 months for pain and swelling to settle down. It can take up to a year for any leg swelling to disappear.
Your new knee will continue to recover for up to 2 years after your operation. During this time, scar tissue will heal and muscles can be restored by exercise.
Even after you have recovered, it’s best to avoid extreme movements or sports where there’s a risk of falling, such as skiing or mountain biking. Your doctor or a physiotherapist can advise you.
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Discharged After Knee Replacement Surgery
My wife left and my son visited to take me home. The nurse and I decided on the pain medication I would be using at home.
At her suggestion, I elected to take Percocet. My prescription was to be filled by my local pharmacy and was for 50 pills.; I was to take one every four hours.
Another hospital worker came by and gave me a choice of several home Physical Therapists that would visit my home. She also asked if I could choose an off site Physical Therapist after my 7 visits at home were over.
My family called a few friends and neighbors who had recently had surgery and they asked them for suggestions. When the hospital worker returned I made my decision, signed papers, and was told I would receive a phone call to set up my first physical therapy appointment.
The nurse returned and had me sign discharge papers and gave me a bathing kit and a bag of some hospital issue items that I could take home. I was given my change of clothing and again signed a paper saying all my belongings were in the bag.
It took some effort to change from my hospital gown into my regular clothes and was told to wait for the hospital volunteer that would drive me to my car in a wheel chair. After goodbyes to the staff and my roommate, a volunteer named Joseph wheeled me out to my car.
What Are The Benefits Of Outpatient Knee Replacement
- More advanced care.;Since outpatient centers are newer, these ambulatory facilities tend to be more technologically advanced. These centers tend to be run by innovative surgeons who practice with orthopedics latest and greatest techniques. In other words, you wont be operated on by a dinosaur in a cave with dated techniques .
- A greater focus on pre-op preparation.;The more mentally, physically, and environmentally prepared you are for surgery, the lower your risk, the better your outcome, and faster your recovery. Outpatient surgery centers tend to invest more in prehab and encouraging patients to go into surgery with their best foot forward.
- Higher patient satisfaction.;Studies suggest outpatient joint patients are more satisfied;with their replacement and the care theyve received.;Other studies;found that staying longer in hospital is not what affects patient satisfaction.
- Lower rates of infection.;The shorter the stay in a care facility, the lower the risk of hospital infections.
- Recover at-home.;You can recovery in your own space where you are comfortable
Dr. Frisch explains, By going home the same day, you are really committing to using your new knee immediately. The result is that you start walking and performing your daily activities sooner than if you were to stay in the hospital. With the right preparation you will start to see the results and become more confident in your knee.
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Living With A Knee Replacement
Your doctor may want to see you from time to time for several months or more to monitor your knee replacement. Over time, you will be able to do most of the things you could do before surgery.
Controlling your weight will help your new knee joint last longer.
Stay active to help keep your strength, flexibility, and endurance. Your activities might include walking, swimming , dancing, or golf. You could also try cycling on a stationary bike or on level surfaces.
For at least 2 years after your surgery, your doctor may want you to take antibiotics before dental work or any invasive medical procedure. This is to help prevent infection around your knee replacement. After 2 years, your doctor and dentist will decide whether you still need to take antibiotics. Your general health and the state of your other health conditions will help them decide.
Do Total Joints Wear Out
The metal parts of total joints can loosen over time, but often the cause of wear is from the bearing surface. Your immune system attacks the particles from the bearing surface but also melts bone away. Now we are using a metal liner , ceramic-on-ceramic and cross-linked polyethylene liners that wear less than what we had years ago.
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How Well It Works
Most people have much less pain after knee replacement surgery and are able to do many of their daily activities more easily.
- The knee will not bend as far as it did before you developed knee problems. But the surgery will allow you to stand and walk for longer periods without pain.
- After surgery, you may be allowed to resume activities such as golfing, riding a bike, swimming, walking for exercise, dancing, or cross-country skiing .
- Your doctor may discourage you from running, playing tennis, squatting, and doing other things that put a lot of stress on the joint.
The younger you are when you have the surgery and the more stress you put on the joint, the more likely it is that you will later need a second surgery to replace the first artificial joint. Over time, the components wear down or may loosen and need to be replaced.
Your artificial joint should last longer if you are not overweight and you do not do hard physical work or play sports that stress the joint.
People who have a partial knee replacement may have less pain. But in one study they were not as satisfied as people who had a total knee replacement.footnote 1
If you wait to have surgery until you have already lost a lot of your strength, flexibility, balance, endurance, and ability to be active, then after surgery you might have a harder time returning to your normal activities.footnote 1
Can Rehabilitation Be Done At Home
All patients are given a set of home exercises to do between supervised physical therapy sessions and the home exercises make up an important part of the recovery process. However, supervised therapy–which is best done in an outpatient physical therapy studio–is extremely helpful and those patients who are able to attend outpatient therapy are encouraged to do so.
For patients who are unable to attend outpatient physical therapy, home physical therapy is arranged.
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Walking After Knee Surgery
As previously mentioned, walking after knee surgery will likely begin the day of or day after surgery in the hospital with a walker or cane. The amount of weight put on the surgical leg is usually as much as tolerated, so using the walker and taking smaller steps can help offload a painful knee. The goal of walking early is to prevent muscles from weakening and to get the knee moving in a normal gait pattern again.
Patients that are hesitant to walk or use the walker as a crutch for too long can also delay the recovery process. This goes back to the as tolerated concept. If you can tolerate walking without a walker, then walking starts with short bouts until longer distances are comfortable.
How Long Does It Take To Recover From Knee Surgery
The timeline for recovering varies from patient to patient, but typically the rehabilitation process takes 10-12 weeks of therapy to reach goals of achieving range of motion, strength, and performing functional activities such as standing from sitting, walking, and climbing up/down stairs independently without difficulty or pain.
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Outpatient Knee Replacement Surgery: What Can I Expect
Sep 29, 2017 | Patient
This post was co-authored by Grace McClure and;Dr. Nicholas Frisch)
Outpatient knee replacement surgerywhat will it look like? Is total knee replacement outpatient? What can I expect during my 24 hour stay at an outpatient center? How is same-day joint surgery different from regular, inpatient surgery? These questions are all common for patients awaiting or considering an outpatient knee replacement.
Knowing what to expect on surgery day for any surgery allows you to feel better prepared and reduces stress and anxiety. This is especially true for an outpatient knee replacement as it is less common and there are fewer accounts of what the procedure actually entails.
What is an outpatient knee replacement?;An outpatient knee replacement, also called a same-day knee replacement means that the entire procedure and hospital stay lasts less than 24 hours. Outpatient knee replacement surgery is not for everyone, but is sometimes preferred amongst patients and especially surgeons.
Read on as we breakdown the benefits to outpatient knee replacement surgery, and what to expect for the procedure and during your brief hospital stay.
Fact:;Experts predict that within the next decade;more than half of all joint replacements will be performed in an outpatient setting.
Pain And Pain Medicine
- You will receive medicine to help control pain. Some pain medicines are given through an IV. Others are taken by mouth.
- Take it as needed, and remember that it is easier to prevent pain before it starts than to stop it after it has started.
- If you are still in pain after you take your medicine, tell your nurse. You may need new medicine or to get the medicine in a different form.
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Rest Of My Hospital Stay Day
The rest of the hospital stay day wasnt fascinating. It consisted of laying in bed, getting up to pee, and never , never turning my CPM machine off. CPM stays for continuous passive motion. If you havent had surgery yet or never had one of these machines, this is the gist of it. You strap your surgically repaired leg into it, and it slowly moves it through the range of motion. I highly recommend you have this machine!
During my hospital stay, mine was set to zero degrees extension and seventy degrees flexion per doctors orders. These numbers changed throughout my first few weeks with the machine as I could tolerate more movement. That machine brought more pain relief than any drug ever did during my whole hospital stay, and really the entire two weeks into my post-op, I had one in my house as well. But we will talk more about that in a later post.
The Comfort Of Loved Ones
My husband and Dad were there to greet me, and they were a sight for sore eyes, after the loneliness I felt in Pre Op. It was so good to see their faces. My dad gave me a big hug and kissed my forehead. I tell you a dads embrace is one of the most comforting things, no matter how old you are.
I felt a rush of emotions come over me, and even some tears. I thanked him again for coming to support me and keeping my husband company while I was in surgery. He said anything for my little girl and then explained that now I needed to rest, and he needed to head into work.
My husband watched and waited patiently for his turn, and when my dad walked out, he came over to me and kissed me one of those knock you off your feet, kisses. That is if I wasnt already lying down. It was so good to see him too. All the fears that I had been building up for two weeks could be released a bit. My husband has a way of calming me. Evan, his presence at that moment, let me know everything was going to be alright, now and in the future.
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What Should I Do When I Get Home
We ask that you rest. Even though our patients typically feel good, it has still been a long day. On the day of your surgery you will learn how to safely transfer in and out of both the bed and the car. We ask that you use the bathroom as needed, eat dinner and rest. You will have nursing and therapy services the very next day. Wait for further instruction from them.
How To Look After Your New Knees
The new normal might be difficult for you to adapt. Heres what to do to properly adjust to your new knees -;
Regularly take your prescribed painkillers or anti-inflammatories to reduce any pain or swelling felt in the body. ;
Use your walking aids but try to rely less on them with time and walk on your own for improving the condition.;
Continue to keep up with your health exercise to get rid of stiffness and other problems, but dont put great force on the knees.;
Do not sit while your leg crossed for the first six weeks after your surgery. It can cause dislocation. Limit your sitting position.;
Avoid using a pillow underneath the knee while sleeping. It can result in permanent knee bend.;
Lift your leg while sitting or applying an ice pack covered in a tea towel for 20 minutes after every 3 to 4 hours to decrease any swelling.;
- Try to avoid twisting at your knee.
- Always wear supportive footwear outdoors.
- Avoid kneeling on your operated knee in the first 6 months after the surgery.
In the period of initial healing, the patient may constantly require assistance for their movement and the need for a caretaker becomes essential.;
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Lifestyle Habits After Joint Replacement
After a joint replacement, patients can resume just about everything, especially walking, swimming, and bicycle riding. We discourage repetitive jumping and running, yoga, or excessive stretching.
You should also take prophylactic antibiotics, because total joints are made of metal and are at risk for infection when bacteria circulate through your bloodstream.
If your joint becomes infected, it requires more than two additional surgeries. Therefore, take antibiotics with any bacterial infection as prescribed by your family practitioner. We strongly recommend that you take antibiotics for all dental and invasive procedures for the rest of your life.