Before Surgery
Once you and your surgeon decide that total knee replacement is right for you, a surgery date will be scheduled, and you may need to do some preparation. For example, your surgeon might ask you to have a physical examination by an internist or your regular doctor. And because blood transfusions may be needed during surgery, you may want to “bank” one or two units of your own blood, to have on hand. You can draw one unit per week, before your surgery.
During Surgery
On the day of surgery, a small tube (intravenous line) will be inserted into your arm. This tube will be used to administer anesthesia, antibiotics, and other medication. After the anesthesia takes effect, your knee will be scrubbed and sterilized with a special solution.
Surgery will take anywhere from 1 to 3 hours, and it will begin with an incision over the knee that will expose the joint. When the bones are fully visible to the surgeon, precision guides and instruments are used to remove the damaged surfaces of the bones.
The replacement parts are then secured to the bones. It might also be necessary to adjust the ligaments that surround the knee. When the surgeon is satisfied with the fit and function of the joint, the incision will be closed.
A tube may be placed in the incision to drain fluids that naturally develop at the surgical site. A sterile bandage will then be applied, and you will be taken to the recovery room, where you will be closely monitored.
Recovery
You will be sent to the recovery room, and as the anesthesia wears off you will slowly regain consciousness. A nurse will be with you, and may encourage you to cough or breathe deeply to help clear your lungs. You will also be given pain medication. When you are fully conscious, you will be taken back to your hospital room.
What Can I Expect After Surgery?
Rehab begins quickly! On the day after your surgery, you’ll get a visit from your physical therapist and begin learning how to use your new knee. You may be fitted with a “continuous passive motion” machine that will gently straighten and bend your knee. Other exercises that promote blood flow to your legs include ankle pumps and pedaling your feet.
Getting up and around soon is important. If you had considerable pain before surgery, you probably cut back on your activities, so your leg muscles may be weak. You will need to build up enough strength to control your new knee, and early activity encourages healing, too. Your doctor and physical therapist will give you specific instructions on wound care, pain control, diet, and exercise.
At home, you will need to continue your exercises, and your physical therapist may continue to work with you. Within 6 weeks after surgery, most patients are able to walk with a cane; and in 6 to 8 weeks, you will probably feel well enough to drive a car.
Even after you have fully recovered from your surgery, you will still have some restrictions like contact sports or other activities that put excessive strain on your knees. Remember, although your artificial knee can be replaced, a second replacement is seldom as effective as the first. But the good news is—in most cases—successful total knee replacement will relieve your pain and stiffness, and allow you to resume most of your normal daily activities. And that really is a happy ending.