frequently asked questions

• What is Total Knee Replacement?

  A total knee replacement is a surgical procedure for replacing the knee joint. This joint is composed of three parts – lower end of the femur (thigh bone), the upper end of the tibia (shin bone) and patella (knee cap).During the surgical procedure, diseased surfaces of the knee joint are removed and replaced with smooth artificial surfaces.

• When do we consider Joint Replacements?

  Total knee replacements are usually performed for severe arthritic conditions that hinder not only work and recreation but also the ordinary activities of daily living, especially walking.

  Consider Joint Replacements if -

  • you are on regular medication
  • X-rays show advanced arthritis

• Getting ready for your operation

  • Keep your weight in check
  • Check for dental hygiene
  • Rule out infections
  • Keep yourself fit as it will speed your recovery and reduce the risk of complications

• Pre-Operative Assessment

  This is done to assess you for surgery :

  • Fresh x-rays and blood tests will be taken
  • Questionnaire about your current health and past medical, surgical and medication history
  • Bring all your current medication and prescriptions by your doctor
  • If you suffer from high BP, then the same will be monitored regularly
  • If you are diabetic, please bring a record of your blood sugar readings
  • If you are on Warfarin, Aspirin or other blood thinners, please let us know as this will impact surgical decisions
  • Smokers must stop it prior to surgery to lessen the likelihood of a postoperative chest infection
  • You might require iron tablets to build up your bodies iron stores ready for surgery

• Admission to Hospital

  Usually you are admitted in the hospital a day before the surgery :

  • The anesthetist will talk to you and assess the most suitable form of anesthesia
  • Our anesthetist may recommend a pre-medication to be given some hours before surgery
  • A period of fasting i.e. nothing to eat or drink for some hours before surgery is necessary to reduce the risk of vomiting
  • A shower is mandatory before surgery post which the side of surgery will be marked.

• After your Surgery

  • You will be kept under observation and monitored until you have recovered from the effects of the anesthetic
  • There will be an intravenous infusion (drip in your arm) and drain tubes coming out of your thigh for 24 hours or so. These prevent excess postoperative blood collections
  • Nausea and sickness are common side-effects of the general anesthetic and painkillers
  • You will be given oxygen through a mask for a few hours

• Pain Management

  A combined multimodal approach is used for effective pain management which resulted in pain free recovery and early ambulation.

• After your Operation

  Day 1

  • Physiotherapists will demonstrate leg exercises that you will need to do once you feel better enough to sit onto the side of the bed/ stand using a frame

  Day 2 & 3

  • You will have to begin walking with the help of a walker and attempt knee bending exercises
  • Practice walking daily as soon as you are able to start using elbow crutches

  Day 4

  • You are ready for discharge depending on your fitness

• Post Discharge – At Home

  • It is important you continue with your exercises
  • The success of the operation has a lot to do with how well you do your exercises as that will strengthen your muscles
  • Wound stitches or staples are removed around the fourteenth day after surgery
  • Look for warning signs - If you notice any swelling, increased pain, drainage from the incision site, redness around the incision, or fever, you should report this immediately to your doctor

• Prevention of Infection

  If at any time (even years after your surgery) you develop a bacterial infection such as a sore throat or significant chest, urinary infection or cellulitis (redness and swelling of the limb) you should inform us or your nearest doctor of your knee replacement. Antibiotics should be administered promptly to prevent the occasional complication of distant infection localizing in the joint area. This also applies even if you have a tooth extraction.

• Do’s and Don’ts:

  DO’s:

  • Perform all the exercises as instructed by your physiotherapist
  • Take regular short walks
  • Keep walking with your walking aids until 2 to 3 weeks after your operation
  • Gradually progress to 1 walking stick held in the opposite hand to your new knee
  • Avoid pressure on the wound until it has fully healed and keep the wound dry until the skin has fully healed
  • Report to us immediately if you have any unusual pain, swelling, notice a discharge from your wound or any pain or swelling in your calves
  • Take regular painkillers for as long as you need to
  • Eat a balanced diet with plenty of fresh fruit and vegetables

  Until reviewed by your surgeon or a member of our team DO NOT:

  • Twist the operated leg in or out whilst sitting or standing for at least 3 months
  • Cross your legs, knees or ankles for at least 3 months
  • Sit on low chairs, stools or toilets
  • Do attempt any heavy lifts, or housework and gardening that involve heavy lifting
  • Discard any walking aids until advised to do so