You need the most experienced and properly trained surgeon you can find. When it comes to surgeries, practice makes perfect — and so the more experienced the surgeon, the better the results. Ask directly: How many of these surgeries have you done? Consider looking for someone who’s been doing surgery for many years with over 30 surgeries each year.
So ask; what is your success rate, and how often do your patients experience any problems? Are you specifically trained for this operation? How can I contact you if I have more questions?
You want a surgeon who’s confident and great at his job, Clear communication and technical skills are more important than a great personality.
For Best care schedule your surgery during the week ((Monday to Friday) and not on Saturday, Sunday and on Public holidays.
Ask your Surgeon questions…and make sure you get answers. What are the risks and benefits of the surgery? What are the alternatives to surgery? How long will it take to recover from surgery? If the surgeon doesn’t welcome questions, you should look around for some other surgeon who will.
Your incision size. You may have option that is less invasive with a smaller incision with fewer risks. This can mean a shorter hospital stay, quicker recovery.
What are my anesthesia options? What kind of anesthesia is best for me considering my health history, and medications, I take?
Personal responsibility plays important role in preparing for any Surgery. The activities during this time are important to get; best healing and faster recovery after operation.
“Life-style modification” In other words, get into shape! There are three rules to abide by: 1. exercise, 2.eat healthy and 3. stop smoking.
Aerobic exercise like daily walking, bicycling, or swimming improves your lung function. In addition, practice your deep breathing. For instance, repeatedly blowing up a balloon can be very helpful. The idea behind aerobic exercise and deep breathing is to expand the tiny air sacs in your lungs called alveoli to their greatest potential. After anesthesia, the alveoli can collapse and cause a condition called atelectasis which can lead to fever and pneumonia. Effective breathing will help prevent atelectasis.
Improving your nutritional status will help your body heal better after surgery. One of the ways your surgeon will assess nutritional status is by testing the level of a protein call albumin in a routine blood test. Research has shown that low levels of albumin are associated with worse outcomes in patients undergoing surgery . Attention to nutrition is even more important for patients with diabetes; blood glucose levels should be between 90 and 110. High glucose levels are toxic to cells and will disrupt normal wound healing.
Stop smoking. Easy for surgeons to say, but they have good reason. Cigarette smoke causes poor wound healing in two ways: nicotine causes blood vessels to constrict which decreases the oxygen rich blood supply to the cells of the wound. There are also many toxins in smoke that impair wound healing.
If you take blood thinners such as warfarin, aspirin, or Plavix, your surgeon will instruct you to stop taking those 5 to 7 days before surgery. Anti-inflammatory medications and certain vitamin supplements such as vitamin E, or garlic Can cause increased bleeding so disclose all of your medications and supplements to your surgeon and anesthesiologist.
Night before Surgery: have a nice dinner and a sound sleep. Do not eat or drink after mid night and not to have coffee or tea in the next day morning.
Take your blood pressure medicine in the morning before surgery with a small sip of water. Remind your surgeon/ anesthetic doctor if you have any drug allergies.
- If you suspect that you are pregnant, please notify your Surgeon.
- Bathe or shower and brush your teeth (taking care not to swallow any water) the morning of surgery.
- Remove all makeup, nail polish and contact lenses. If you must wear contact lenses, please bring your storage case for use during surgery.
- Leave all jewelry, cash and valuables at home.
What will happen during surgery?
Once you’re in the operating room, you breathe oxygen through a mask. Your surgical team will track your health during the whole procedure. They’ll probably use:
- A clip on your finger to measure your oxygen levels.
- A cuff on your arm to check blood pressure.
- Pads on your chest to keep tabs on your heart rate.
After the Operation;
You’ll wake up in a recovery room. A nurse checks your heart rate, breathing, and the bandaged area where your procedure was done. He might ask you to take deep breaths and cough to clear your lungs. Until you’re fully awake and all your medical signs (like blood pressure and heart rate) are stable, you’ll stay in the recovery room.
After that, you’ll get sent to a hospital room where you’ll be ready to be greeted by your loved ones and begin the road to recovery.
In the surgical ward, you may be given a switch that enables you to self-administer painkillers at a safe rate. You may also be given oxygen through a mask or tubes. Blood transfusion is rarely required after single knee replacement and often required after you had your both knees done on same day. You will have a large dressing on your knee to protect your wound. Various drains will siphon off blood from the operation site to prevent it collecting inside the wound. These will be removed within 24 to 48 hours.Your wound dressing will be changed after couple of days.
Staff will help you to get up and walk about as quickly as possible after you have fully recovered from the anesthetics. Generally you will be helped to stand within 12 to 24 hours after the operation.
Walking with a frame or crutches is encouraged. Most patients are able to walk independently with sticks after about a week but this can vary depending on the individual. Physiotherapist will teach you exercises to help strengthen your knee.
It is normal to experience initial discomfort while walking and exercising and your legs and feet may be swollen.
You will usually be in hospital for 3 to 5 days depending on what progress you make . With latest muscle sparing technique and enhanced arthroplasty recovery programme where you start walking on the day of operation and are discharged within three days.
When I get home?
You may feel tired at first. You have had a major operation and muscles and tissues surrounding your knee will take time to heal. It is essential to continue with exercises at home.
How long will it be before I feel normal?
You should be able to stop using your crutches or walking frame and resume normal activities 6 weeks after surgery. However it may take upto 3 months for pain and swelling to settle down. It can take upto a year for any leg swelling to disappear. Your new knee will continue to recover upto 18 months to 2 years.
Even after you have recovered fully, it is best to avoid extreme movements or sports.
When can I drive again:
When you can bend the knee enough to get in and out of car and control the car properly. This is usually around 4 to 6 weeks but check with your surgeon.
When can I go back to work/do house work?
This depends on job, but you can return to work 6 to 12 weeks after operation. Avoid heavy house hold task for 3 months. Do not stand for long periods as this may cause ankle swelling.
Follow up visit:- usually 12 weeks after operation with your surgeon.
Medications: Continue taking painkillers only if required. However you should continue with other medication as before operation e.g. tab for blood pressure.
Looking after your new knee:
- Keep up exercises to help prevent stiffness.
- Do not sit with legs crossed for 6 weeks.
- Do not put pillow underneath your knee when sleeping.
- Do not kneel on your operated knee.
- Raise your legs when sitting and use ice packs to help with any swelling.
For more than 2/3rd patients their operated knee feels totally normal and natural said to have “Forgotten” it. Patient reported as “forgotten knee” within 18 months.