Before, During, and After Surgery

Before, During, and After Surgery Calendar

It’s never too early to begin preparing for your knee replacement surgery. Knowing what to expect and planning ahead of time will help make your surgery and your recovery as smooth as possible.

This information is intended to be an overview of what to expect before , during, and after knee replacement surgery. It is not intended to replace any instructions provided by your doctor, and we encourage you to discuss this information with your doctor.

Before surgery

4 weeks before:

  • Know your knee’s anatomy. Familiarizing yourself with how your knee works will help you understand your doctor’s instructions.
  • Prepare a list of questions to ask your doctor. Print this handy list of questions and take it with you when you visit your doctor. Use it to take notes during your appointment so you can refer to them once you are home.

3 weeks before:

  • Move frequently used items to easy-to-reach cabinets. Put food and supplies where they can be reached without bending or using a step stool.
  • Plan meals ahead of time. Make and freeze meals or stock up on frozen dinners so that meal preparation requires little effort. Try to plan enough meals for a week or so.
  • Contact friends and family for support. You might need their assistance with activities such as driving and moving items in your home. The Arthritis Foundation also has a support network that can provide emotional support. You can contact your local chapter or visit www.arthritis.org for more information.
  • Make your home safe so you don’t fall or trip. Move long cords against the wall, remove rugs, and place a nonskid mat in your bathtub.

2 weeks before:

  • Limit anti-inflammatory medications. Your doctor may not want you to take any aspirin or nonsteroidal anti-inflammatory medications (Advil, Ibuprofen, Motrin, etc.) for the 14 days before surgery. You may be able to take Tylenol or medicines with acetaminophen. Be sure to discuss this with your doctor.
  • Purchase or borrow the special equipment your doctor recommends. This may include an elevated toilet and small devices such as a grabber. You can find these items at most hospital supply sections of large drug stores or in mail order catalogs from department stores. Practice using the items at home.

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1 week before:

  • Write down all of the medications you take, the dose, and how often . Take this with you when you are pre-admitted to the hospital.
  • Pre-admit to the hospital. Your doctor may suggest that you pre-admit to the hospital before your surgery. If so, plan at least 2½ hours for the visit. During this time, your insurance will be verified; you may have lab work, x-rays, and/or an EKG. You may receive a breathing exerciser, at which point the nurse will review the directions with you. If you have blood slips from blood you or your family have donated, bring the slips with you and give them to the nurse in the admissions area. You may also see someone from the anesthesia department to discuss anesthetic.
  • Manage finances. You may want to balance your checkbook, pay bills, make arrangements to board pets, and stop the delivery of your mail and newspaper.
  • Contact local supermarkets and pharmacies. Some supermarkets and pharmacies provide delivery services to your home. Call them to find out the details, including whether they charge a fee.
  • Go to the supermarket. Make a list of the items you may need once you return from the hospital and purchase them or arrange for them to be delivered.
  • Arrange transportation. You will need someone to drive you home or to the rehabilitation facility after your surgery. You may also need this person to run errands for you.  

Week of surgery:

  • Pack for the hospital. Use the list below to help you decide what to bring to the hospital. Check with your doctor, too; he or she may want you to bring additional items.
    • You'll want your personal grooming items such as a toothbrush, toothpaste, hairbrush, eyeglasses/contacts, comb, deodorant, shaving cream, razor, shampoo, lotion, undergarments, and a robe.
    • Bring slippers or flat rubber-soled shoes.
    • Don't forget loose-fitting clothing for your trip home.
    • Bring any medications you are currently taking.
    • Bring your breathing exerciser (IBE) if you use one, as you will probably need this right after surgery. Check with your doctor about this.
    • You can bring personal belongings, but they should be left in the car until after surgery. Tell your family that your room will be assigned when you are in surgery or in recovery, at which point they can bring your items to your room.
    • Leave jewelry, credit cards, car and house keys, checkbooks, and items of personal value at home. Bring only enough pocket money for items such as newspapers or magazines.
  • Check with your doctor about eating and drinking the night before your surgery. Your doctor may not want you to eat or drink (not even water) after midnight the night before, so be sure to check with him or her about this. Your anesthesiologist may prescribe a medication for you to take the evening before surgery.
  • Report to the hospital at least two hours before your scheduled surgery . The nurses will complete your preparation for surgery and will likely review your care following surgery.
  • Ask your doctor how you may feel after surgery. You may be nauseous, dizzy, weak, and/or have a lack of an appetite or constipation. You will also probably experience some amount of pain.
  • Know what to expect after surgery:
    • A catheter may be in place after surgery. It is normally removed when you can get from the bed to the bedside toilet or restroom, you can feed yourself and can bathe your face and upper body.
    • A bedside toilet will probably be available until you are able to walk to the restroom. Walking to the restroom will build your strength and prepare you for discharge home.
    • Your bandage will probably be changed once or twice a day.
    • Your surgeon will visit you, and your physical therapist will begin your recovery exercises.
    • Your pain may be managed with shots or pills.
  • Let the nursing staff know how you feel about visitors. Typically you are allowed visitors once you have been moved from the recovery room into your own room. If you would prefer not to have visitors, please tell the nursing staff.
  • Plan your discharge from the hospital. You will be allowed to leave the hospital when your doctor feels the time is right. Again, make arrangements for someone to drive you home from the hospital, as you will not be able to operate an automobile. Wear comfortable, loose clothing to avoid pressure on the incision area.
  • Find out whether you’ll need to transfer to a rehabilitation facility. Your doctor may recommend that you be transferred to a rehabilitation facility after you leave the hospital. There you can begin physical therapy and your health can be monitored.
  • Fill pain medication prescription. Your doctor will probably give you a prescription for pain medication. You will probably need less each day after surgery, but you may need them at night for a few days. Some people find that Tylenol or aspirin will relieve their pain. Just be sure to follow your doctor’s instructions, and do not drink alcoholic beverages while you are taking pain medication.

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During surgery

  • Your knee will be prepared for surgery. First you’ll be taken into the operating room and given anesthesia. Once you’re asleep, the skin around the knee will be thoroughly scrubbed with an antiseptic liquid. Your knee will be flexed about 90 degrees, and the lower portion of the leg including the foot will be placed in a special device to securely hold it in place during the surgery. Then a tourniquet will be applied to the upper portion of the leg to help slow the flow of blood during the surgery. An incision of appropriate size is then made.

 

Knee Prepared for Surgery
  • The damaged surfaces of the bone and cartilage will be removed. Precision instruments and guides are used to help make sure the cuts are made at the correct angles so the bones will align properly after the new surfaces (implants) are attached. The amount of bone that is removed depends on the amount of bone that has been damaged by the arthritis or injury. A small portion of the top of the tibia and the back of the kneecap may also be removed, making the end of the bone flat.
Be Prepared for Knee Replacement Surgery
Be Prepared for Knee Replacement Surgery Be Prepared for Knee Replacement Surgery

  • The implant will be attached. An implant is attached to each of the three bones using a special kind of cement for bones. The implant that fits over the end of the femur is made of metal. Its surface is rounded and very smooth, covering the front and back of the bone as well as the end. The implant that fits over the top of the tibia usually consists of two parts. A metal baseplate fits over the part of the bone that was cut flat. A durable plastic piece is then attached to the baseplate to serve as a spacer between the baseplate and the metal implant that covers the end of the femur. The implant that covers the back of the patella is also made of a durable plastic.
Gender Knee on Bone

After surgery

  • Talk to your doctor about what to do once you are home. He or she may suggest the following things:
    • If you will be using a walker or crutches, find out how much weight you should be putting on your new knee.
    • You might tire more easily than usual. Plan rest periods throughout the day.
    • Get in and out of chairs using both arms, and avoid low or overstuffed furniture. Use a cusion or pillow to keep your body raised while seated.
    • Use an elevated toilet seat to reduce stress on your knees.
    • Place a shelf in the shower at chest height, so you don't have to bend to retrieve items.
    • Use a bathtub seat or bench while bathing for increased safety and comfort.
    • A long-handled bath sponge may be used to reach the lower leg. Razor extendors are also available.
    • Avoid sweeping, mopping, and running the vacuum cleaner. Use long-handled feather dusters for dusting high and low items.
    • Follow your doctor’s instructions on how to get in and out of cars. Raising the height of the car seat with pillows will help protect your knee.
    • Your doctor will talk with you about when you can drive. If you have a car with manual transmission, talk with your doctor about driving limitations. Make sure you can brake the car without discomfort before you attempt to drive in traffic.
    • Constipation is a common problem for patients following surgery. This is usually due to your limited activity and any pain medications you may be taking. Discuss your diet with your doctor. It should include fresh fruits and vegetables as well as eight full glasses of liquid each day, unless you doctor tells you otherwise.
    • You’ll probably get a prescription for pain medication. Please follow your doctor’s instructions concerning this medication.
    • Some swelling around the incision is normal. Wear loose clothing to reduce pressure on the incision. Ask your doctor or other qualified health professional about appropriate wound care.
  • Eat well-balanced meals. A healthy diet promotes healing.
  • Keep your wound clean. Your bandage may be removed and replaced with a smaller bandage when you are discharged from the hospital. Change your bandage as recommended by your physician, usually once a day. Call your physician if you notice any signs of infection.

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1 week after surgery:

  • Keep visitors to a minimum. This will give you an opportunity to rest and get comfortable in your home setting.
  • Schedule a postoperative appointment. You should meet with your surgeon about two weeks after your surgery.

2–3 weeks after surgery:

  • Go to your post-op appointment. Your blood pressure and temperature will be taken, and your surgeon will examine the surgery area to check for any signs of infection. Your stitches or staples will likely be removed as well. Your range of motion will be examined, and you will review your physical therapy instructions. Wear comfortable, loose clothing. You will likely return for follow-up appointments at 3 months, 6 months, and one year after your surgery. You will probably return once a year thereafter.

4 weeks after surgery:

  • If you drive, you may start driving again. You will need to talk with your physician, but normally, you can resume driving 4 to 6 weeks after surgery. Make sure you can use the brake of the car without discomfort before you attempt to drive in traffic.

 

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