Knee replacement is probably one of the most major operations that a large number of people may end up going through. More than 300,000 total knee replacements or TKRs are performed each year in the United States, and according to a March 2008 article in Time magazine, that number is expected to continue rising.
Find a Surgeon You Can Trust
Successful patients say that a top tip for getting ready to have knee surgery is to find the best surgeon in the area and follow his or her advice and instructions to the letter, before and after the surgery. A number of online resources exist for evaluating surgeons and hospitals, including insurance company and state agency websites. The American Academy of Orthopaedic Surgeons’ website lists doctors who are board certified in orthopedic surgery – one important credential to check.
Referrals from friends and other healthcare professionals can also help in finding a skilled and trustworthy surgeon – preferably one who specializes in knee surgery or at least does numerous similar operations each year.
Questions to Ask Before Surgery
- Ask the surgeon whether he recommends any special exercises before the operation. Building up muscle strength before surgery will help in recovery and protect the new artificial joint.
- Also ask whether the surgeon recommends storing the patient’s own blood prior to the surgery or having friends and family bank blood in advance. In most routine total knee replacements, a blood transfusion isn’t needed. But some surgeons like to be prepared.
- The patient should also find out whether she needs to adjust any medication ahead of time. For example, some patients will be advised to stop taking high blood pressure medicine or anti-inflammatories (some of which promote excessive bleeding).
- Discuss whether the surgeon intends to insert a foley catheter to collect urine. Some kinds of pain medication make it difficult for a patient to urinate for awhile after surgery. Having a foley catheter put in while awake can be uncomfortable, although not seriously painful, so many patients ask to have the catheter put in while they are still under anesthesia.
Getting Ready at Home
Some simple preparations can make the patient’s recovery and homecoming easier for everyone. The first step is to line up friends and family members to come visit in the hospital or at least call. Visits are a welcome distraction from pain and the boredom of the hospital stay.
Any patient not fortunate enough to have a spouse, roommate or housemate living at home should consider lining up a friend or other relative to stay with her for a few days after coming home from the hospital. Younger patients especially may not realize how much help is needed in the first few days, when they will still be tired and in a certain amount of pain. Having someone available to cook, bring snacks or medicines and just keep an eye on the patient is crucial.
Coworkers, neighbors and fellow church members are also great to ask for help. If several people are asked for help, no one will feel too overburdened. A lot of people worry about putting too much pressure on their family and friends, but in fact, most people are anxious to know how they can help in some way.
Stock up on easy-to-cook meals before the operation, even if there will be help at home. The patient or friends and family can make some of her favorite meals in advance and freeze them in small, easy-to-carry-and-heat containers. The patient will likely be using a walker, cane or crutches at first and won’t have both hands free to carry a plate or other items. Cooking in advance is another great thing that friends or a church group can do to help.
The knee surgery patient who lives in a two-story house should consider setting up a “headquarters” downstairs so that she won’t have to deal with stairs for the first few days. Put a daybed in a guest room, office or other spare room, or set up a “nest” on a big, comfortable couch. The most important thing is that the bed or couch be high enough to make getting up and down as easy as possible.
Some suggestions of things to keep close include:
- Footstool
- Cushions and pillows
- Blanket or throw
- Ice packs
- Walker
- Reacher
- Books and magazines
- Snacks
- TV remote
- Bottled water
- Medicines
- Phone
- Bell (to ring for attention)
Many orthopedic surgeons will prescribe the use of a Continuous Passive Motion (CPM) machine for their patients, usually starting immediately after surgery. This machine simply bends the new knee slowly in and out, starting at a very mild angle and slowly increasing over time. Many patients say that using the machine faithfully, according to the surgeon’s instructions, really helped them gain range of motion and reduce scar tissue formation.
With the CPM machine as with all other preparations for total knee replacement surgery, the key is to find an experienced and trusted surgeon … and follow doctor’s orders.
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