Knee replacement surgery replaces parts of injured or worn-out knee joints. This also is known as knee arthroplasty. During the surgery, damaged bone and cartilage are replaced with parts made of metal and plastic.
Knee replacement surgery can help ease pain and make the knee work better. To decide whether a knee replacement is right for you, a surgeon checks your knee’s range of motion, stability and strength. X-rays help show the extent of damage.
The right artificial joints and surgical techniques needed depend on many factors including age, weight, activity level, knee size and shape, and overall health.
Why it’s done
The most common reason for knee replacement surgery is to ease pain caused by arthritis. People who need knee replacement surgery often have problems walking, climbing stairs and getting up out of chairs.
In total knee replacement the ends of the thigh-bone and shin-bone are reshaped and the entire joint is resurfaced. The thigh bone and shinbone are hard tubes that contain a soft center. The ends of the artificial parts are inserted into the softer central part of the bones.Ligaments are bands of tissue that help hold joints together. If the knee ligaments aren’t strong enough to hold the joint together by themselves, the surgeon may choose implants that can be connected so they remain stable.
Medical preparations
If you and your surgeon decide that knee replacement surgery is the best treatment for you, there is some information you need to prepare, including personalized instructions, during appointments before your surgery. To get started, here are the basics.
- Drugs and supplements
If you take blood thinners (anticoagulant medications), the doctor who prescribed them will determine how long before surgery you should stop. These include clopidogrel (Plavix), enoxaparin (Lovenox), warfarin (Coumadin, Jantoven), apixaban (Eliquis) and dabigatran (Pradaxa).
- Dental evaluation
Significant dental conditions need to be resolved before surgery. A dental procedure may allow bacteria to enter your bloodstream and cause an infection that could travel to your artificial joint.Be sure to see your dentist well before the day of your joint replacement surgery. If you’ll need dental work within two weeks of your scheduled surgery, let your surgeon know right away.
Organizing support
You’ll need help caring for yourself when you get home. We recommend having a family member or friend with you 24 hours a day for the first week. Figure out who has the time and ability to help you. If no one is available, please let us know so a discharge planning nurse can discuss options with you.
- Preparing your home
Consider buying or borrowing helpful devices such as:
- A raised toilet seat (an attachment that adds height)
- A bathtub or shower chair
- A Reacher/grabber tool
- A shoehorn and a sock aid (a device that lets you slip socks on without bending over)
You can find these items at many drugstores and medical supply stores as well as online.
To prevent accidents at home, we recommend:
- Making pathways in crowded areas
- Removing throw rugs
- Securing extension and telephone cords so they’re not strung across the floor
- Installing handrails in your bathtub and on stairways
- Placing important items where you can easily reach them
- Packing for the hospital
If you have a walker or crutches, bring them to the hospital. If you don’t, the hospital will provide them before you’re discharged.
Please pack the following:
- Dental care items, deodorant and other toiletries (the hospital has basic toiletry items if needed)
- Comfortable, loose-fitting clothes
- A knee-length robe and slip-on shoes
- A cell phone (optional)
- ID (driver’s license or passport)
Please do not bring:
- Valuables such as jewelry, wallets and watches
- Medications (the hospital will provide any that you need)
- The days before surgery
Before surgery, you’ll be given special antibacterial soap and instructions for when and how to use it. Take a shower or bath, washing thoroughly with the soap as instructed, two nights before surgery, the night before surgery and the morning of surgery.
- One day before surgery
Our hospital staff will call to notify you of your scheduled admission time. Do not eat or drink anything after midnight. Rest as much as possible and go to bed early.
Prepare for your recovery
For several weeks after the procedure, you might need to use crutches or a walker, so arrange for them before your surgery. Make sure you have a ride home from the hospital and help with everyday tasks, such as cooking, bathing and doing laundry.
To make your home safer and easier to navigate during recovery, consider doing the following:
- Create a living space on one floor since climbing stairs can be difficult.
- Install safety bars or a secure handrail in your shower or bath.
- Secure stairway handrails.
- Get a stable chair with a firm seat cushion and back, and a footstool to elevate your leg.
- Arrange for a toilet seat riser with arms if you have a low toilet.
- Get a stable bench or chair for your shower.
- Remove loose rugs and cords.
The risk of blood clots increases after knee replacement surgery. To prevent this complication, you may need to:
- Move early. You’ll be encouraged to sit up and walk with crutches or a walker soon after surgery.
- Apply pressure. Both during and after surgery, you might wear elastic compression stockings or inflatable air sleeves on your lower legs. The air sleeves squeeze and release your legs. That helps keep blood from pooling in the leg veins, reducing the chance that clots will form.
- Take blood thinners. Your surgeon might prescribe an injected or oral blood thinner after surgery. Depending on how soon you walk, how active you are and your overall risk of blood clots, you might need blood thinners for several weeks after surgery.