Total Knee Replacement

WHAT YOU SHOULD KNOW:

Total knee replacement is surgery to replace a knee joint damaged by wear, injury, or disease. It is also called a total knee arthroplasty. The knee joint is where your femur (thigh bone) and tibia (large lower leg bone or shin bone) meet. A small bone called the patella (kneecap) protects your knee joint.


CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

  • You may be allergic to the anesthesia and have trouble breathing. You may bleed more than expected or get an infection. Nerves, muscles, or tendons may be damaged during surgery. After surgery, your knee may be stiff or numb. Your legs may not be the same length.

  • You may get a blood clot in your leg. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs or brain. A blood clot in your lungs can cause chest pain and trouble breathing. A blood clot in your brain can cause a stroke. These problems can be life-threatening.

  • Your implant may get loose or move out of place. The implant may get worn out over time and need to be replaced. If you do not have this surgery, your knee pain may get worse. You may have trouble walking, moving, or doing your usual activities.

WHILE YOU ARE HERE:

Before your surgery:

  • Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

  • An IV is a small tube placed in your vein that is used to give you medicine or liquids.

  • Anesthesia:

    • Regional anesthesia: Medicine is injected to numb the body area where the surgery or procedure will be done. You will remain awake during the surgery or procedure.

    • General anesthesia will keep you asleep and free from pain during surgery. Anesthesia may be given through your IV. You may instead breathe it in through a mask or a tube placed down your throat. The tube may cause you to have a sore throat when you wake up.

During your surgery:

Your knee area will be cleaned. Your caregiver will make an incision over your knee joint. Your kneecap will be removed. The damaged parts of your femur and tibia will be removed. Your caregiver will place the knee implant in your knee joint. He will secure it with screws or medical cement. The kneecap, muscles, and other tissues around the joint will be moved back into place. A drain may be placed to remove extra blood and fluids from the surgery area. Your incision will be closed with stitches or staples and covered with a bandage.

After your surgery:

You will be taken to a room where you can rest until you are fully awake. Caregivers will monitor you closely. Do not try to get out of bed. When caregivers see that you are okay, you will be taken to your hospital room.

  • Deep breathing and coughing: This will help decrease your risk for a lung infection after surgery.

    • Hold a pillow tightly against your incision when you cough to help decrease pain. Take a deep breath and hold it for as long as you can. Deep breaths help open your airways. Let the air out and follow with a strong cough. Spit out any mucus you cough up. Repeat the steps 10 times every hour.

    • You may be given an incentive spirometer to help you take deep breaths. Put the plastic piece into your mouth and take a slow, deep breath. Let out your breath and cough. Repeat the steps 10 times every hour.

  • Pressure stockings: These are long, tight stockings that put pressure on your legs to promote blood flow and prevent clots.



  • Pneumatic boots: Inflatable boots are put on your legs. The boots are connected to an air pump. The pump tightens and loosens different areas of the boots.

  • Exercise: Move your legs, ankles, and feet as directed while you are in bed. You may be asked to stand the same day of your surgery. You may start to walk the day after your surgery.

  • Support devices: You may need to wear a knee brace during exercises. It may be worn for 30 to 40 minutes, 2 to 3 times a day. You may need to use a cane, walker, or crutches. These devices will help decrease your risk of falling. Use your device as directed.

  • Physical therapy: You may need to see a physical therapist to teach you special exercises. These exercises help improve movement and decrease pain. Physical therapy can also help improve strength and decrease your risk for loss of function.

  • Continuous passive motion machine: You may need to use a continuous passive motion (CPM) machine. This machine slowly bends and straightens your knee as you lie in bed. You may need to use this machine several hours each day to prevent stiffness and decrease pain.

  • Medicines:

    • Pain medicine: Caregivers will give you medicine to take away or decrease your pain. Do not wait until the pain is severe to ask for your medicine. Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.

    • Patient controlled analgesia: You may get pain medicine through an IV or an epidural line attached to a patient controlled analgesia (PCA) pump. Caregivers set the pump to let you give yourself small amounts of pain medicine when you push a button. Your pump may also give you a constant amount of medicine, in addition to the medicine that you give yourself. Let caregivers know if your pain is still bad even with the pain medicine.

    • Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.

    • Antinausea medicine: This medicine may be given to calm your stomach and to help prevent vomiting.

    • Muscle relaxers: This medicine helps relax your muscles. It is also given to decrease pain and muscle spasms.

    • Blood thinners help prevent blood clots. Blood thinners may be given before, during, and after a surgery or procedure. Blood thinners make it more likely for you to bleed or bruise.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Total Knee Replacement (Inpatient Care)

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