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Total Knee Replacement
WHAT YOU SHOULD KNOW:
- Total knee replacement (TKR) is also called total knee arthroplasty. It is surgery that is done to remove and replace your knee joint. The knee joint is where your femur (thighbone) and tibia (large lower leg bone or shinbone) meet. A small triangular bone called the patella (kneecap) protects your knee joint. Arthritis, Paget's disease, hemophilia, or an infection can damage your knee joint. Surgery that is done to fix a fractured (broken) femur can also damage your knee joint. Avascular necrosis is a condition that occurs when blood cannot flow well to certain body areas, causing bones to weaken. This can also harm your knee joint. These conditions may cause knee pain and decrease your ability to do sports and activities. You may still have knee pain after 3 to 6 months of treatment. Your knee pain may be so bad that you cannot sleep. If you have either of these problems, you may need to have a total knee replacement.
- During the TKR, the damaged parts of your knee joint are removed and replaced with an implant. This implant may be made of metal, ceramic, or plastic. You may need to have one or both of your knee joints replaced. TKR surgery may decrease or take away your knee pain, and make standing, sitting, and walking easier.
Take your medicine as directed:
Call your primary healthcare provider if you think your medicine is not helping or if you have side effects. Tell him if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.
- Antibiotics: This medicine helps prevent or treat an infection. After a total knee replacement, you are at a higher risk of getting infections. Your caregiver may tell you to take antibiotic medicine before you have dental work, such as a tooth filling or root canal. You may need to take antibiotics before having other procedures, such as a colonoscopy. You may need to do this for three or more years after surgery.
- Nonsteroidal anti-inflammatory medicine: This family of medicine is also called NSAIDs. Nonsteroidal anti-inflammatory medicine may help decrease pain and inflammation (swelling). NSAIDs may also be used to decrease a high body temperature (fever). This medicine can be bought over the counter with or without your caregivers order. NSAIDs can cause stomach bleeding or kidney problems in certain people. Always read the medicine label and follow the directions on it before using this medicine.
- Pain medicine: You may be given medicine to decrease or take away pain. Your caregiver will tell you how much to take and how often to take it. Do not wait until the pain is too bad before taking your medicine. The medicine may not decrease your pain if you wait too long to take it. Tell your caregiver if the medicine does not decrease your pain, or if your pain comes back too soon.
- Blood thinners: Blood thinners are medicines that help prevent blood clots from forming. Clots can cause strokes, heart attacks, and death. Blood thinners make it more likely for you to bleed or bruise. If you are taking a blood thinner:
- Watch for bleeding from your gums or nose. Watch for blood in your urine and bowel movements. Use a soft washcloth on your skin and a soft toothbrush on your teeth. This can keep your skin and gums from bleeding. If you shave, use an electric shaver. Do not play contact sports, such as football.
- Be aware of what medicines you take. Many medicines cannot be used when taking medicine to thin your blood. Tell your dentist and other caregivers that you take blood-thinning medicine. Wear or carry medical alert information that says you are taking this medicine.
- Take this medicine exactly as your caregiver tells you. Tell your caregiver right away if you forget to take the medicine, or if you take too much. You may need to have regular blood tests while on this medicine. Your caregiver uses these tests to decide how much medicine is right for you.
- Talk to your caregiver about your diet. This medicine works best when you eat about the same amount of vitamin K every day. Vitamin K is found in green leafy vegetables and other foods, such as cooked peas and kiwifruit.
- Warfarin: Warfarin is a type of medicine that helps prevent clots from forming in the blood. Clots can cause strokes, heart attacks, and death. Using warfarin may cause you to bleed or bruise more easily. If you are taking warfarin:
- Watch for bleeding from your gums or nose. Watch for blood in your urine and bowel movements. Use a soft washcloth on your skin, and a soft toothbrush to brush your teeth. Doing this can keep your skin and gums from bleeding. If you shave, use an electric shaver. Do not play contact sports.
- Many medicines cannot be used when taking warfarin. Talk to your caregiver about all of the other medicines that you use. Tell your dentist and other caregivers that you take warfarin. Wear a bracelet or necklace that says you are taking this medicine.
- You will need to have regular blood tests while taking warfarin. Your caregiver uses these tests to decide how much medicine is right for you to take. Take warfarin exactly how your caregiver tells you to. Tell your caregiver right away if you forget to take the medicine, or if you take too much.
- Talk to your caregiver about your diet. Warfarin works best when you eat about the same amount of Vitamin K every day. Vitamin K is found in green leafy vegetables and certain other foods.
Ask for information about where and when to go for follow-up visits:
For continuing care, treatments, or home services, ask for more information.
- Ask your caregiver when to return to have your wound checked, and have the drain or stitches removed. Ask your caregiver how to take care of your knee, including how to clean the cut, and when to change the bandages. You may need to have x-rays done on your knee. Ask your caregiver when to return for the x-rays, blood tests, and other tests that you may need.
Your caregiver may ask you to wear compression stockings. These tight stockings put pressure on your legs after your surgery. Wearing pressure stockings helps blood flow through your blood vessels to help prevent blood clots. When blood clots form in your leg veins and block blood flow, it is called deep vein thrombosis (DVT). Ask your caregiver for more information about DVT, and what you can do to help prevent it.
You may need to have physical therapy. A physical therapist will help you with exercises such as knee bending, sit-stand-sit exercises, straight leg raises, and heel slides. You may also be asked to do leg stretching, squatting, and ankle bending and stretching. You may need to begin a walking program, or use an exercise bicycle. These exercises help strengthen the bones and muscles around your knee joint. These exercises may also help your knee heal.
Ice causes blood vessels to shrink, which helps decrease swelling, pain, and redness. You may put crushed ice in a plastic bag and cover it with a towel. Place this over your knee for 15 to 20 minutes every hour as long as you need it. Do not sleep with the ice pack on your knee. Doing this may cause frostbite.
Falls can cause bone fractures (breaks). Ask your caregiver for more information on how to prevent falls. You may need to use a shoe lift, knee brace, crutches, a cane, or a walker. These items can help you walk, and decrease your chances of falling. Use your crutches, cane, or walker correctly. Ask your caregiver for information on how to choose and use crutches, a cane, or a walker.
What to do to help your wound heal:
- Do not drink alcohol. Alcohol is found in adult drinks, such as beer and wine. Alcohol can damage your brain, heart, and liver. Drinking alcohol can also make you more likely to get an infection after your surgery. Talk to your caregiver if you drink alcohol.
- Eat healthy foods. Eat a variety of healthy foods to give you more energy and help your wound heal faster. Some healthy foods are fruits, vegetables, whole-grain breads, low-fat dairy products, beans, lean meat and fish. Being overweight or obese may delay your wound healing. Eating the right foods can help you lose weight. Ask your caregiver to help you find the best eating plan for you.
- Do not cross your ankle over your knee while sitting. When you are sitting, do not cross your legs so that your ankle is placed resting on the knee where you had surgery. This position causes your implant to move out of place.
- Stop smoking. Smoking harms the heart, lungs, and the blood. You are more likely to have a heart attack, lung disease, and cancer if you smoke. Smoking can also delay wound healing. You will help yourself and those around you by not smoking. Ask your caregiver for more information on how to stop smoking if you are having trouble quitting.
- Talk to your caregiver about taking vitamins. Vitamin C and E, and minerals such as zinc may help wounds heal faster. They help repair tissues, and help your body fight infection.
- If you have diabetes, keep your blood sugars in the range suggested by your caregiver. It may take longer for your knee to heal if you have high blood sugar levels. Ask your caregiver for help managing your blood sugar levels.
CONTACT A CAREGIVER IF:
- You have a fever.
- You are not able to do the exercises that you have been told to do.
- You have trouble stretching your leg and moving or bending your knee.
- Your wound begins to drain fluid again after it has stopped.
- You have trouble sitting or getting up from a chair, walking, or climbing stairs.
- You have back pain or lower leg pain when you flex (bend) your foot upwards.
SEEK CARE IMMEDIATELY IF:
- You are unable to walk or move your leg, or your knee feels very stiff.
- You fell and hurt your knee.
- You have fainted (passed out).
- Your leg feels warm, tender, and painful. It may look swollen and red.
- You have chest pain or trouble breathing that is getting worse over time.
- You suddenly feel lightheaded and have trouble breathing.
- You have new and sudden chest pain. You may have more pain when you take deep breaths or cough. You may cough up blood.
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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.