Dr. Tozzi s and Dr. Roehrig s Patient Guide to Total Knee Replacement

Transcription

1 Dr. Tzzi s and Dr. Rehrig s Patient Guide t Ttal Knee Replacement This guide is meant t help yu better understand yur upcming knee surgery. It is generalized infrmatin, and individual patients have unique, individual circumstances which can impact their peratin and their surgery experience. Cntact yur surgen with any particular questins r cncerns. Arthritis is the prcess f wear and destructin f the cartilage (the cushin ) in yur knee, leading t inflammatin, swelling, pain, and smetimes defrmity. Ttal knee replacement remves arthritic bne and cartilage, replacing it with metal and high-grade plastic, prviding yu with a well-aligned, well-functining knee that des nt have arthritic pain Yur knee replacement will be perfrmed at Jersey Shre University Medical Center. Average time spent in the hspital is 2-3 days. The surgery takes abut minutes t cmplete. The entire surgical prcess (anesthesia, preparing and sterilizing, x-rays) adds anther hur r s fr the family that is waiting t hear that all the wrk went well and is cmpleted. Mst patients then g directly t an inpatient rehabilitatin facility fr a variable length f time, depending n their mbility and hme situatin. This is strngly recmmended, as it allws fr therapy multiple times per day and teaches techniques fr caring fr yurself at hme.

2 Yu will receive physical therapy in the hspital, at Rehabilitatin, and as an utpatient. This usually includes walking, stairs, mtin exercises, and a cntinuus passive mtin (CPM) machine that bends and straightens yur knee fr yu while yu are in bed. Recvery time is variable. In the early mnths f healing, try nt cmpare yur knee replacement t ther patients r t yur ther knee (if replaced). Each knee is unique and recvers at a different rate. Mst patients can prgress frm a walker t cane within 2-3 weeks, nt require the cane in 4-6 weeks, and be functining well at 2-3 mnths. Cmfrt, mbility, functin, and strength cntinue t imprve up t ne year after surgery. Risks an Ptential Cmplicatins: The fllwing is a (nncmprehensive) list f risks and pssible cmplicatins that yu will als find n yur cnsent frm fr surgery. Frtunately, mst are very uncmmn. Bleeding, infectin, wund healing difficulties, stiffness, instability r lseness, bld clts, nerve r bld vessel damage, very rare lss f extremity, fracture, lsening f the implants, wearing away r breakage f the implants, clicking r crunching sensatins in the knee, tendn damage r failure, failure f surgery t relieve all f the pain, lss f functin, need fr mre surgery, and anesthesia risks nt limited t strke, heart attack, death Knee Range f Mtin: Maintaining the full extensin (fully straight psitin) achieved at the time f yur surgery is as imprtant as hw far yu are able t bend yur knee after cmplete healing. Yu will be taught exercises t help with this imprtant gal.

3 Hw far yu can bend yur knee after cmplete healing depends n hw stiff the knee is befre surgery and each individual s healing/scarring respnse t the surgery, and is therefre very difficult t predict. A knee replacement that can fully (r nearly fully) straighten, and bend >110 degrees will functin well in activities f daily living. Kneeling is smetimes uncmfrtable after a knee replacement, but will nt harm the knee. The Incisin: Yur first pst-perative visit t yur surgen s ffice is abut 2-3 weeks frm yur surgery date. The staples that clse yur incisin will either be remved at rehab r in the dctr s ffice apprximately 2 weeks frm surgery. The incisin must be kept dry until the staples are remved. Yu shuld nt immerse the knee in water (bath, pl, lake, cean) fr 4 weeks frm surgery. Bld thinners will be prescribed fr 2-3 weeks after yur surgery t help reduce the risk f bld clts, a well-knwn cncern with jint replacements. Examples f these medicatins include Xarelt, Arixtra, Lvenx, Cumadin, and Aspirin. Driving may resume after: LEFT knee replacement when ff narctic pain medicines and able t get in and ut f the car n yur wn RIGHT knee replacement when ff narctic pain medicines and able t step n the brake quickly and firmly (usually ~6 weeks)

4 Returning t wrk varies n yur recvery and yur duties at wrk. It may be as sn as a few weeks, r as lng as a few mnths. Yu may travel when yu are cmfrtable and have finished the pst-perative curse f bld thinners (2-3 weeks), but we strngly recmmend taking a break every hur during lng trips t get up and stretch and walk. The risk f bld clts is higher than usual in the pst-perative perid. Sprts and activities that yu can participate in are numerus. Yu shuld avid high r repetitive impact activities like running, jumping, and pen field sprts including sccer, ftball, and aggressive basketball. Dental wrk: Antibitics will be prescribed t yu prir t any dental wrk r invasive medical prcedure in the future. This will help lessen the risk f bacteria in yur muth reaching yur bld stream and yur knee jint. Please call yur surgen fr this prescriptin a few days befre yur appintment. Avid nn-urgent dental wrk and prcedures fr 3 mnths fllwing yur knee replacement. What else t expect: It is nrmal fr the knee t be swllen and warmer than the ther knee. Icing the knee regularly will be helpful during the first mnth r tw. Numbness f the skin t the side f yur incisin is very cmmn and usually imprves with time, but may always feel different t the tuch. The knee replacement will smetimes feel like it clicks r clunks. This is nrmal and is due t the metal and plastics parts tuching each ther. If it is persistent r painful, ntify yur surgen.

5 Yur new knee may set ff metal detectrs (airprt, curthuse, etc.) and n letter r card frm yur dctr will change hw security wrkers handle this. Wear lse fitting clthes t easily allw yu t shw them yur incisin during the screening prcess. Knee replacements can last a very lng time. There is an 80-90% chance that yur jint replacement will still be functining well 20 years after yur surgery. It is impssible t predict hw lng yur new knee will last befre mre surgery may be necessary t change ut wrn r lse parts. The newest technlgy is imprving the lifespan f these implants. Minimally invasive surgery and cmputer-assisted surgery have a rle in certain situatins. Please refer t the fllwing link fr the American Assciatin f Hip and Knee Surgens psitin statement n these issues: Things t be cncerned abut include: Painful leg swelling Wrsening redness Persistent drainage frm the incisin Fever >101 degrees *These symptms shuld prmpt a call t yur surgen s ffice.