Must Things to Do Before and After Total Knee Replacement Surgery

Joseph R. Anticaglia MD
Medical Advisory Board

Having total knee replacement surgery (TKR) is a major undertaking that most likely you’ve been putting off for years. Over time, the pain might now persist throughout the day and even interfere with sleep. You could find it painful to walk, getting up from a chair or out of a car or climbing up and down stairs. The knee joint becomes stiff. Eventually, pain medications may not provide enough relief. Physical therapy, corticosteroid or hyaluronic injections, in retrospect, were useful temporarily. However, after exhausting medical options, one comes to the inevitable decision to have TKR surgery.

The above was the situation with Barbara who was one of 700,000 thousands TKR surgeries performed in the United States annually. She was diagnosed with osteoarthritis (arthritis) of the left knee. “When my knee cartilage disintegrated and bone was rubbing against bone, it was only a matter of time before I had the surgery.”

Total knee replacement surgery has been successful in relieving pain, restoring mobility and correcting leg deformity for most individuals suffering from intensifying arthritis of the knee. TKR surgery replaces the surfaces of the diseased thigh bone (femur) and the surface of the shin bone (tibia) with different types of implants.

What steps I can take before TKR to delay or eliminate the need for surgery? What can I do after being discharged from the hospital to minimize pain and hasten recovery?

Before Entering the Hospital

TKR surgery can be delayed or possibly avoided when you:

• Understand the reason for your knee pain
• Diet If you’re overweigh get to and maintain a healthy weight
• Exercise Strengthen your knee joint muscles, the quadriceps and hamstrings muscles.
• Consult a physical therapist with experience concerning knee problems to customize a muscle-strengthening program The physical fitness goals are to:
  Help patients regain strength
  Recoup and enhance range of motion
  Lessen symptoms prior to surgery
  Hasten recovery after surgery
• Incorporate balance and stretching movements into your exercise program
• Low impact exercises (e. g. swimming)
• Wear proper shoes
• Utilize corticosteroid or hyaluronic injections

Home preparations might include:

• De-clutter, remove throw rugs
• Tub/shower seats and hand-held shower attachments should be purchased and installed before your surgery date.
• You might need a “reacher” to pick up items from the floor and a long handled shoe horn
• Install stair railing on any stairwell you use during recovery
• Wear slip resistant shoes
• Determine and make arrangements so that the chair with arms and toilet seat are at the appropriate height for you

Before Leaving the Hospital

Before leaving the hospital, have needed prescriptions filled by the hospital or another pharmacist and obtain necessary dressings from the nursing staff. Check with your insurance company about coverage concerning crutches, a walker and other items.

Physical therapy is an essential aspect of rehabilitation after TKR surgery. Speak with social service, your case worker, about making arrangements for a physical therapist to visit your home.

If you’re being driven home, have the car seat pulled back and elevated. You might also sit on a cushion to help exiting from the car. Expect pain and pain relief with proper medications. Stay in contact with your case worker.

After TKR—At Home

• Get help from family, visiting nurses and physical therapists
• Follow the exercise program outlined by your surgeon and physical therapist
• Consistently doing exercises will help speed-up the recovery time.
• Take prescribed medications
• Sponge baths for two week post-surgery
• No creams, lotions or ointments near incisional area
• Common sense will tell you if you’re doing too much or too little exercises and activities

Total knee replacement surgery has been successful in relieving pain and improving mobility in the vast majority of cases. They’ve also have been durable lasting 15 to 20 years. It’s a serious commitment to undergo this operation and the better you are informed, the greater the likelihood of a successful outcome.

References

1. Foran, Jared R. H; Fischer, Stuart J; Orthoinfo, AAOS; Total Knee Replacement; August, 2015
2. National Association of Orthopedic Nurses; Total Knee Replacement; Patient Education Manual

Glossary

Total Knee Replacement surgery is also called Total Knee Arthroplasty

Partial knee replacement surgery is suitable for people who experience arthritis only in one section of the knee joint

This article is intended solely as a learning experience. Please consult your physician for diagnostic and treatment options.