After years working construction, climbing ladders and wearing a heavy tool belt my father could no longer tolerate walking. the cartilage in his left knee had worn away leaving his knee joint rubbing bone on bone. Ow!
When considering a major surgery such as joint replacements many questions arise. In my work as a pre-op nurse my patients and their families pose many questions to me. I will try to answer most those questions here today.
1 . How long will surgery take?
The surgery usually takes one to two hours in the operating room and approximately one to two hours in recovery after surgery. It is a bit of a non-day!
2. Is the surgery painful?
Many of my patients report improved pain after surgery. They say they are in pain but it is a different type of pain than what they had prior to surgery. Your physician will make sure you have the right type of pain medication for you. Your pain is usually controlled to a tolerable level with these pain medications, if used as the doctor prescribes.
3. How long will I be in the hospital?
The average length of stay for a total knee replacement is 3-4 days. However, each patients needs are different so it could shorter or much longer. Your doctor will discharge you when he knows your pain is controlled and there is a safe discharge plan for you. That may mean a rehab plan as well.
4. How long is the recovery after a knee replacement?
Knee replacement surgery does have a long recovery process. There are specific phases to your recovery. First, you want to see your incision heal well, without infection. During this time you will also be working diligently at balancing being mobile and working the joint with rest to heal. You may have a lot of swelling in your knee during this phase and you may need to use a front wheeled walker, scooter, wheelchair or crutches to get around. This phase usually lasts about a month.
The second phase you will concentrate on really getting that knee working. You will be walking on it and may be continuing physical therapy. Most doctors will estimate this phase to be about 2 months expecting at least close to full recovery by 3 months. However, as in my father’s case, this phase can easily last up towards 6 months or even a year.
You can also expect your knee to continue to have a great deal of swelling for the first 6 months to a year as well.
5. What are the risks of knee replacement surgery?
Ninety percent of cases have no problems at all. Ten percent may end up with infection or scar tissue in the joint. Either of these problems could require another surgery to fix.
There is also a low risk with anesthesia. A plethora of side effects could occur with your anesthesia but these problems are extremely rare.
6. Will I set off the alarms at the airport after knee replacement surgery?
Yes, you most likely will be setting off the alarms while going through security at the airport. It is a good idea to allow for an extra 10-15 minutes for a thorough security check before catching your flight.
7. When can I drive again after knee replacement surgery?
When you go back to driving depends on a lot of factors. First, your doctor will not release you to drive until you are no longer using narcotic pain pills. Secondly you must have some good range of motion to operate the pedals as well as get in and out of the car easily. This may take many weeks. The photos below show a knee incision in some various stages of healing. You can see that driving would be difficult for many weeks to come. If your right leg was operated on it will likely be 6 weeks or more before you can drive a car again. If you left leg was operated on it may be closer to 4 weeks. Your surgeon will give you the directive when you can drive again based on your rate of recovery.
The answer to this questions depends on many factors. Knee replacements are known for having a long recovery. Everyone’s recovery is different and some people take longer to get back on their feet. Your age and overall health condition are a factor as well. However, on average, if you have a desk job you may be back to work in about a month. If you have a job that is physically demanding you may be off work for as much as 3-6 months.
9. How long will my knee replacement last.
Knee replacements have great outcomes. Many people keep their knee replacements for the rest of their lives without any problems at all. On occasion a knee replacement will wear out or become loose. Most people can expect many happy years with their new knee.
That depends on the type of anesthesia you are given. If you receive general anesthesia you will not be awake for surgery. If you are given a spinal anesthesia and a nerve block then you might have some awareness during surgery. Usually, if you have a spinal and nerve block you will also get some light conscious sedation and most people do indeed sleep through the surgery. Your anesthesiologist will meet with you before you go into surgery and explain the different types of anesthesia and give you his recommendation.
Yes, your dentist will prescribe antibiotics for you to take prior to any dental work. The reason for this is that a foreign object in your body is susceptible to infection. If bacteria were to get into your blood stream the infection could settle in your knee and the joint would have to be either removed or debrided. Neither is a good option, especially with easy prevention by taking a few antibiotics before getting dental work done.
12. Will I be able to have an MRI with an artificial knee.
Magnetic Resonance Imaging or MRI uses a magnetic field and pulses of radio waves to make pictures of the body or organs in a body. People who have metal in their body often times can not have an MRI. The magnetic field in an MRI is extremely strong and could cause severe damage or injury to a patient with metal in their body.
However, most joint replacements are not magnetic. Some distortion could occur on the MRI if the area they are imaging is near the joint but an MRI should still be a practical diagnostic option. Be sure to let your doctor know that you have a metal joint before going in for an MRI. There are often other diagnostic options that can be used instead of an MRI.
Before having a total knee replacement surgery, my father was unable to walk long distances. He would resort to using a scooter and his daily activity decreased substantially. He was in a lot of pain and he really suffered. After he had his knee replacement he was able to walk without assistive devices, work in the garden, build a deck, and play with my children. Just last week he painted his own house top to bottom. He is 77.
Knee Replacement Alternatives: