Your operation will be performed by a specialist knee surgeon, usually at Chapel Allerton Hospital.
To help prepare you knee for your operation you need to start doing some exercises that will help strengthen the muscles around your knee to help you recover as quickly as possible.
See the videos in our exercise section, perhaps try and do these with friends and family before you come into hospital. Getting support from those around you will help you recover more quickly following your operation.
Preparing for your total knee replacement surgery
Welcome to the elective total knee replacement session. This video will help you prepare for your knee surgery. If you have any questions please make a note of them and join us at the question and answer zoom call that you will be invited to.
For a knee replacement to take place the damaged cartilage and bone ends of the knee are replaced with metal and plastic parts also known as the prosthesis. Operation time is approximately between one to two hours. A knee replacement can help reduce pain and improve your ability to perform daily tasks.
It is important that you prepare yourself and your home before coming into hospital to make the best recovery. You may find it beneficial to think about the layout of your home to make sure you can safely get around with a walking aid such as elbow crutches.
If you live alone you may want to arrange support from friends or family for activities such as shopping. You will need to try to arrange your own transport to and from hospital with family or friends. Following your knee replacement you are able to travel in a car as a passenger. Practice this before coming into hospital. Low sports cars are not advised as they are more difficult to get in and out from.
For your hospital stay, we encourage you to wear day clothes on the ward. Bring loose-fitting clothes and underwear, things such as tracksuit bottoms, shorts, an elastic loose dress so that your physiotherapist can easily assess your knee. We advise you to bring in loose-fitting supportive footwear with full backs and toes as your feet can swell up after your operation. New footwear is not advisable.
Your Surgery
On the day of your operation you will have the opportunity to ask questions. You will meet a physiotherapist and your anaesthetist who will explain what happens when you have an anaesthetic and answer any questions you might have.
You will also meet your surgeon who will discuss the indications, benefits and risks of you surgery. The knee undergoing surgery will be marked and you will be asked to sign a consent form.
You will be asked to change into a theatre gown and you may be asked to wear compression stockings, these help reduce the risk of developing a blood clot. With leg surgery these are not usually worn on the leg being operated on, but the nurses preparing you for your operation will tell you if and how you need to wear them. The operation can take between 1-3 hours.
To understand more about how knee replacement surgery is performed check out this animation on the NHS website (knee replacement). You will also find other useful information about why people have knee replacement surgery and some of the risks of such surgery.
After Surgery
When your operation is finished you will usually be taken to the recovery area until you wake up from the anaesthetic. The wound on your leg will be covered by a simple dressing and a bandage will be wrapped around your knee. When you are well enough, you will be transferred to the ward.
Below is a video about what happens after your operation, and what it’s like to wake up in the recovery room, and getting out of bed for the first time after your operation.
After your knee replacement surgery
Immediately after surgery, you will be placed in the post-operative unit to recover from the anaesthetic. You may have several attachments including oxygen, the pulse oximeter, blood pressure cuff, and ECG.
The nurses will tell the physiotherapists when you are medically stable for these attachments to be removed. You will also have a flotron’s cuff around your calves. These will help to pump the blood around your body to avoid blood clots. You will usually need to wear these until you have blood thinning medication given by the nurses. This will be explained in more detail when you come into the hospital.
You will also have a bulky dressing around the operated knee for up to 24 hours after your surgery. Either on the day or the morning after your surgery, the physiotherapy team will check your sensation and strength in your legs.
Once you are ready, the physiotherapists will help to move yourself to the edge of the bed and aim to mobilise a short distance using a walking frame for the first time.
Pain Relief
Before you are discharged from hospital you will spend time with a physiotherapist and when your pain is under control you can go home. It is normal to have some pain, swelling and bruising to your thigh, knee and leg after your operation.
Good pain relief is important to ensure adequate range of movement and prevent stiffness, it is important that you feel comfortable enough to breathe deeply, cough and move around.
Before you come to hospital we recommend you have some simple pain relief medication at home such as paracetamol so that you don’t need to worry about getting to the shops for the first few days after your operation.
After the operation it is normal to experience swelling around the operated knee. To help reduce swelling your physiotherapist will provide you with an ice pack that can be worn as a cuff around your knee, this is called a Cryocuff. Please watch this video about how to wear and use your cryocuff:
How to wear and use your cryocuff
It is normal to experience increasing swelling within the first few days after your surgery. It can take up to one year for this swelling to fully settle, but this usually improves significantly after the first three months. Once the bulky dressing is removed, your physiotherapist will provide you with an ice pack, also known as a cryo cuff, while you’re in hospital.
To use the cryocuff, place the cuff over your knee with the file facing towards you. The circular hole should be directly over your kneecap. Wrap the straps around the back of your knee to secure it, and straps should be fitted tight enough to keep the cuff positioned in place.
You should aim to use the cryocuff for 20 minutes at a time. This can be repeated every hour. While in hospital, the physiotherapist or nurses will review the cryocuff with ice-cold water every day. This can be taken home and kept in the fridge to keep cool.
Do not place this in the freezer as it can damage the cryocuff.
Discharge home after your operation
We aim to discharge you from hospital as soon as you are safe to go home. In some cases this may be on the same day as the operation. There are certain criteria that help the medical team know you are safe to go home, this includes:
- Your wound is healing
- You are able to walk independently with a walking aid
- You can go up and down stairs, with you walking aid independently
- You can lift and bend your operated leg 70 degrees.
Watch this video about preparing to go home after your operation and ways to help your knee recover when at home.
Discharge home after knee surgery
The number of days in hospital fairies some patients are now going home on the
day of their surgery, but you will be informed of this plan before coming into
hospital.
You will be discharged home once your wound is dry you are able to walk
independently with a walking aid usually with elbow creatures. If you can manage stairs do exercises independently and are able to lift your operated legs straight up and off the bed independently and bend your knee to 70 degrees.
You will either receive a telephone or video call as your follow-up appointment
two weeks after you are discharged home. Should you have any difficulties or
problems with your knee you may receive a face-to-face appointment.
Once you are home it is important to do your exercises daily as well as resting and elevating your knee to do this you can sit on the bed or use a full stool if you are sitting on a sofa.
Remember every knee operation and every patient is different. Please do not compare to previous experiences. Please do not take advice from others on social media.
Driving after your operation
As a general guide, depending on your range of motion and your ability to perform an emergency stop, you should refrain from driving for around six weeks. It is essential you are able to perform an emergency stop without discomfort or hesitation before starting to drive again. It is also recommended that you inform your insurance company that you have had a joint replacement procedure.
Returning to work
Return to office work should be possible after approximately 2-3 weeks. If you have a job that involves heavy physical work you should leave 8-12 weeks before going back to work.
If you have any concerns after you are discharged home, particularly with your wound, pain or swelling please feel free to contact Ward C3 for advice.