Knee replacement surgery

[Carakeel]

Hi everyone! In about 5 months time I am having knee replacement surgery (arthroplasty) on my left knee. The right knee will be done three months later. At 57, I am quite young to have this done, but really have no options left. The early deterioration in my knees is not solely due to arthritis, but started when I fell a few times while lifting my son (19 yrs of age at the time and 6'4"), when he had cancer and my own bone cancer previous to that. Has anyone had this op and can tell me their experiences, please? Are there any suggestions as to things I can do before the op to improve my chances of success. I have seen how the op is done on several medical videos and have been to various sites to learn as much as I can. But, it would be nice to hear from someone with first hand experience as a patient in this situation. Ta!

[alijangra]

Im a nurse in orthopaedics and have nursed many patients following knee replacement. As you have requested a patient perspective I will only answer if you want my advice.

[Carakeel]

Hi Alijangra, thanks for answering. I would appreciate any advice you can give me. To be honest, as much as I desperately long to have my new knees and less pain every day, I will admit I am quite terrified of the ops, as during two major ops years ago I had two cardiac arrests, one during and one after. So, am feeling a bit afraid, bit of a coward I guess. I am determined to go ahead with this though. I always have the attitude that patients should work with the medical team, so want to do my bit to get this right. Hence, any advice would be appreciated. Thanks.

[alijangra]

Are you being given the option of a spinal anaesthetic because of your medical history? I hope so and do go for it if you are, it really is a much better option.

Everyone will have a different experience so sometimes I think its best maybe not to take too much on board of anybodies personal experiences, as yours will be unique.

When you are admitted you should expect a thorough explanation of everything to expect. Where I work we call it a 'pre-op talk' , where they should discuss your aftercare with you and answer any questions. I would advise you to write your questions down at home as nerves may get the better of you when you are admitted.

Pre-op theres not an awful lot you can do other than trying to be as healthy and physically fit as possible, although I understand this may be difficult due to your pain. Excess weight will make things harder to a certain extent.

Post-op, you will most likely have a PCA (patient controlled analgesia) with morphine or similar so there is no need to be in pain. You cannot overdose with these pumps as they have a lock-out period. Nurses will be checking you regularly to ensure you are rousable. This is likely to be up overnight and come down next morning if you feel up to it. You may have a very small vacuum drain in place to drain off any excess blood and prevent pressure build up. You will have a HUGE multilayer pressure bandage but dont worry it will come down post-op day 2 or 3 and you will notice the main dressing is not that large. Physio begins fairly soon and you will have a physiotherapist to instruct you on how and when to do the exercises. You will be expected to do them yourself hourly.

[alijangra]

The main thing is to remember that you should never be in pain. Discomfort yes, but actual pain is a failing on the medical teams behalf with regards to your pain control. Also, when it comes to your dressing being reduced right down for the nurse to check your sutures or staples (most likely to be staples but surgeons have personal preferences, strange creatures!!) please ensure they are washing their hands and wearing gloves as infection in the wound is probably the single worst thing that could occur.

So really you will have a lot of hard work to do post-op with regards to physio, and before you know it you will feel as good as new. Good luck I hope it all goes well x Alison

[FoxLee]

I can't speak from my own experience but my husband had a knee replacement op. in Jan. 2005 (at age 59) so I've just asked him if he had any advice. Pre op, if possible, he said it was a good idea to build up the muscles round the knee as much as possible. Afterwards, if you have the oppportunity of physio. in a pool (hydrotherapy?), he said this was really good, he could do much more in the way of exercise. Then to keep up with all the physio - for one exercise, he used to sit on the edge of the desk, swinging his leg back and forth and I would get hold of it and try and push it a little further. It took a few weeks of some discomfort but by six weeks, he was really glad he had had it done.

I wish you all the best and hope the op. goes well for you.

[Carakeel]

Thanks Alison, you're a star! I am very lucky in that the head physio and the head occupational therapist know me very well from before and after my son died. We have a mutual admiration society going, as I know how great they are and they, having given me treatment before, know that I work harder than most patients to recover. They have in the past told me off on occasion, as I do tend to push myself too hard sometimes. But they are brilliant, those two and it is such a confort konwing they will be there to help me recover. My immune system has never fully recovered from the experimental treatment I had for my cancer in the US, so yes... I am worried about infection. Thanks for your advice on this. I can see that the spinal anaesthetic would probably be a safer option for me, but I worried that I will hear and feel movement and noises that will be hard to go through. When I have had pre-meds ahead of ops before, they have not worked as planned and I have gone into a panic before being knocked out totally .... soooooo embarrassing!! It is all to do with the fact that I am afraid of having another cardiac arrest, even though my heart is fine. It was back then too! So, amongs a waterfall of tears I kept asking the medical team please to not let me die. I felt such a fool afterwards and really felt sorry for the team in the OR. My problem was apparently caused by the anaesthetic in the first place; my blood pressure dropped to an all-time low and my heart stopped. The surgeon has been great and has put me on the 'urgent list' as I have been waiting for a very long time. He has also scheduled for me to come in for a full workup six weeks before the first op. So, hopefully I will not have any problems. Thanks for all your help Alison. I always feel better when well informed.

[Carakeel]

Thanks FoxLee! I'm really glad it all went so well for your husband. Like your husband, I have a lovely supportive partner, who does everything he can to help. He massages my knees nearly every night with a painkilling gel, which helps me find some sleep. He has been a tower of strength for me during the past year and a half. I just love him to bits!

[Morticiah]

Hi Carakeel, I suffered a rather nasty knee injury last year, so I do feel for you.

I found loads of info, help and support from this web-site -
http://www.kneeguru.co.uk/KNEEtalk/index.php
why not have a look at it.
I think you'll find lots of people who are in similar situations and can advise/support you.

Regards, Mort.

[Carakeel]

Thanks Morteciah, found it and it is a very good site. Hope you are fully recovered. Best wishes.