What to expect when expecting a knee replacement...trust the process

What to expect when expecting a knee replacement…trust the process

    What to expect when expecting a knee replacement can be an unknown. This is especially true for patients unfamiliar with anyone that has had a knee replacement. This series will paint a picture of the knee replacement experience. The first entry in this series was about the journey to a knee replacement. It discussed the pre-operative journey. This entry discusses the process that starts on the day of surgery until discharge. 

  On the day of surgery, the patient is seen by the surgeon in the pre-operative area. The surgical site is marked by the surgeon. Some pain medications are given to help get ahead of pain before there is any operative pain. The surgery will start several minutes after the patient has been taken to the operating room. This allows for administration of anesthesia, positioning, cleaning the surgical site, and draping. A knee replacement can take up to 2 hours depending on the complexity of the surgery. Local anesthetic injection like Novacaine at the dentist’s office (but different medication) is injected to the tissues around the knee at the time of surgery. This helps with getting ahead of pain before the patient develops significant pain issues. Following the surgery, the patient is taken to the recovery room for observation for any post-surgical issues. 

The time spent in the recovery room can vary depending on a number of factors. These include pain control, medical issues, and whether the procedure is scheduled as an outpatient surgery versus surgery with an overnight stay. For overnight stays, the patient is transferred to the orthopedic floor after the recovery room stay. Physical therapy usually starts the day of surgery. Average length of day is an overnight stay and most patients are able to go home by the next day. Few patients will end up needing another night for a variety of reasons. These reasons can include difficulties with mobilization, and medical issues that need monitoring. A small percentage of patients will require a swing bed/sub-acute rehabilitation facility. Patients are discharged on pain medications (Tylenol, NSAIDs, and a short supply of opioid medications). They are also discharged on medications to help prevent blood clots (e.g. Aspirin, Eliquis). The actual medication to prevent blood clot will not be the same for every patient. It varies depending on the medical history and risk factors for developing a blood clot after surgery.