Welcome to our pre-operative page. The video above are some of the same things that we would already have gone through in the rooms, where we discuss all things total knee replacement. It is to be used to reinforce some key points in the knee replacement journey, and answer any other questions that you may have about the procedure, and process. Below will be some frequently asked questions regarding your upcoming total knee replacement. If you have further questions, please do not hesitate to contact us at the rooms.
A total knee replacement is an exciting starting point in improving your mobility, and comfort. It is designed to remove all of the pain in your knee, and allow you to function far above where you are now. We never decide to perform a knee replacement solely on an XRAY which is why it’s important to discuss your functional demands, and limitations before considering a knee replacement.
There are several things that need to be done after booking your knee replacement, which includes, scheduling a time for the surgery, your 3 dimensional scan, standard screening tests (including bloods, ECG and urine tests) and a discussion with our anaesthetist. We will guide you through that entire process so it is seamless and as convenient as possible for you. At the stage of your reading this, all these things have probably been done, or have been scheduled for you.
Should I be performing physiotherapy before surgery?
In general, we would recommend that it is beneficial for all of our patients to stay as fit and healthy before surgery. For some, this means a physiotherapy program. Whilst physiotherapy is essential in general peri-operatively, it is not useful if you are experiencing a lot of discomfort whilst performing the movements. There are numerous programs that have been shown to be beneficial for reducing knee pain associated with arthritis. When you have exhausted this, then you can continue with physiotherapy to prepare yourself for surgery if you wish. It is not essential however, for a good result.
When do I stop my blood thinners?
We aim to give each patient a custom plan for their blood thinners (if you are on them). It is important that the decision to stop blood thinners is discussed with you to ensure it is safe to do so. In general, the below applies – please ensure you check with us if you are not sure.
- Aspirin – Stop 2 weeks before surgery (Unless you have a cardiac stent in which case we continue with Aspirin and accept a slightly higher level of post operative bleeding)
- Xarelto/Apixaban/Eloquis/Pradaxa – Stop 4 days before surgery if it is used for Atrial Fibrillation. Do not stop if you are on them for an artificial valve. A custom plan would need to be created for you, which usually includes bridging anti-coagulation.
- Warfarin – Stop 5 days before surgery. Again, if this is for something more than Atrial Fibrillation, then a custom plan would need to be created for you.
- Clopidogrel (Plavix) – Stop 2 weeks before surgery. If this is for a cardiac stent or similar, then we would normally swap this for Aspirin. In general, those on Clopidogrel would need a custom plan created for them based on their risk profile.
- Glucosamine, Fish Oil, Ginkgo, Ginger and other supplements – Please stop these 2 weeks before surgery.
- Anti-inflammatories (Voltaren, Nurofen, Mobic) – Stop 2 weeks before surgery. If you are unable to cope without these, then they post a small risk of bleeding and can be taken ONLY when absolutely necessary during the 2 weeks before surgery. If you can stop them and cope, then please do so.
The above covers most anti-coagulants. If you believe you are on something other than the above and need guidance, please contact us.
How soon after surgery can I swim?
While you can shower post operatively (The dressing is water resistant) we recommend not swimming or having a bath until the wound has fully sealed. For Total Knee Replacements, this is 4 weeks post op.
When can I resume my natural supplements after my surgery
The reason why we stop the natural supplements such as Glucosamine, Fish Oil, Turmeric, Ginkgo, Garlic etc – is that they can cause blood thinning. This would be possibly too much when combined with the medicated blood thinners we give you after the surgery (usually twice daily aspirin). Once you have completed your 4 weeks post op of the medicated blood thinning, you can resume all natural supplements if you wish.
Can I shower with my wound dressings?
How long do the dressings stay on
The dressings are designed to remain on, and do not need to be changed. We wait a minimum of 2 weeks, and up to 4 weeks post op to change your dressings. You will not require regular dressings, unless there is some pooling of some bleeding under the dressing in which case we will create a customised plan for you.
How soon after surgery can I travel?
Interstate flights – as soon as you are discharged.
Overseas flights – given the normal increased duration of flights to international destinations, and the higher risk of blood clots after surgery for 28 days, we would recommend not flying overseas for 28 days post op. When flying on long flights after surgery, it is recommended to take a before and after flight aspirin to further reduce the risks of blood clots until 6 weeks post op.
How soon after surgery can I resume work
This is highly dependent on the type of working being performed. It is our recommendation that you do not resume until you can drive, which for 80% of our patients is somewhere between 2-3 weeks post op. Whilst you would certainly not be fully recovered, you should be able to accomplish sedentary type work (ie office based duties) then, as long as there was flexibility in having opportunities throughout the day to stretch, exercise gently and ice the knee down.
For more strenuous or manual roles, 6 weeks minimum is recommended.
You should be able to do stairs post op when you wish.
I will need a sick certificate - How do I get one?
If a sick certificate is required at any stage, please contact Jalmin by email advising her of the name (ie you or carer), the dates required and we will send you one via email.
When do I find out what time I need to be at the hospital the day of surgery?
We will send you an SMS and an email confirming your admission time 3 days prior to your surgery. Please fast 6 hours prior to this time. An admission to hospital can take 1-2 hours, to complete paperwork, and double check all the details, medical details and ensure you are safe to proceed with surgery. You may have 100mLs of water in the hour before your admission time. If you have any queries regarding your admission time, either respond to the email sent, or call us at any time.