A study by AHRQ ( Agency for Healthcare Research and Quality) found that over half a million knee replacement surgeries are conducted in the US, annually, and the number is set to rise by 2030. This form of operation is considered to be one of the most successful in the medical field, with 90% of post-op patients enjoying the new joints for no less than 20 years before they wear out.
Regardless of the success rate, it is still an invasive procedure that requires both pre and post-operative preparation. Your medical professionals will often give a preparation list, weeks, or months ahead of the actual surgery date. The main focus is often getting you mentally and physically prepared through adequate health along with knee strengthening training.
While there is no avoiding the need for replacement surgery, you can still understand the requirements, which will decrease the possibility of surgical anxiety. Here are 12 things you will find useful before having a knee replacement.
1. The Actual Procedure
Due to the invasive nature of knee replacement surgery, it is always conducted under anesthetic either epidural or under spinal. This is done as the surgeon has to push aside the kneecap to gain access to the knee joint. The bone needs to be prepared by removing the damaged knee portions along with underlying smaller bones. In this way, the worn-out bones are replaced with plastic and metal parts precisely cut to match the shape of the knee.
The metal implants must be placed in such a way so as to fit directly into the bone. A plastic spacer is inserted between the metal parts to ensure a smooth surface. Thereafter the kneecap that was moved needs to be replaced. The surgery itself is not always smooth sailing and hence complications can be expected during the surgery. Despite the chances of, during surgery, complications being low there are reported cases of post-surgery knee joint infections and increased chronic illnesses.
2. Benefits And Risks
Knowing about the procedure is not the entire story. Knowledge of both the benefits and potential risks associated with knee replacement surgery is paramount. Obviously, after a successful knee replacement, the patient feels minimal or none of that knee pain that instigated the requirement for the replacement in the first place. Most people who endure the surgery feel they have been given a new lease on life and can, therefore, partake in activities they previously avoided because of their bad knees.
There are risks involved with knee replacements too like knee stiffness, persistent knee pain, blood clots, and wound infections. There might even be knee implant problems. These problems are more likely due to the fact that the implant surfaces can wear out and plastic components can loosen. Despite the hope that surgery will increase knee mobility, post knee surgery can limit motion. This knowledge is vital as it makes postoperative care expectations applicable.
3. Surgery Cost
The cost of knee replacement surgery can often sway a decision. However, since most of these surgeries cannot be avoided it is best to see if your medical insurance covers you as some hospitals can charge up to $49,500 for a whole knee replacement. The cost becomes lower for partial part replacement.
Another consideration to make when calculating the final medical bill is inpatient charge, medication, surgeon, or other specialists. Other factors of inclusion are the number of days spent in the hospital and the length of time spent in the operating theatre. Being financially prepared will ensure that you are not working on dealing with financial as well as recovery stress.
After the surgery, the patient is likely to gain other replacement related charges. Many knee replacement patients may require physiotherapy. The durability of the replacement is not long-lasting, hence within ten to twenty years, the patient may have to undergo another knee replacement surgery. Medical aid coverage and payout also need to be considered prior to opt for the surgery.
4. Following Instructions
A medical practitioner would often consider the patient’s optimal pre and postoperative success. It is for this reason they give out information and resources that assist in the manner, therefore, taking the advice is in your best interest.
Understand what type of action is required before your surgery and aim to do it. If you are having trouble ask for advice. The most common requirement prior to this operation is strengthening the muscles that support the knee. When experiencing pain you are most likely to give up. However, it might only require a technique adjustment. An equally important consideration is the type of medication you should or should not be taking.
Blood-thinning painkillers like aspirin or often put on the reject list. Without consulting, and enquiring you are more likely to lessen the chances of a successful surgery. No matter the difficulties you may encounter, it is best to follow the instructions to the best of your ability.
5. Tests and Evaluations
Prior to any knee replacement surgery patients will undergo a variety of tests. These tests often include checking blood and urine samples, and electrocardiogram. The tests are conducted so the surgeon can aptly prepare for the surgery. A full physical evaluation needs to be conducted so as to ensure that the patient is healthy enough to have the replacement.
Patients who have chronic illnesses or other medical ailments may have to undergo more thorough evaluations by specialists. Through the entire evaluation process, patients need to be upfront with their surgeons and reveal any medications that they may be taking. This information helps to keep you informed on whether certain medications might need to be replaced or stopped prior to any surgical procedure being undertaken.
Urine testing is essential as people who’ve suffered from urine infections may have to consult specialists before undergoing a replacement. Aside from urine testing dental evaluations are also conducted. Any major dental procedure needs to be concluded prior to knee replacement surgery to avoid the risk of postoperative infection.
Physical therapy is a requirement for proper knee replacement surgery rehabilitation. Due to the limitations that are likely to be imposed, your mobility will be drastically affected. The longer your joints are not moving, the harder it is to return to your normal walking gait. Different methods are applied to assist and make you feel more confident with your new knee.
Finding a physiotherapist is part of the procedure as you want someone you are comfortable with. Besides getting you back on your feet they will be able to recommend other methods of dealing with swelling and pain management.
In some cases, doctors often recommend patients to attend physio sessions prior to the surgical procedure, in order to assist with the exercise which is in alignment with knee muscle strength improvement. Naturally, this is a cost that will be incurred, so it’s best to find out if you have adequate medical coverage to fully utilize this service.
7. Lifestyle Change
Undergoing this type of surgery may require certain lifestyle adjustments. Advanced preparation is a prerequisite to the success parameters. Being physically fit and engaging in regular exercise prior to surgery is beneficial to strengthening ligaments, bone, and toning the upper body in order to be able to handle the weaker knee.
You can engage in simple exercises that do not require any gym membership. These can include simple leg raises, thigh tightening, knee bending, and clamshells. This way the exercises won’t seem too strenuous when you have to continue after the surgery. It is this daily practice and persistence that increases the chances of surgical success.
Obese and overweight people can opt to diet before surgery. The reduction in upper body weight can be beneficial and reduce the strain on the knees post-surgery. In addition, a lifestyle change, in terms of weight, can ensure longevity to the knee replacement parts.
8. Surgical Diet
As per the dietary requirements prior to the surgery one is not allowed to eat anything and limit drinks on the day of surgery. The main reason is due to the effects of the anesthetics, which may, in most cases, induce nausea or vomiting.
In the weeks leading up to the surgery, patients should drink more than eight glasses of water per day. Eating a well-balanced diet that includes plenty of vegetables, fresh meat, fish, and fruits before and after surgery is integral in ensuring that pre-surgery healthy weight is maintained and post-surgical healing is speedier.
Having zinc and vitamin C in the diet helps, as it promotes wound healing. Vitamin C and calcium need to be incorporated together as they are essential components that build stronger bones. They are a needed dietary requirement to repair any worn out bones, tendons, and ligaments. The stronger and healthier the body is, the faster the recovery time.
9. Stop Smoking
Apart from having a healthy diet, it is imperative that you consider smoking cessation. The earlier you do this, the quicker the body can regain the oxygenated blood, which is crucial for the healing process. The substances found in cigarettes are harmful, which are knowing to affect how wounds heal.
With knee replacement surgery, it is extremely important that the bones are able to heal well. When a person quits smoking they ensure that the chances of increased pain are limited.
A study conducted by the Journal of Bone and Joint indicated that smokers are likely to have repeat surgical procedures due to complications caused by this habit, namely, infected wounds which sometimes cannot be cured using antibiotics. Hospital readmission rates are higher for smokers as more than 50 percent are likely to suffer some form of postoperative infection closely linked to smoking.
10. Home Reorganization
An important aspect worth considering prior to knee surgery is home mobility. This applies to how well you can move around your home after the operation. Safety should be paramount. Understand that the more obstacles there are around the movement space, the more likely you are to bash into things. Reorganization of furniture is essential to ensure ease of movement.
Substitute a main living area, such as the lounge especially if your bedroom is upstairs. It is best to consider making temporary living arrangements on the same level as the kitchen. Using the downstairs shower or having a washbasin, which you can use to bathe yourself will be extremely helpful.
Remove unnecessary furniture like small chairs or climbing ladders. Think open-plan planning living for the first few weeks. This way you can access all the important amenities. Having less clutter around the house may offer greater ease when passing by with a walker or walking stick. Fixing rails in the bathroom is another safety measure that can be implemented to avoid slipping and falling.