A Patient’s Guide to a Total Knee Replacement

Medically Reviewed by: Clint McCullough, ATC, OTC

Deciding to have surgery and preparing for a knee replacement can be an intimidating time. There will be multiple questions that arise throughout the process, along with managing your anxiety and planning for a successful recovery.  You are not alone, according to the American Academy of Orthopedic Surgeons, nearly 1 million joint replacement surgeries were performed in 2011, making it one of the most common orthopedic procedures. A knee replacement can reduce the pain you feel on an everyday basis, and give you the ability to live a more comfortable, active life. The American Academy of Orthopedic Surgeons also cites that more than 90% of people who have total knee replacement surgery experience a dramatic reduction of knee pain and a significant improvement in the ability to perform common activities of daily living.

A Total Knee Replacement can be more accurately described as a “cartilage” replacement.  The surgeons will be removing the damaged cartilage from the ends of the femur and tibia and replace it with an artificial joint made of metal and other strong polymers. By removing the damaged cartilage and replacing it with a new joint, this restores function in the joint and provides relief from pain caused by arthritis.

Before heading to the hospital the day of your surgery, you will need to manage your expectations and be aware of the challenges of surgery and recovery.  Preparing yourself mentally, psychologically, and having the right tools and practices in place will ensure a more positive outcome. We have prepared some useful topics to help you get ready for your knee replacement surgery.

Phase 1: The Weeks Leading up to Surgery

The days leading up to surgery will be a whirlwind, from checking and double checking your preoperative instructions that were given to you by your surgeon and their team, to ensuring you are pre authorized by your insurance company, and making sure everything is prepared properly at home to ensure a safe and comfortable recovery. It can seem overwhelming as the days get closer to surgery, here are a few items to focus on as your manage your preparations:

1. Take care of the administrative items.  Make sure to bring your driver’s license, insurance card, social security card and a list of current medications the day of surgery. Bring a copy of the legal documents with you to the hospital. If you have any pertinent documents you have made, such a power of attorney or a living will. Put them in a folder to ensure nothing is missed.
2. Contact your insurance company to ensure preauthorization for the procedure, and a clear picture of the coverage offered to you and the costs associated with it so there are no surprises after the fact.
3. Get familiar with your preoperative checklist that was provided by the hospital. Having a plan in place will help ensure all of the steps are covered and you have all of the supplies for proper preparations.
4. Prepare your home to make it safe. John’s Hopkins Hospital preoperative checklist for their Total Knee Replacement patients suggests preparing your entire home for surgery by removing any throw rugs, and tacking down loose carpeting, installing night lights throughout hallways and bathrooms, and removing loose electrical cords to avoid a fall. Additionally, make frequently used items within an easy reach, such as a water bottle, chapstick, your favorite book, the TV remote, or a cell phone charger.
5. Line up your help. Responsibilities can pile up around the house or at work while you recover, which can lead to additional stress. Delegate a family members or hire a service to take care of these items so you don’t rush your recovery. Have a neighbor mow your lawn or take your dog for a walk while you are bedridden, hire a gardener or arrange a meal delivery service. Tying up and loose ends will help ease your anxiety and let you focus on your recovery.

Phase 2: Day Before Surgery

Tomorrow is the big day! You’ve spent the past few weeks making specific arrangements and preparing yourself mentally and physically, and are finally taking a big step towards regaining your quality of life. Time to relax and put your trust into the health care team.

1. Do the final steps in your preoperative checklist that was provided by your hospital. Typically this includes a shower with chlorahexadine wash that can prevent surgical site infection. Taking the proper steps to prevent infection will be crucial to your recovery.
2. Wear loose fitting clothing that is comfortable, and can zip or button up to put on easily.  Avoid clothing that does not stretch and is tight fitting.
3. Do something you enjoy. The preoperative checklist provided by John’s Hopkins Hospital encourages patients to do something they enjoy the night before an operation. Eat at your favorite restaurant, go see a movie or simply spend time with people you care about.  Surgery can be scary, but know you are taking the right steps towards a more mobile life.
4. Plan your commute to the hospital by checking weather, typical traffic conditions during that time and setting your alarm accordingly.

Phase 3: Days Following Surgery

Managing your discomfort, controlling your knee pain caused by edema and dealing with the changes your body are going through after surgery will be at the top of your mind once you have transitioned from the hospital back into your home to begin your recovery.  A proper recovery is the second half of a successful surgery, and having the correct tools in place to make that happen can put you on the road to a successful recovery.

1. Elevate the operative leg to reduce edema, avoid using unstable bed pillows, and use the MyComfortMD Knee Buddy to elevate your leg. It is a stable and reliable surface that will cradle your operative leg.
2. If extension exercises are suggested by your Doctor to regain range of motion, the Knee Buddy cushion has a dedicated section that holds your knee in extension, and prevents external rotation. No need to rehab with unstable pillows again!
3. Do your Physical Therapy exercises as instructed by your Doctor. Integrating these exercises early in your recovery will increase your range of motion, and get you back on your feet quicker.
4. Stay hydrated and drink a lot of water. This can help flush your body of the anesthesia and other medications. Having accessible water will also help avoid a urinary tract infection.

Phase 4: Don’t Let Your Discomfort Define You

Investing in your rehab and making it a priority can increase your quality of life in the long run. Using a dedicated tool like the MyComfortMD Knee Buddy can simplify your recovery process, and also hold you accountable to your elevation routine and extension exercises.  Recovery can be a long road, and having the correct products accessible and planning accordingly can make the transition to a full recovery that much easier. Heal faster and get back on your feet quickly!