Preoperative Visit to Surgeon
You may have an appointment in your surgeon's office the week before your surgery. This will serve as a final checkup and a time to ask any questions that you might have.
Excercising Before Surgery
It is important to be as fit as possible before undergoing a total knee replacement. This will make your recovery much faster. Eleven exercises are shown here that you should start doing now and continue until your surgery. You should be able to do them in 15-20 minutes, and it is recommended that you do all of them twice a day. It is not harmful for you to do more. Consider this a minimum amount of exercise prior to your surgery. You can document this on your exercise chart in your clinical diary section.
Also, remember that you need to strengthen your entire body, not just your leg. It is very important that you strengthen your arms by doing chair push-ups (exercise #8), because you will be relying on your arms to help you get in and out of bed, in and out of a chair, walk, and to do your exercises postoperatively.
Stop doing any exercise that is too painful.
Total joint surgery does require the use of either general anesthesia or regional anesthesia. You will discuss this with the anesthesiologist at the time of your pre-admission appointment.
What types of anesthesia are available?
Decisions regarding your anesthesia are tailored to your personal needs. Certain illnesses can potentially make one type of anesthetic better than another. For instance, a patient with emphysema would probably do better with a spinal. Meanwhile, a patient with a bleeding disorder or on anticoagulants cannot have a spinal due to the risk of bleeding in the spinal canal.
The types available for you are:
GENERAL ANESTHESIA - renders the patient unconscious for the duration of surgery. The patient is typically sedated prior to surgery and put to sleep once in the operating room and awakened in the recovery room.
REGIONAL ANESTHESIA - techniques include spinal blocks, epidural blocks, and arm and leg blocks. Patients undergoing spinal block are also usually sedated prior to surgery, and the spinal is placed in the operating room. This involves sitting the patient upright on the operating table, numbing the skin low in the middle of the back, and with a small-diameter needle injecting a dose of local anesthetic, which begins to work almost immediately. Patients are then sedated for the rest of the operation and allowed to stay in the recovery room until most of the spinal has worn off.
Will I have any side effects?
Your anesthesiologist will discuss the risks and benefits associated with the different anesthetic options, as well as any complications or side effects that can occur with each type of anesthetic. Nausea or vomiting may be related to anesthesia or the type of surgical procedure. Although less of a problem today because of improved anesthetic agents and techniques, these side effects continue to occur for some patients. Medications to treat nausea and vomiting will be given if needed. The amount of discomfort you experience will depend on several factors, especially the type of surgery. Your doctors and nurses can relieve pain with medications. Your discomfort should be tolerable, but do not expect to be totally pain-free. The staff will teach you the pain scale (1-10) to assess your pain level.
What will happen before my surgery?
You will meet your anesthesiologist immediately before your surgery. Your anesthesiologist will review all information needed to evaluate your general health. This will include your medical history, laboratory test results, allergies and current medications. With this information, together you will determine the type of anesthesia best suited for you. He or she will also answer any further questions you may have.