WHAT IS A KNEE REPLACEMENT?

A total knee replacement is a procedure which is undertaken to replace a damaged knee. A knee wrist is a hinge type of wrist that gets replaced with a prosthesis manufactured from stainless steel. The top part of the prosthesis is secured into the upper leg. The rest of the prosthesis is secured into the top part of the lower leg with the knee socket being covered with a plastic insert. All these components are connected to the muscles.



THE PURPOSE OF A KNEE REPLACEMENT

• Mainly to reduce pain
• To reduce stiffness in the knee
• To increase mobility

TIPS BEFORE YOU COME IN FOR YOUR OPERATION

In the event of you being overweight, endeavor to loose a few kilograms. Create open areas in your home for greater maneuverability. Roll up all loose mats so that you do not slip and fall. Ask someone to take care of your pets to prevent them jumping all over you. Place items that you are going to use on a regular basis, at an easy accessible height.

PRE OPERATIVE PREPARATION

• Do not eat, drink or smoke for at least 6 hours prior to your operation.
• On being checked into your ward, the nursing staff will obtain a full medical and surgical history. All allergies are recorded.
• Depending on your doctor, blood tests may be done to see if you may have an allergy to the anesthetic. They can also request blood from the blood bank for you (if you have not arranged this yourself).
• Theatre consent document needs to be signed by you. This will give the doctor authorisation to perform the procedure.
• Ensure that you understand what the doctor is going to do, and that the specific knee is clearly identified (left/right).
• X-rays must accompany you to the theatre.
• You will be asked to wear a theatre gown.
• Your doctor will instruct our ward staff how to prepare the area that you are going to be operated on:
• Pre medication is given to you as prescription.
• You are wheeled to theatre by nursing staff and a porter.
• Special pillows will accompany you to theatre. This will keep your legs apart after the operation.
• After the operation you will be either sent to the Intensive Care Unit or back to your own unit.
   

POST OPERATIVE

• Observations are done initially every 15, 30 and 60 minutes, until you are stabilised. This normally takes 4 hours. You might be connected to a monitor which performs the same procedure as above.
• You will have an intravenous line (drip).
• Depending on your doctor, you might have a Pain pump. This will assist you to control the pain.
• Any bleeding in and around the operated area will be monitored. With new technology it is possible to recycle your blood back into your system.
• Records are kept to insure a balanced intake and output of all liquid.
• You will be given something to eat and drink once you are fully awake and are not nauseous.
• Pain medications will be prescribed by your doctor, and will be administered as per his instructions.
• You will be kept as comfortable as possible.
• The following day you will be visited by a physiotherapist. You will be instructed on exercises that needs to be done in bed. The physiotherapist consults with your doctor and once they both are in agreement that sufficient progress has been made, you will be allowed to get up. You will also be supplied with a walking aid.
• Bandages and draining tubes will be removed as instructed by your doctor.
• Constipation may occur, and you will be asked everyday as to whether you have had any bowel movement.
• A normal diet will be provided.
• Post operative X-rays will be taken.
• Ongoing support and help will be there for you at all times.
   

PRACTICAL TIPS

• If you stand and you wish to change direction, first turn on your normal leg, as this will give you more stability.
• To maintain your balance, use your walking aid.
• Try to walk on level surfaces only during the next 6-8 weeks.
• You can resume sexual activities after 4 weeks.
• Try not to carry any heavy items, use a trolley instead.
• Your toenails must be cut by someone else for the next 6-8 weeks.
• When picking up an object, do not bend your leg.
• Use a chair with an armrest. This will enable you to get up easier.
• Sport will place more stress on your knee as apposed to a brisk walk. Golf is relatively safe.
• If you are overweight, you are placing additional stress on your prostheses. Try and lose weight as this will increase the life span of your prostheses.

BED

• Sleep on a hard mattress.
• Lift the end of the bed for the next 3 months.

STAIRS

• Up: First with the normal leg, then the operated leg and lastly the walking aid.
• Down: First with the walking aid, then the operated leg and lastly the normal leg.

CAR

• For the first 6-8 weeks you may not drive.
• Move the passenger seat as far back as possible.
• You may resume driving after 3 months.

DISCHARGE

• Wounds are kept closed until you see the doctor.
• Take your medication as prescribed.
• Do your exercise as given to you by the physiotherapist.
• Make sure you take your X-rays home with you.
• Please ensure that you pack all your items that you brought with you to hospital.
• Should you experience any discharge or bleeding around the wound and this results in an offensive smell, contact your doctor immediately.
• We will make a follow up call to you to find out how you are doing. In the event you experience any problems at home, do not hesitate to contact us.

Contact persons:

Sr. Heila Burke Tel (016) 454 6025

Sr. Colette Louw Tel (016) 454 6044