FREQUENTLY ASKED QUESTIONS ABOUT KNEE SURGERY  

Patients often have many questions to ask about knee replacements.  Below is a list of the most frequently asked questions and answers compiled by the Joint Center at Brooksville Regional Hospital.   

What is arthritis and why does my knee hurt?
In the knee joint there is a layer of smooth cartilage on the lower end of the femur (thighbone), the upper end of the tibia (shinbone) and the undersurface of the patella (kneecap).  This cartilage serves as a cushion and allows for smooth motion of the knee.  Arthritis is a wearing away of the smooth cartilage.  Eventually, the cartilage wears down to bone.  Rubbing of bone against bone causes discomfort, swelling and stiffness.  

What is a knee replacement?
A knee replacement is really a cartilage replacement with an artificial surface.  The knee itself is not replaced, as is commonly thought, but rather an artificial substitute for cartilage is inserted on the end of the bones.  This is done with a metal alloy on the femur and plastic spacer on the tibia and kneecap (patella).  This creates a new, smooth cushion and a functioning joint that does not hurt.  

What are the results of knee replacement?
Results will vary depending on the quality of the surrounding tissue, the severity of the arthritis at the time of surgery, the patient’s activity level and the patient’s adherence to the doctor’s orders.   When should I have this type of surgery? Your orthopedic surgeon will decide if you are a candidate for the surgery.  This will be based on your history, exam, x-rays and response to conservative treatment.  The decision will then be yours.  

Am I too old for this surgery?
Age is not a factor if you are in reasonable health and have the desire to continue living a productive, active life.  You may be asked to see your personal physician for his/her opinion about your general health and readiness for surgery.  

How long will my new knee last and can a second replacement be done?
All implants have a limited life expectancy depending on an individual’s age, weight, activity level and medical condition(s). A joint implant’s longevity will vary in every patient.  It is important to remember that an implant is a medical device subject to wear that may lead to mechanical failure.  While it is important to follow all of your surgeon’s recommendations after surgery, there is no guarantee that your particular implant will last for any specific length of time.
Why might I require a revision?
Just as your original joint wears out, a joint replacement will wear over time as well.  The most common reason for revision is loosening of the artificial surface from the bone.  Wearing of the plastic spacer may also result in the need for a new spacer.  Your surgeon will explain the possible complications associated with knee replacement.  

What are the major risks?
Most surgeries go well, without any complications.  Infection and blood clots are two serious complications that concern us the most.  To avoid these complications, we use antibiotics and blood thinners.  We also take special precautions in the operating room to reduce the risk of infections.  

How long will I be incapacitated?
You will probably stay in bed the day of your surgery.  However, the next morning most patients will get up, sit in a chair or recliner and should be walking with a walker or crutches later that day.  

How long will I be in the hospital?
Most knee patients will be hospitalized for three days after their surgery.  There are several goals that you must achieve before you can be discharged.  

How do I make arrangements for surgery?
After your surgeon has scheduled your surgery, the Joint Center Clinical Leader will contact you.  The Joint Camp Clinical Leader will guide you through the program and make arrangements for both pre-op and post-op care.   

Do I need to be put to sleep for this surgery?
You may have a general anesthetic, which most people call “being put to sleep”.  Some patients prefer to have a spinal or epidural anesthetic, which numbs your legs only and does not require you to be asleep.  The choice is between you, your surgeon and the anesthesiologist.   

Will the surgery be painful?
You will have discomfort following the surgery, but we will try to keep you comfortable with the appropriate medication.  Generally, most patients are able to stop very strong medication within one day.  Most patients control their own medicine with a special pump that delivers the drug directly into their IV.   

Who will be performing the surgery?
Your orthopedic surgeon will perform the surgery.  An assistant often helps during the surgery and that assistant will bill you separately.  

Will I need a walker, crutches, or a cane?
Yes, for about six weeks we do recommend that you use a walker, a cane, or crutches.  The Total Joint Coordinator can arrange for them if necessary.  

Where will I go after discharge from the hospital?
Most patients are able to go home directly after discharge.  Some patients may transfer to a sub-acute facility, where they will stay from 3-5 days.  The Total Joint Care Coordinator will help you with this decision and make the necessary arrangements.  You should check with your insurance company to see if you have sub-acute rehab benefits.  

Will I need help at home?
Yes, for the first several days or weeks, depending on your progress, you will need someone to assist you with meal preparation, etc.  If you go directly home from the hospital, the Total Joint Care Coordinator will arrange for a home health care nurse to come to your house as needed.  Family or friends need to be available to help if possible.   Preparing ahead of time, before your surgery, can minimize the amount of help needed.  Having the laundry done, house cleaned, yard work completed, clean linens put on the bed and single portion frozen meals will help reduce the need for extra help.  

Will I need physical / occupational therapy when I go home?
Yes, in most cases, you will have either outpatient or in-home physical/occupational therapy.  Patients are encouraged to utilize outpatient physical therapy.  The Total Joint Care Coordinator will help you arrange for an outpatient physical therapy appointment.  If you need home physical/occupational therapy, we will arrange for a physical/occupational therapist to provide therapy at your home.  Following this, you may go to an outpatient facility three times a week to assist in your rehabilitation.  The length of time required for this type of therapy varies with each patient.  

How long until I can drive and get back to normal?
The ability to drive depends on whether surgery was on your right leg or your left leg and the type of car you have.  If the surgery was on your left leg and you have an automatic transmission, you could be driving at two weeks.  If the surgery was on your right leg, your driving could be restricted as long as six weeks.  Getting “back to normal” will depend somewhat on your progress.  Consult with your surgeon or therapist for their advice on your activity.  

When will I be able to get back to work?
We recommend that most people take at least one month off from work, unless their jobs are quite sedentary and they can return to work with crutches.  An occupational therapist can make recommendations for joint protection and energy conservation on the job.  

How often will I need to be seen by my doctor following the surgery?
Two to three weeks after discharge, you will be seen for your first post-operative office visit.  The frequency of follow-up visits will depend on your progress.  Many patients are seen at six weeks, twelve weeks and then yearly.  

Do you recommend any restrictions following this surgery?
Yes, high-impact activities, such as running, singles tennis and basketball are not recommended.  Injury-prone sports such as downhill skiing are also dangerous for the new joint.  

What physical/recreational activities may I participate in after my recovery?
You are encouraged to participate in low-impact activities such as walking, dancing, golf, hiking, swimming, bowling and gardening.  

Will I notice anything different about my knee?
Yes, you may have a small area of numbness to the outside of the scar, which may last a year or more.  Kneeling may be uncomfortable for a year or more.   Some patients notice some clicking when they move their knee.  This is the result of the artificial surfaces.  

The Joint Center at Brooksville Regional Hospital features seven private suites dedicated solely to total joint replacement patients. Unique infection control measures, effective and thorough pain and symptom management and dedicated nurses help foster faster, more complete recoveries. Our joint care team is made up of our orthopedic surgeons, as well as nurses and therapists who provide specialized care for our total joint patients  

This information is intended solely for the general information of the reader. It is not to be used for treatment purposes, but rather for discussion with the patient's own physician. The information presented here is not intended to diagnose health problems or to take the place of professional medical care. The information contained herein is neither intended to dictate what constitutes reasonable, appropriate or best care for any given health issue, nor is it intended to be used as a substitute for the independent judgment of a physician for any given health issue. If you have persistent health problems or have further questions, please consult your health care provider.