Knee Replacement Surgery | What to Expect

hi I'm Tim Louisville and I want to talk to you all about your upcoming knee replacement surgery I want to tell you all about what we're going to do I want to tell you about potential risks and complications and then I'm going to come back in answer all your questions and we will do our consent form for surgery first I would encourage you to have a spinal for anesthesia that's where they numb you up from the waist down now they will also give you medicine through your IV so you sleep the whole time but if anesthesia says it's okay for you to have a spinal I would encourage you to have a spinal once you're comfortable we make an incision on the front of your knee and we go into the knee without going through or across any muscles or tendons we pull them out of the way we also use computer navigation to help us get the parts lined up right so you will also have two little Nick's about in the middle of your shin and we put two temporary pins into the tibia or leg bone and through the main incision we put two temporary pins in the femur or thighbone that allows us to use a computer to help get everything lined up just right now when people hear a total knee replacement I think they think that we take out six inches of the knee we don't we are truly just resurfacing the ends of the bones we only take out about a quarter inch maybe a little bit more off of the ends of the bones and we resurface your knee with metal and plastic so in a total knee replacement there will be a piece of metal on top of and into the tibia or the leg bone and a piece of plastic goes into that there will also be a piece of metal on the end of the femur thigh bone so you have metal rubbing on plastic we also put a piece of plastic behind your kneecap so the kneecap that you feel underneath your skin will still be you underneath that goes a piece of plastic the parts are made of metal and plastic they're held in place with bones cement once the parts are in there we close you up you go to the recovery room for a couple of hours and you go up to your room on the floor and we'll get you up walking that same day or the next day you're typically in the hospital for one to three days so for example if your surgery is on a Tuesday we would let you go home Wednesday Thursday or Friday I don't care so much when you go home I care that you're safe to go home and that means that you and the nurses and therapists all agree that you're safe and ready to go home I don't care if it's one two or three days after surgery having said that we do try to get you out of the hospital as quick as we can to get you away from all the resistant bacteria that live in the hospital so honestly if you're ready to go home the day after surgery we're happy to have you go home the day after surgery and it's not because we're trying to be mean and kick you out of the hospital we want to get you away from all those resistant bacteria that live in the hospital but we will not let you go home unless everybody thinks that you're safe and ready to go now initially we're going to get you up walking with crutches or a walker and I don't doesn't matter to me if it's crutches or a walker I let you and the therapist decide that but you can put all the weight you want on your leg immediately we still have you protect it with crutches or a walker but you can put all the weight you want on it immediately when you go home whenever you feel comfortable you can get rid of the crutches or Walker and go to a cane we then have you use the cane until you can walk without a limp and the reason is if you're limping it puts more stress on the parts so if you're limping I really would prefer if you use a cane now for you to get as good as you're going to get after a knee replacement is honestly two to three years there's actually a study that shows it takes three years to get as good as you're going to get after a knee replacement now most of the getting better is in the first six months in fact I let people play golf in three months but you will feel better two years from now than one year from now any time you have surgery there are risks and I'm going to tell you these things not to make you nervous it's just so you know what's going on anytime you have surgery there's bleeding and you could need a transfusion it's possible anytime you have surgery there's a risk of infection we're going to give you antibiotics through your IV just before we start surgery and for the next day and that helps decrease the risk of infection nationwide it's considered just under two percent unless you're diabetic and then it's about four percent risk of infection now if you were to get an infection if it happens in the first few weeks after surgery it's sometimes can mean another surgery to wash it out and up to six weeks of IV antibiotics and sometimes that will take care of it if it did not take care of it or if you were to get an infection a few years from now then it's typically a minimum of two surgeries to get rid of the infection the first surgery we have to go in and take out all the parts and thoroughly wash and clean out the knee then we would put in a temporary knee replacement using bone cement that was just packed full of antibiotics the idea is that the antibiotics would then leak out of the bone cement to give very high levels of antibiotics in the knee joint you then would get six weeks of IV antibiotics and three or four months from the take out surgery we come back and if the infections all gone then we can put final parts back in big deal if you get an infection any time after this you have dental work done even a routine cleaning at the dentist we would like you to take antibiotics by mouth an hour ahead of time and that's for the rest of your life and you can either call your dentist's office or our office and we will call them into your the antibiotics into your pharmacy anytime you have surgery there is a risk of damage to blood vessels or nerves and I'm working right on top of all the big ones behind your knee we know that and we are paranoid about protecting them and the risk of injury to the big blood vessels or nerves is less than 1% now all of us have these little skin nerves that come down your leg and crossover like this that are so small I can't see them and whenever we make the incision for a knee replacement those little skin nerves always get cut so your skin will be permanently numb on the outside of your knee anytime you have knee surgery there is a risk of getting blood clots in the veins of the legs we take those very seriously because rarely they can break off and go to the heart of the lungs and extremely rarely people have actually died from that so we do everything we can to prevent blood clots we're going to put you on a blood thinner after surgery we're going to put these lovely white Ted hose on your lower legs while you're in the hospital we put these squeezers on your calves that help pump the blood up as soon as you wake up I want you to start moving your feet up and down just like this and that's the other reason we're going to get you up walking right away because all of those things help prevent blood clots anytime any of us have surgery scar tissue forms because that's how all of us human beings heal that scar tissue would just love it if you would go home and sit in your recliner and do nothing because then it wouldn't hurt so much the problem is that scar tissue eventually sets just like concrete sets and if you were to go home and just sit in your recliner and do nothing your knee would eventually get stuck in one position this is where surgery truly is a team effort and you are the most important player on the team and I'm going to give you the ball as soon as surgery's over how much motion you have in your knee a year from now is going to be more up to you than it is up to me I will not leave the operating room unless your knee goes perfectly straight and bends all the way then I know the parts can do what they need to do how much motion you have a year from now is up to you and how hard you work on it now we're going to help you with that when you go home I want you working with a physical therapist ideally three days a week but I want you you yourself working on it at least three times a day the surgery is actually the easy part I get the easy job the hard part is the rehab afterwards and that is completely up to you and we will show you exactly what we want you to do now whenever we put anything artificial in the body one of two things has to happen either the parts are going to outlast you or you're going to outlast the parts what we all want is for the parts to outlast you the problem is they're just artificial parts and it is possible that they can wear out or come loose from where they attach to the bone and if that happens we just go back and redo them anytime you have surgery there is a risk of heart attack stroke pneumonia bladder infection things like that any time we do a knee replacement not 100 percent of people will love it so there is a chance that you may not love your knee replacement it's not a high percentage but there is a percentage of people who don't like their knee replacement as well as they had hoped it would turn out the last thing is even if everything goes perfect nothing I do can make you like you were when you are 16 I'm going to come in in a few minutes and answer all the questions you have and we will do our consent form this is not the last call for questions though when you go home if you think of any questions write them down and bring that list with you to the hospital because I am going to see you in the hospital before the surgery and I don't care if you come in with 10 pages of questions I will go through every single question before we do the surgery thank you

Channel: ProvidenceSpokane

Views: 612,779

Rating: 4.7724605 out of 5

Keywords: Knee Replacement (Medical Treatment), Surgery (Medical Specialty), femer, hip, ball and socket, thigh bone, joint replacement surgery, orthopedic surgery, Spokane WA, surgery, total knee replacement, tibia, leg bone, knee cap, Knee (Anatomical Structure)

Id: Uji_ba-dqUI

Length: 10min 45sec (645 seconds)

Published: Tue May 26 2015