Upon Arrival at the Connecticut Joint Replacement Institute
The Surgical Procedure
You will most likely be admitted to the hospital on the day of your surgery. After admission, you will be evaluated to determine what type of anesthesia is be best for you. The most common types of anesthesia are general anesthesia, in which you are asleep throughout the procedure, and spinal or epidural anesthesia, in which you are awake but your legs are anesthetized.
Your orthopedic surgeon will remove the damaged cartilage and bone and then position the new metal and plastic joint surfaces to restore the alignment and function of the knee.
Many types of designs and materials are currently used in total knee replacement surgery. Most of them consist of three components: the femoral component (made of a highly polished strong metal), the tibial component (made of a durable plastic often held in a metal tray), and the patellar component (also plastic).
The complication rate following total knee replacement is low. Serious complications, such as a knee joint infection, occur in less than 2 percent of patients. Major medical complications such as heart attack or stroke occur even less frequently. Chronic illnesses may increase the potential for complications. Although uncommon, when these complications occur, they can prolong or limit your full recovery. Blood clots in the leg veins are the most common complication of knee replacement surgery. Your orthopedic surgeon will outline a prevention program, which may include periodic elevation of your legs, lower leg exercises to increase circulation, support stockings and medication to thin your blood. Although implant designs and materials as well as surgical techniques have been optimized, wear of the bearing surfaces or loosening of the components may occur. Additionally, although an average of 115 degrees of motion is generally anticipated after surgery, scarring of the knee can occasionally occur and motion may be more limited. This is particularly true in patients with limited motion before surgery. Finally, while rare, injury to the nerves or blood vessels around the knee can occur during surgery.
After surgery, you will be moved to the recovery room while your recovery from anesthesia is monitored. After you awaken, you will be taken to your inpatient, private room.
Call, Don't Fall
One of the highest risks for complications associated with joint replacement surgery is the danger of patients falling after surgery.
"Patients who have joint replacement surgery have typically experienced significant pain for prolonged periods of time. When they wake up post-operatively, they are suddenly pain-free due to the anesthesia and pain medication used in their operations and post-operativley,” said Kim Beekmann, R.N., CJRI’s executive director. “When they first try to stand, they often find themselves very unsteady.”
From pre-surgery classes through surgical preparations, CJRI staff stress to patients that regardless of their age or condition, they are at risk to fall following surgery.
“When patients come in for their surgery, we partner with them and family members by asking them to sign a pledge stating that they are aware that they are at risk of falling and that they will promise to give us a call anytime they need to mobilize — getting in or out of bed, a chair or the bathroom, so we can assist them,” Ms. Beekmann said. Patients are reminded of this pledge by staff at eight-hour intervals following surgery and through a message on the communication boards in their rooms that reads: Call — Don’t Fall.
In a further step to prevent patient falls, the beds on CJRI’s post-operative units are equipped with special monitors. "The beds are weight-activated so that if a certain percentage of the patient’s weight is lifted off the bed, it will trigger an alarm at the nursing station so that staff can come to make sure they have the assistance they need,” Ms. Beekmann said.
Total knee, hip, and shoulder replacement surgery, as well as other surgical and non-surgical treatment for rheumatoid arthritis and osteoarthritis of the joints.