What to Expect with Your Total Knee Arthroplasty

Preparation prior to your surgery is vital in the success of your entire experience.

Surgical Clearance:

You’ll need to obtain a surgical clearance from all physicians who are involved in your care. Our office has a specialized clearance form that we will fax to their offices upon scheduling surgery. You will also be given a copy of the form. It is important that you contact your doctors to verify if you will need to be seen in their office prior to your doctor signing your clearance for surgery, or if your doctor is comfortable signing off without seeing you for an appointment.

Lab Work:

You will also need to complete lab work (within 30 days prior to your surgery date) and have a current EKG (within the last 6 months) and chest x-ray (within the last year). Our office will facilitate these orders for you. It is important that these are all completed at the hospital your surgery is scheduled at.

• ‍St. Mary’s Hospital: You will be directed to call Pre-Admissions at 217-464-5876 and schedule an appointment. At that appointment, all your lab work, EKG and chest x-ray (if necessary) will be completed, along with education on your joint replacement. You will also meet with someone from the Anesthesia team, discharge planning, and physical therapy. Upon arrival to the hospital’s main entrance you will check in with the registration desk to the left of the entrance and they will direct you where you need to go.
• ‍Decatur Memorial Hospital: You will be directed to call the Joint Clinic at 217-876-5920 and schedule an appointment. At that appointment, all your lab work, EKG and chest x-ray (if necessary) will be completed, along with education on your joint replacement. You will also meet with someone from the Anesthesia team, discharge planning, and physical therapy. When you schedule your appointment, you will be instructed on where to go when you arrive to the hospital that day.

Medications:

There are some medications that you will be instructed to stop prior to your surgery. It is vital that we are aware of ALL prescription medications, over-the-counter medications and herbal supplements. If you fail to stop the medications, SURGERY WILL BE CANCELLED. Common medications that are necessary to stop prior to your surgery are NSAIDs, blood thinners, and most herbal supplements. You will be given a list of which medications to stop and when at your surgery scheduling appointment in our office. You will be advised of which medications are safe to take the morning of surgery, as there are some that are not compatible with Anesthesia, and therefore, held the morning of surgery.

Pre-Op Appointment:

Your surgeon would like to see you in clinic for a pre-operative appointment the clinic day prior to surgery. At this appointment, any last-minute questions can be answered, your surgeon will mark the operative area in preparation for surgery, and you will get confirmed surgery times. All these appointments are conducted before the noon-hour to ensure everything is ready for surgery the following day. You will be given your pre-operative appointment date and time at your surgery scheduling appointment in our office.

Night Before Surgery:

• Hibiclens Soap: Please ensure you have used this as directed. It is vital in the prevention of post-operative infections. If you have any questions regarding the use of your Hibiclens soap, then please contact our office.
• NPO: Nothing to eat or drink, smoke or chew after midnight. Non-compliance will result in cancellation of your surgery.

Reminders:‍

• Do NOT shave your legs two days prior to your surgery and try to keep your surgical leg free of cuts, scrapes and bug bites.
• Ensure you complete your Blood Type and Crossmatch the day prior to surgery at the hospital surgery will be performed at.
• Review your Surgery Scheduling Folder that was given to you from our office at the time of surgery scheduling.
• If you have any medical forms that your employer is requiring to be filled out by your surgeon, please ensure our office has obtained these. Allow 7-10 days for them to be completed.

• Follow-up Appointment: 3 weeks post-operative- If this has not already been scheduled, please call the office at 217-864-2665 to make this appointment ASAP.
• Walker: The hospital will provide you with a walker that you will be discharged home with. This will be billed through your insurance as a durable medical equipment.
• Post-Op Bandage: The bandage over your incision is a Negative Pressure Wound Dressing. The Home Health nurse will take care of all the bandage changes. Please refer to the Pico Negative Pressure Wound Dressing paper attached to your discharge papers or found in your surgery scheduling folder for further questions pertaining to your bandage.
• Staples: The Home Health nurse will remove the staples in your home at 2 weeks post-op.
• Showering: Permitted AFTER 7 days. No soaking, tub baths, or swimming until 6 weeks after your surgery. DO NOT apply any lotions, creams or ointments to the incision until 6 weeks after your surgery.
• Medications: Follow the medication regimen given to you. If you have any questions pertaining to your medications, please call the nurse at the office. If any undesired side effects from the medications, STOP the medication immediately and call the nurse at the office. Pain medications will not be renewed after 6 weeks post-op.
• Home Health Services: A case manager at the hospital will set you up with Home Health Nursing and Home Health Physical Therapy services to provide home care for 3 weeks post-op. Home Health services will begin 1 or 2 days after surgery. Physical therapy will come 3 times a week during those 3 weeks, and the nurse will come weekly to perform bandage changes. Your Home Health staff is on call for you 24/7. If our office is closed and you need assistance related to your surgery, please reach out to the Home Health Agency that you have been set-up with.
• When to Call the Office: Contact the office if you notice any signs and symptoms of infection, such as increased incisional drainage, redness, swelling, fever, chills, or increased pain. Also, contact our office immediately if you experience lower extremity calf pain, swelling, redness or shortness of breath.
• Weight Bearing: Weight bearing as tolerated, unless otherwise directed by your surgeon post-operatively.
• Driving: If your left knee was operated on, you cannot drive until 3 weeks after your surgery. If your right knee was operated on, you cannot drive until 4 weeks after your surgery.
• Numbness: The skin around your incision may be slightly numb, which is NORMAL.
• Kneeling: May be slightly uncomfortable post-operatively but is not harmful.
• Clicking Noise: You may notice a clicking noise occasionally when walking or bending, this is NORMAL.
• Icing: Anytime you are sitting down, apply ice to your knee. There is no such thing as too much icing. DO NOT apply the ice directly to your skin. Place a piece of fabric in between the ice and your skin.
• Therapy: When you are seen in the office 3 weeks post-op, your doctor will order outpatient PT to be done 3 times a week for 3 weeks. After that has been completed, you should continue your post-operative exercises on your own at home.
• Return to Work: Your return to work date will be dependent on the type of work you do. You will be homebound for the first 3 weeks post-operatively to reduce any risk for infection. You can discuss with your surgeon at the 3-week post-op appointment about when you may be able to return to work.
• Dental: You will need to take an antibiotic 1 hour prior to all dental procedures. An antibiotic is NOT required for routine cleanings.