Q14. What are the possible complications after surgery?
The incidence of complications after knee arthroplasty is very low. The incidence of serious complications, such as infection, is less than 2％ and the incidence of larger complications, such as heart attack and stroke, is even lower.
Infections: Joint replacement surgery is done in the cleanest operating room possible and you will be given prophylactic antibiotics before the procedure begins and for 24 hours afterwards.
Blood clots: Venous thrombosis in the lower extremities is the most common complication of knee replacement. Your surgeon will take a number of preventive measures, including regular elevation of the affected limb, lower extremity exercises to improve circulation, compression stockings, and anticoagulant medications. Also, the doctor will monitor the patient after surgery.
Implant problems: Despite optimal implant design, materials and surgical techniques, wear and loosening may still occur.
Limited mobility: The average mobility of the knee joint after surgery is 115°, but sometimes scarring can form and movement will be limited, especially in patients who had limited mobility before surgery.
Nerve damage: Damage to peripheral nerves and blood vessels rarely occurs with knee replacement surgery.
Q15. How many days will I need to stay in the hospital?
Your hospital stay will be approximately 10 days – 2 weeks, depending on the length of time needed for preoperative preparation, and some patients need to be conditioned for medical conditions, which may take a little longer. Most patients are discharged home about a week after surgery.
Q16. What should I expect when I go home?
The success of your surgery depends on whether you follow your doctor’s recommendations for recovery at home in the weeks following surgery.
Wound care: The skin may have sutures, staples or intradermal stitches. Sutures and staples need to be removed 2 weeks after surgery, and intradermal sutures do not need to be removed. Do not immerse until the wound is completely healed.
Activity: The most important thing to do after going home is to exercise, especially in the 2-3 months after surgery. Activity should be gradual and increased gradually, limited to indoor at first and then starting outdoor activities. You should be back to being able to perform most daily activities 3-6 weeks after surgery. It is normal to have pain with activity or nighttime pain for 6-8 weeks after surgery.
Prevention of blood clots: Take oral blood clot prevention medication as recommended by your doctor and wear compression stockings as much as possible for 5 weeks after surgery. The following signs indicate the possibility of blood clots and should be contacted promptly.
– persistent worsening of pain in the lower leg
– Pressure or redness above and below the knee joint
– Persistent swelling in the calf, ankle and foot
Infection prevention: The main causes of infection after knee replacement are skin infections, urinary tract infections or bacteria entering the bloodstream during dental procedures. It is important to keep the wound site clean and to use antibiotics to prevent infection if dental work must be performed. The possibility of wound infection is indicated by the presence of the following symptoms, which should be followed up promptly.
– Persistent fever (body temperature over 38°C)
– persistent redness, pressure or swelling of the wound
– Watery wound
– Persistent worsening of knee pain
Avoid falls: You should use a cane, crutches or walker until your balance, bending angle and muscle strength have improved sufficiently, and use handrails or someone to help you when going up or down stairs.
Regular follow-up: You should be reviewed in the outpatient clinic at 1, 3, 6 and 12 months after surgery, and thereafter you should be reviewed annually for x-rays.
Q17. What is the difference in my new knee?
You will feel some numbness in the skin around the wound. You will feel some stiffness, especially with excessive bending activity. Improving knee mobility is the goal of knee replacement, but it is not easy to return to full flexion and post-operative mobility is related to pre-operative mobility. Kneeling usually causes discomfort, but is not detrimental to your artificial joint. You may sometimes feel a slight popping between the metal and polyethylene during knee flexion and walking.
These differences usually diminish over time and most patients will find them to be minor compared to the pain and functional limitations they experienced prior to surgery.
When going through airport security, your new knee will set off a metal detector alert and you can tell the security officer that you have undergone knee replacement surgery.
Q18. What do I need to know about my diet after surgery?
There is no special dietary control required after arthroplasty. You can eat easily digestible foods for the first few days after surgery and you will be able to eat normally by the time you are discharged from the hospital.
A certain degree of loss of appetite or constipation is normal in the early days after joint replacement and will gradually disappear as the body recovers. A balanced diet with more iron-rich foods will promote tissue healing and muscle strength recovery.
Drink alcohol as little as possible, especially post-operative medications should not be taken with alcohol. Avoid excessive caloric intake and weight gain, because the more weight you put on your new joint, the more stress it will be under!
Q19. What sports can I participate in after surgery?
The speed and degree of post-operative recovery varies between patients. Once your surgeon allows exercise based on your recovery, you can gradually begin your favorite pre-operative form of fitness, such as: walking, swimming, dancing, golf, biking, etc. However, none of these exercises should replace the rehabilitation exercises described previously.
Some competitive or contact sports can place excessive stress on the knee joint and are not suitable for post-arthroplasty patients, such as soccer, baseball, tennis, running, weight lifting, skiing or skating. Please consult with your surgeon for specific exercise options.