You and Your Knee Joint Replacement Joint School Surgical Rehabilitation Team
Housekeeping Length of Session Questions during the session Fire Toilet Facilities Moving around to relieve discomfort
Enhanced Recovery Program Planning and actively participating in the steps to success before and after your operation can help you to: Leave hospital, sooner Make you feel better, sooner Return to normal living, sooner
My role in My Enhanced Recovery. I had always thought my role before going into hospital before an operation was to give myself up to other people and to shut off my mind to what is happening to me if I knew what I know now, I would have taken more of a role in my recovery
Do I need a knee replacement? You may need a knee replacement if: Your arthritis causes pain, stiffness, instability or loss of function that severely affects your daily life and activities Other, non-surgical treatments haven t worked
What are the alternatives to knee replacement surgery? Diet Losing weight will reduce the strain on your knee Exercise Even though this may be difficult because of the pain, there is usually some form of exercises you can start gently to improve the strength and flexibility of the knee. Medication Pain killers can reduce the amount of pain in your joint, while anti-inflammatory tablets may help if your knee is swollen; although as with all medications, there is a risk of side effects
What are the possible advantages? The likely advantages of having knee surgery are: Pain relief Improved mobility Improved quality of life 4 out of 5 people who ve had knee replacement surgery are happy with their new knees
Pain Expected Outcomes 10-20% of patients have unexplained ongoing pain Range of Movement Important to complete regular exercises to move knee after surgery Should be able to get knee straight and bending just past 90
What are the possible disadvantages? The disadvantages of having surgery can include: Some limitations in movement Finding kneeling uncomfortable Risks associated with surgery, including pain that won t go away
Preparing for Surgery and Admission
Video time! https://www.youtube.com/watch?v=8gd q1tsyem8
Any questions? Focus on topics covered by the video there will be further opportunities for other questions later on
Health Check Make sure your general health is as good as it can be i.e. Blood pressure, diabetes, recurrent urine infections Arrange to see your dentist before your surgery to check your dental health Skin condition of your whole leg (including foot) if there are any ulcerations or breaks in skin your surgery will be cancelled
Before coming into Hospital Pre op drinks Use Hibi scrub 5 days before Nasal cream Shower in the morning prior to surgery Clean clothing Medication
Drinks Eating and Drinking Stop drinking 2 hours prior to surgery (non fizzy) Pre op drinks on the morning of surgery Food Stop eating 6 hours prior to surgery Medication Do not take your medication on the morning of surgery ( unless otherwise advised)
Admission Basics Welcomed by the nursing staff on surgical centre who will check you in Eating and drinking Vital observations See the surgeon and or his registrar Sign your consent form See the Anaesthetist and discuss your options for anaesthesia
Your knee replacement
What will my recovery involve? Recovery room 2012 Ward new ward specially for elective orthopaedic patients Reviews by: Orthopaedic Team Pain Team Nurses Physiotherapy Occupational Therapy Rehabilitation Assistants
Discharge Home Most people are in hospital for 2-3 days after their surgery Criteria for discharge home: Pain under control Wound healing without complications Eating and drinking Walking
Post-discharge Your knee will likely be very swollen after your surgery The area around it may be red and sore this is a natural response to the surgery If you are concerned, call us or district nurses, rather than coming straight to A&E.
What are the possible complications of knee replacement surgery? Most knee joint operations are problem-free, but complications arise in about 1 in 20 cases. Most of these are minor and can be successfully treated Blood clots Anti Embolic Stockings Foot pumps (use of flowtrons) Medication (injects or tablets) Keep moving!
Possible complications cont Wound infection Hand washing Dressings will only be changed if necessary Do not touch your wound
How long will the new knee joint last? For most people (80-90%) the artificial knee should last about 15-20 years Younger patients are likely to need a repeat knee operation at some point in later life
Looking after your new knee Your knee will continue to improve for as much as 1 year after your operation as: Scar tissue heals Muscles are restored from exercise Avoid any high impact activities such as running and jumping Exercise is an important part of recovery and low impact activities are recommended, such as walking, cycling, swimming, golf
National Audits National Joint Registry (NJR) Patient Reported Outcome Measure (PROMS) Surgical Site Infection Surveillance (SSI) You will be contacted by phone or reviewed in person about any wound issues you might of had
Any Questions?
Rehabilitation after your Knee Replacement Surgical Rehabilitation Team Incorporating hospital and community health services, teaching and research
Introducing SRT who are we? SRT: Surgical Rehabilitation Team A team comprised of: - Occupational Therapists - Physiotherapist - Rehabilitation Assistants - Consultant Orthogeriatrician
Before Surgery We will discuss your home environment with you and how you manage day to day Talk to us if you feel you will have problems managing things, if you live on your own for example
After your surgery We will come and see you on the ward after your operation (same day or day after) to try to walk with you for the first time
There is lots of evidence to say that the sooner you start walking and moving the better Don t worry SRT will help by: Taking things slowly the first time you get up Making sure you have had your painkillers before we move you Giving you a walking aid and showing you how to use it properly to help with your pain
While you are in hospital we will also Practice going up and down the stairs (if needed) Show you how to do your exercises and progress them Advise you on how to manage your normal activities if you are having difficulties Practice functional tasks such as dressing and getting in / out of bed
Exercises The aim is to have a strong, flexible knee There are no restrictions on movements Practice your exercises 10 repetitions each, 4 times a day It s good to practice them before you have the operation too!
You re at home now what? SRT will be in contact with you the next working day and if you are a City and Hackney resident we will come and visit you. If you are out of area, we will call you. We will also refer you to your local rehabilitation team. All are invited to attend our weekly circuit class
Managing at Home After Your Washing Operation It will be easier to have a sit down wash for the first week or so. We can discuss equipment to help you do this. If you have a shower you can use this but be careful of your wound dressing Getting dressed Dress the operated limb first and use your handy reacher We can practice this with you
Continuing Your Rehabilitation Exercises It is very important you keep doing these four times a day. Goals Your goals are up to you! We can help you achieve them by practicing with you. Eg, walking with one crutch, being able to catch a bus, being able to dress independently.
SRT Rehabilitation Group Every Thursday in the RNRU gym- 12:30-14:00. Run by us, it s not scary! For SRT patients in City and Hackney with knee or hip replacements. Warm up, exercise stations and cool down. Don t worry- we can help you get there if you are concerned!
Any questions? You can contact the SRT office on: 020 8510 7423 Monday-Friday 08:30 16:30 & Saturday 9-2 Leave a message if there is no reply, we check our phone regularly. We work together and regularly liaise with orthopaedic nurse and consultants, you can contact us with any concerns about your hip.