Our Services
Total
Knee Replacement
A total knee replacement is using an artificial surface to replace degenerative o damaged cartilage. The knee itself is not replaced. An artificial substitute is inserted on the end of the bones. This is done by placing a metal alloy on the femur and a plastic spacer on the tibia and patella. This creates a new, smooth cushion and a functioning joint that does not hurt. Surgical time for a total knee replacement may be up to two hours.
WHAT ARE THE RESULTS OF A TOTAL KNEE REPLACEMENT?
WHEN SHOULD I HAVE THIS TYPE OF SURGERY?
HOW LONG WILL THE REPLACEMENT LAST?
WHY MIGHT I REQUIRE A REVISION?
WHAT ARE THE MAJOR RISKS?
SHOULD I EXERCISE BEFORE SURGERY?
WILL I NEED BLOOD?
WHAT KIND OF ANESTHESIA WILL BE USED?
HOW LONG WILL I BE INCAPACITATED?
WHEN CAN I DRIVE?
WHEN WILL BE ABLE TO RETURN TO WORK?
WILL THERE BE ANY RESTRICTIONS AFTER SURGERY?
WILL MY KNEE FEEL DIFFERENT AFTER SURGERY?
ANY BODY CHANGES?
IN THE FUTURE?
HOW DO I GO ABOUT SCHEDULING SURGERY?
CARING FOR YOUR SELF AT HOME:
CARING FOR YOUR INCISION:
PREVENTING COMPLICATIONS:
SIGNS OF INFECTION:
SIGNS OF BLOOD CLOTS:
SIGNS OF PULMONARY EMBOLUS
WHAT ARE THE RESULTS OF A TOTAL KNEE REPLACEMENT?
Result will vary depending on the quality of the surrounding tissue, the severity of the arthritis at the time of the surgery, the patient’s activity level and the patient’s adherence to the doctor’s orders.
WHEN SHOULD I HAVE THIS TYPE OF SURGERY?
You and your orthopedic surgeon will decide if you are a candidate for surgery based on your history, examination, x-rays and response to conservative treatment. Age is not a factor if you are in good health and have a desire to continue living a productive, active life.
HOW LONG WILL THE REPLACEMENT LAST?
All implants have a limited life expectancy depending on the individual’s age, weight, activity level and medical condition. It is important to remember that an implant is a medical device and subject to wear and can lead to mechanical failure. There is no guarantee that your implant will last for any specific length of time.
WHY MIGHT I REQUIRE A REVISION?
Just as your original joint wears out, a joint replacement will wear over time as well. Loosening of the artificial surface from the bone may occur. The plastic spacer may wear away.
WHAT ARE THE MAJOR RISKS?
Most surgeries go well, without any complications. Infection and blood clots are two serious complications. To avoid these complications, we use antibiotics and blood thinners. Special precaution is also used in the operating room to reduce the risk of infection.
SHOULD I EXERCISE BEFORE SURGERY?
You should go about your daily routine.
WILL I NEED BLOOD?
There is a possibility you will need blood after the surgery. The blood bank is considered safe. Your surgeon will discuss taking from the blood bank or donating your own blood. If you choose to donate, the surgical coordinator in the surgeon’s office will help you set this up.
WHAT KIND OF ANESTHESIA WILL BE USED?
This will be ultimately determined by the anesthesiologist after a discussion with you. You may expect a call from him or her the day before or the morning of the surgery to discuss this.
SPINAL ANESTHESIA involves an injection in the lower back which produces numbness from the waist down to the toes. You will also receive sedation through an intravenous line. You will not feel pain.
EPIDURAL ANESTHESIA involves insertion of a thin catheter into the space surrounding the spinal cord. This is similar to spinal anesthesia.
GENERAL ANESTHESIA will put you to sleep using anesthetic gases.
HOW LONG WILL I BE INCAPACITATED?
Most patients will stay in the hospital for three days after the surgery, during which you will receive physical therapy. During that time the HOSPITAL SOCIAL WORKER will work with you to find a suitable rehabilitation center for you to go to after discharge. The hospital will transport you to the rehab center were you will stay for approximately two weeks during which you will receive enough physical therapy and training to allow you to be comfortable when you are discharged home. The REHABILITATION SOCIAL WORKER will work with you to set up home help and physical therapy if you qualify for this benefit. While you are in the rehabilitation center you will be under the doctors on staff. When you have gone home you will be required to make an appointment to see the surgeon in his office. Most patients will have had the staples removed at the rehabilitation center two weeks after the date of your surgery.
Some patients may be discharged home after three days in the hospital. This will depend on your home situation and the doctor. The HOSPITAL SOCIAL WORKER will work with you to set up home help and physical therapy.
WHEN CAN I DRIVE?
If you have had surgery to the left side of the body and you have automatic transmission, you may be able to drive at two weeks post op. If the surgery was to the right side of the body, you may not be able to drive for six weeks. The answer will depend on your progress.
WHEN WILL BE ABLE TO RETURN TO WORK?
Returning to work will depend on the type of duties you perform and your progress. We recommend you remain disabled for approximately six months post surgery. You will be followed in the office monthly and then at some point your surgeon will advise you to return yearly.
WILL THERE BE ANY RESTRICTIONS AFTER SURGERY?
High-impact activities, such as running, singles tennis and basketball are not recommended. Injury prone sports such as downhill skiing are also dangerous for the new joint.
You are encouraged to participate in low-impact activities such as walking, dancing, golf, hiking, swimming, and bowling.
WILL MY KNEE FEEL DIFFERENT AFTER SURGERY?
You may have a small area of numbness to the outside of the scar for about a year or more. Kneeling may be uncomfortable for a year or more. Some patients notice some clicking when they move their knee. This is the result of the artificial surfaces.
ANY BODY CHANGES?
Your appetite may be poor. Drink plenty of fluids to keep from getting dehydrated. This will only last awhile post surgery.
You may have difficulty sleeping. Do not sleep or nap too much during the day.
Your energy level will be decreased for the first month.
Pain medication may promote constipation. Use stool softeners or laxatives such as milk of magnesia if necessary.
IN THE FUTURE?
Whenever you have dental work or cleaning performed, you will need to take a prophylactic antibiotic to prevent infection of your total joint implant. MAKE SURE YOUR DENTIST IS AWARE YOU HAVE HAD A TOTAL JOINT REPLACEMENT.
The office will give you a prescription if the Dentist’s office doesn’t.
HOW DO I GO ABOUT SCHEDULING SURGERY?
If you feel you are ready to have surgery scheduled you may call the office and set up an appointment with the surgeon to be examined and to discuss the procedure. You then will be directed to the surgical coordinator who will obtain certain information from you and then contact your insurance company, schedule your surgery, schedule your pre-admission testing, schedule appointments with your primary doctor and cardiologist if you see one. They will then call you with all the information and then put a detailed packet of information in the mail for you. This packet will answer your questions regarding before, during and after the surgery. YOU WILL NOT NEED TO CONSULT YOUR INSURANCE COMPANY YOURSELF.
CARING FOR YOUR SELF AT HOME:
Take your pain medicine at least 30 minutes before physical therapy.
Gradually wean yourself from prescription medication to Tylenol. You may take two extra-strength Tylenol in place of your prescription medication up to four times per day.
Change your position every 45 minutes throughout the day.
You may use ice for pain control. Do not exceed 20 minutes at at time each hour.
CARING FOR YOUR INCISION:
Keep your incision covered with a light dry dressing until the staples are removed, usually two weeks post surgery.
You may shower seven days after surgery unless instructed otherwise. Apply a dry dressing afterwards.
PREVENTING COMPLICATIONS:
Notify the surgeon if there is increased drainage, redness, pain, odor or heat around the incision.
SIGNS OF INFECTION:
Increased swelling and redness at incision site
Change in color, amount, odor of drainage
Increased pain in knee
Fever greater than 100.5 degrees.
SIGNS OF BLOOD CLOTS:
Swelling in thigh, calf or ankle that does not go down with elevation
Pain, heat and tenderness in calf, back of knee or groin area.
Please note a blood clot can occur in either leg.
SIGNS OF PULMONARY EMBOLUS
Sudden chest pain
Difficult and /or rapid breathing
Shortness of breath
Sweating
Confusion
Knee Replacement
A total knee replacement is using an artificial surface to replace degenerative o damaged cartilage. The knee itself is not replaced. An artificial substitute is inserted on the end of the bones. This is done by placing a metal alloy on the femur and a plastic spacer on the tibia and patella. This creates a new, smooth cushion and a functioning joint that does not hurt. Surgical time for a total knee replacement may be up to two hours.
WHAT ARE THE RESULTS OF A TOTAL KNEE REPLACEMENT?
WHEN SHOULD I HAVE THIS TYPE OF SURGERY?
HOW LONG WILL THE REPLACEMENT LAST?
WHY MIGHT I REQUIRE A REVISION?
WHAT ARE THE MAJOR RISKS?
SHOULD I EXERCISE BEFORE SURGERY?
WILL I NEED BLOOD?
WHAT KIND OF ANESTHESIA WILL BE USED?
HOW LONG WILL I BE INCAPACITATED?
WHEN CAN I DRIVE?
WHEN WILL BE ABLE TO RETURN TO WORK?
WILL THERE BE ANY RESTRICTIONS AFTER SURGERY?
WILL MY KNEE FEEL DIFFERENT AFTER SURGERY?
ANY BODY CHANGES?
IN THE FUTURE?
HOW DO I GO ABOUT SCHEDULING SURGERY?
CARING FOR YOUR SELF AT HOME:
CARING FOR YOUR INCISION:
PREVENTING COMPLICATIONS:
SIGNS OF INFECTION:
SIGNS OF BLOOD CLOTS:
SIGNS OF PULMONARY EMBOLUS
WHAT ARE THE RESULTS OF A TOTAL KNEE REPLACEMENT?
Result will vary depending on the quality of the surrounding tissue, the severity of the arthritis at the time of the surgery, the patient’s activity level and the patient’s adherence to the doctor’s orders.
WHEN SHOULD I HAVE THIS TYPE OF SURGERY?
You and your orthopedic surgeon will decide if you are a candidate for surgery based on your history, examination, x-rays and response to conservative treatment. Age is not a factor if you are in good health and have a desire to continue living a productive, active life.
HOW LONG WILL THE REPLACEMENT LAST?
All implants have a limited life expectancy depending on the individual’s age, weight, activity level and medical condition. It is important to remember that an implant is a medical device and subject to wear and can lead to mechanical failure. There is no guarantee that your implant will last for any specific length of time.
WHY MIGHT I REQUIRE A REVISION?
Just as your original joint wears out, a joint replacement will wear over time as well. Loosening of the artificial surface from the bone may occur. The plastic spacer may wear away.
WHAT ARE THE MAJOR RISKS?
Most surgeries go well, without any complications. Infection and blood clots are two serious complications. To avoid these complications, we use antibiotics and blood thinners. Special precaution is also used in the operating room to reduce the risk of infection.
SHOULD I EXERCISE BEFORE SURGERY?
You should go about your daily routine.
WILL I NEED BLOOD?
There is a possibility you will need blood after the surgery. The blood bank is considered safe. Your surgeon will discuss taking from the blood bank or donating your own blood. If you choose to donate, the surgical coordinator in the surgeon’s office will help you set this up.
WHAT KIND OF ANESTHESIA WILL BE USED?
This will be ultimately determined by the anesthesiologist after a discussion with you. You may expect a call from him or her the day before or the morning of the surgery to discuss this.
SPINAL ANESTHESIA involves an injection in the lower back which produces numbness from the waist down to the toes. You will also receive sedation through an intravenous line. You will not feel pain.
EPIDURAL ANESTHESIA involves insertion of a thin catheter into the space surrounding the spinal cord. This is similar to spinal anesthesia.
GENERAL ANESTHESIA will put you to sleep using anesthetic gases.
HOW LONG WILL I BE INCAPACITATED?
Most patients will stay in the hospital for three days after the surgery, during which you will receive physical therapy. During that time the HOSPITAL SOCIAL WORKER will work with you to find a suitable rehabilitation center for you to go to after discharge. The hospital will transport you to the rehab center were you will stay for approximately two weeks during which you will receive enough physical therapy and training to allow you to be comfortable when you are discharged home. The REHABILITATION SOCIAL WORKER will work with you to set up home help and physical therapy if you qualify for this benefit. While you are in the rehabilitation center you will be under the doctors on staff. When you have gone home you will be required to make an appointment to see the surgeon in his office. Most patients will have had the staples removed at the rehabilitation center two weeks after the date of your surgery.
Some patients may be discharged home after three days in the hospital. This will depend on your home situation and the doctor. The HOSPITAL SOCIAL WORKER will work with you to set up home help and physical therapy.
WHEN CAN I DRIVE?
If you have had surgery to the left side of the body and you have automatic transmission, you may be able to drive at two weeks post op. If the surgery was to the right side of the body, you may not be able to drive for six weeks. The answer will depend on your progress.
WHEN WILL BE ABLE TO RETURN TO WORK?
Returning to work will depend on the type of duties you perform and your progress. We recommend you remain disabled for approximately six months post surgery. You will be followed in the office monthly and then at some point your surgeon will advise you to return yearly.
WILL THERE BE ANY RESTRICTIONS AFTER SURGERY?
High-impact activities, such as running, singles tennis and basketball are not recommended. Injury prone sports such as downhill skiing are also dangerous for the new joint.
You are encouraged to participate in low-impact activities such as walking, dancing, golf, hiking, swimming, and bowling.
WILL MY KNEE FEEL DIFFERENT AFTER SURGERY?
You may have a small area of numbness to the outside of the scar for about a year or more. Kneeling may be uncomfortable for a year or more. Some patients notice some clicking when they move their knee. This is the result of the artificial surfaces.
ANY BODY CHANGES?
Your appetite may be poor. Drink plenty of fluids to keep from getting dehydrated. This will only last awhile post surgery.
You may have difficulty sleeping. Do not sleep or nap too much during the day.
Your energy level will be decreased for the first month.
Pain medication may promote constipation. Use stool softeners or laxatives such as milk of magnesia if necessary.
IN THE FUTURE?
Whenever you have dental work or cleaning performed, you will need to take a prophylactic antibiotic to prevent infection of your total joint implant. MAKE SURE YOUR DENTIST IS AWARE YOU HAVE HAD A TOTAL JOINT REPLACEMENT.
The office will give you a prescription if the Dentist’s office doesn’t.
HOW DO I GO ABOUT SCHEDULING SURGERY?
If you feel you are ready to have surgery scheduled you may call the office and set up an appointment with the surgeon to be examined and to discuss the procedure. You then will be directed to the surgical coordinator who will obtain certain information from you and then contact your insurance company, schedule your surgery, schedule your pre-admission testing, schedule appointments with your primary doctor and cardiologist if you see one. They will then call you with all the information and then put a detailed packet of information in the mail for you. This packet will answer your questions regarding before, during and after the surgery. YOU WILL NOT NEED TO CONSULT YOUR INSURANCE COMPANY YOURSELF.
CARING FOR YOUR SELF AT HOME:
Take your pain medicine at least 30 minutes before physical therapy.
Gradually wean yourself from prescription medication to Tylenol. You may take two extra-strength Tylenol in place of your prescription medication up to four times per day.
Change your position every 45 minutes throughout the day.
You may use ice for pain control. Do not exceed 20 minutes at at time each hour.
CARING FOR YOUR INCISION:
Keep your incision covered with a light dry dressing until the staples are removed, usually two weeks post surgery.
You may shower seven days after surgery unless instructed otherwise. Apply a dry dressing afterwards.
PREVENTING COMPLICATIONS:
Notify the surgeon if there is increased drainage, redness, pain, odor or heat around the incision.
SIGNS OF INFECTION:
Increased swelling and redness at incision site
Change in color, amount, odor of drainage
Increased pain in knee
Fever greater than 100.5 degrees.
SIGNS OF BLOOD CLOTS:
Swelling in thigh, calf or ankle that does not go down with elevation
Pain, heat and tenderness in calf, back of knee or groin area.
Please note a blood clot can occur in either leg.
SIGNS OF PULMONARY EMBOLUS
Sudden chest pain
Difficult and /or rapid breathing
Shortness of breath
Sweating
Confusion