FAQs for Knee Replacement

 

What happens after I schedule surgery?

Dr. Hickman's medical assistant will schedule your surgery with the facility you and Dr. Hickman have selected. The M.A. will then authorize this procedure with your health insurance company. Please understand that authorization is not a guarantee of payment and it is always a good idea to check with your insurance company also regarding deductibles, copays, and coinsurance responsibilities. You also should have selected a preoperative appointment in our office. This usually takes place 1-2 weeks prior to your surgery date.

How do I prepare for surgery?

Have nothing to eat or drink after midnight the night before your surgery. You should also wash your surgical site with an antibiotic soap (which will be given to you at your preoperative appointment). You do not need to shave over your surgical site, this will be taken care of in the operating room.

What time will my surgery be?

Your surgery time will be set by the hospital or surgical center. They will contact you on the last working day before the surgery. They usually call after 1 pm. Questions or concerns regarding the time of your surgery should be addressed to the hospital.

Should I stop my medications prior to surgery?

This will be discussed at your preoperative appointment. If you are taking Ibuprofen, Naproxen, or any other anti-inflammatories you will need to stop these one week prior to the surgery. If you are on Plavix or other blood thinners, please contact Dr. Hickman's office to determine when these should be stopped prior to surgery. If you are a diabetic DO NOT take your diabetic medications after midnight on the day of surgery. The hospital or surgery center will instruct you on which of your home medications you should take the morning of surgery.

How do I care for my wound?

Your incision will be closed with dissolving sutures under the skin. There will be no need to remove any stitches. You will go home with two dressings placed on your incision after surgery. The first is directly on the skin and is a clear mesh strip that should be left on for 2-3 weeks. If the strip starts to peel off, trim the edges. The second is an outer brown surgical bandage. The brown bandage should be left on for at least 1-2 days after surgery. Once your surgical bandage is off it is okay to shower and let your incision get wet. Let soap and water run across the incision. rinse clean and pat dry. Do not soak the incision for at least 4 weeks following surgery (no tub, pool, hot tubs, river, creeks, etc.). If you have any concerns about your incision you can email a picture to ma.hickman@mountainortho.com

Do I need a motion machine after Knee Replacement surgery?

Studies show a motion machine does not improve motion or function after surgery. We currently do not recommend using one at home.

How will my wound look after surgery?

Redness and increased warmth around your incision can be normal. You may continue to note increased warmth for up to one year. If you experience significant drainage from your wound (drainage that soaks through a gauze pad in 5-6 hours), redness extending away from your incision or flu like symptoms, please notify our office immediately.

Do I need TED hose (compression stockings)?

Most patients do not need compression stockings after surgery. They do not help prevent blood clots but may be helpful for swelling for select patients.

Do I need an ice machine after Surgery?

We highly recommend using an ice machine to aid in your recovery after total knee replacement. Cold Therapy via an intermittent pneumatic compression (IPC) and motorized cold therapy (MCT) machine is very beneficial following a total knee arthroplasty. MCT circulates cold water through a wrap over the injury or surgical site. Some of the benefits of  MCT include: decreased postoperative discomfort, swelling, inflammation, and narcotic use, provides a consistent, comfortable and safe temperature for hours, and enables patients to control and self-regulate pain management at home. IPC mimics natural muscle contractions to increase blood flow, oxygen, and mechanically flush edema from the affected site. When combined with cold therapy, IPC has shown to: decrease analgesic drug requirements, improve range of motion (ROM) during post op recovery, provide better pain control and improve post operative recovery. We provide ice machines through our office. Unfortunately, we cannot bill your insurance for this item so it will be an out of pocket expense. Contact Dr. Hickman's office to inquire about purchasing an ice machine.

What about dental work after joint replacement?

All dental appointments should be avoided for the first 3 months following surgery unless in an emergency. Antibiotics before dental work are not necessary unless a tooth is being extracted for an infection or major periodontal procedures such as gum or bone surgery. They are not necessary for cleanings, cavity fillings, tooth crowns, or other routine exams. Contact Dr. Hickman's office if you or your dentist have any questions concerning dental work following your total knee replacement.

How long will I need to take pain medication after surgery?

Get off pain pills as soon as possible. You should anticipate discontinuing your pain medication between 2-4 weeks after surgery.

Will I need home health after surgery?

Dr. Hickman recommends outpatient physical therapy whenever possible. Depending on your personal circumstances, you may be released to a rehab center or to home with home healthcare. In either circumstance, it is anticipated that you would complete rehab or home healthcare in 7-14 days. You should make every effort to work hard so you can get to outpatient therapy in no more than 14 days.

Will I need physical therapy after surgery?

Yes. Start outpatient therapy within 3-5 days of leaving the hospital or surgery center. Most patients attend formal therapy 2-3 times per week for approximately 6 weeks after surgery. You will be doing exercises on your own at home as well.

What will my knee feel like after surgery?

Some patients complain of painless "knocking" or "clicking" in the knee after surgery. This is very normal with a knee replacement and does not cause any damage. Many patients also feel stiffness or tightness in the knee for the first several months. Night pain is also often very common after surgery and can disrupt sleep for the first couple of months after surgery. Numbness, the size of two silver dollars can be expected on the lateral side (outside) of the knee after surgery.

Can I kneel on my knee after surgery?

Yes, you may kneel as tolerated. Most patients do have tenderness and difficulty kneeling the first few months postoperatively, but this typically improves with time.

I'm having difficulty sleeping after surgery, is this normal?

Yes, many patients complain of insomnia after surgery and night pain. This is very normal. Dr. Hickman does not recommend or prescribe sleeping pills.

How much will I follow up with Dr. Hickman?

Your first postoperative appointment will be 3-4 weeks after your surgery, then a follow up at 4 months after surgery, and again at 1 year after surgery. Then you will need annual appointments each year. Should you have questions or concerns outside of those time frames, please contact our office.