Overview
This transcript provides a comprehensive educational session for patients preparing for total knee replacement surgery at Alaska Regional Hospital, including pre-surgery preparation, hospital expectations, recovery strategies, infection and fall prevention, and home readiness.
Understanding Knee Anatomy and Surgery
- The knee is a hinge joint formed by the femur, tibia, and patella, with muscles, ligaments, and two cartilage types for movement and stability.
- Degeneration of knee cartilage leads to pain and stiffness, addressed by total knee replacement with metal and plastic components.
- Surgical techniques and implants may vary; patients should discuss incision placement and implant types (cemented/uncemented) with their surgeon.
- Physical therapy is crucial post-surgery for regaining strength and motion.
Risks and Complications
- Complications include stiffness, infection, nerve injury, implant loosening, blood clots, and anesthesia side effects.
- Risk factors are elevated by negative attitude, lack of therapy, excess weight, poor nutrition, high blood sugar, smoking, and poor home safety.
- Preventive measures: pre-surgical exercises, infection protocols, blood sugar management, smoking cessation, and close adherence to post-op instructions.
Pre-Surgical Preparation
- Complete hospital registration and pre-surgical labs, including MRSA screening, within 30 days of surgery.
- Follow preoperative showering instructions with chlorhexidine soap and avoid shaving 24 hours prior.
- Eat a protein-rich dinner the night before; stop eating and drinking as instructed.
- Clarify medication management, especially for anticoagulants, diabetes medications, and herbal supplements.
- Prepare a medication list for review; secure medical clearances from specialists if needed.
What to Bring to the Hospital
- Bring insurance card, identification, medication list, personal hygiene items, comfortable clothing, CPAP/BiPAP if used, and a walker for discharge.
- Leave valuables, jewelry, and medications at home; only bring necessary items.
Hospital Experience and Recovery
- Expect to meet with the surgical and anesthesia team preoperatively; family can stay until surgery.
- After surgery, you will be monitored, receive pain management, physical and occupational therapy, and gradual food and fluid intake.
- Early and safe ambulation is prioritized, with fall prevention measures throughout your stay.
- Equipment provided includes compression devices, IV fluids, oxygen, cryotherapy, and a post-op knee dressing.
Pain Management and Home Care
- Pain is managed with IV and oral medications, nerve blocks, ice, and elevation; expect gradual improvement, not immediate pain-free status.
- Track medication usage, walks, exercises, and bowel movements to avoid complications like constipation.
- Infection prevention includes wound care, hand hygiene, and monitoring for signs of infection or blood clots.
Physical and Occupational Therapy Focus
- Therapy goals are no falls and no infections, tailored to your discharge plan.
- Physical therapy focuses on mobility, stair navigation, and safe exercise.
- Occupational therapy addresses daily tasks using adaptive equipment like reachers and sock aids.
Preparing Your Home for Recovery
- Clean and declutter all areas, especially bathrooms, bedrooms, and kitchens.
- Arrange commonly used items between waist and face height for easier access.
- Remove rugs and ensure pathways are clear; adjust seating to avoid low, deep surfaces.
- Install bathroom safety equipment (shower chair, tub bench, grab bars, toilet risers) as needed.
- Plan pet care and avoid having pets near the surgical site during recovery.
Discharge Planning and Home Management
- Ensure necessary equipment (walker, dressings) is ready before leaving the hospital.
- Review discharge instructions, medication, therapy appointments, and home exercise plan with the care team.
- Continue nutrition, mobility, wound care, and regular physical therapy after discharge, with gradual increase in activity.
Questions / Follow-Ups
- For questions or to receive credit for the presentation, contact Donna Koecher at (907) 264-1481 or [email protected].