Preparing for Surgery

Medical Evaluation	:	If you decide to have knee replacement surgery, you may be asked to have a medical assessment before your surgery. This is needed to assess your health and find conditions that could interfere with your surgery or recovery. This will also correct any abnormalities such as high blood pressure and can detect conditions previously undiagnosed like diabetes.
Tests	:	Blood tests, a cardiogram, 2-D echo of heart, chest X-ray, urine examination will be needed. Occasionally, assessment of blood circulation in your leg is necessary with Doppler ultrasound scan.
Medications	:	Tell your orthopaedic surgeon about the medications you are taking. He will advise you which medications you should stop or can continue taking before surgery.
Weight Loss	:	If you are overweight, you may be asked to try to lose some weight before surgery to reduce the stress on your new knee joint.
Dental Evaluation	:	Although infections after knee replacement are not common, an infection can occur if bacteria enter your bloodstream. Since bacteria can enter the bloodstream during dental procedures, treatment of significant dental diseases (including tooth extractions and periodontal work) should be considered before your knee replacement surgery.
Urinary Evaluation	:	Individuals with a history of recent or frequent urinary infections should consider a urological evaluation before knee operation. Older men with prostate disease should consider a urologic evaluation and treatment before having knee replacement surgery.
Social Planning	:	Although you will be able to walk with crutches or a walker soon after surgery, you will need some help for several weeks with such tasks as cooking, shopping, bathing.
Blood Donation	:	Normally two units of blood needs to be kept ready for transfusion during or after operation. Blood bank will require replacement donations from patient’s relatives and friends.
Preparing Your Skin	:	Your skin should not have any infections or irritations before surgery.

Your Operation

You will most likely be admitted to the hospital on the day before your operation. After admission, you will be evaluated by your anaesthetist.. The most common types of anesthesia for knee replacement surgery are general anesthesia (which puts you to sleep throughout the procedure) or spinal (epidural) anesthesia (which allows you to be awake but anesthetizes your body from the waist down). Epidural anaesthesia is a very safe technique in which a thin plastic tube is inserted in the lower back, through which calculated dose of medication is injected during surgery, making only the legs numb. It is safe for elderly, those who have high blood pressure or heart trouble & during surgery it helps reduce bleeding. After the surgery, the tube is connected to a syringe attached to a computerized pump, through which small dose of pain relieving medication is injected, reducing pain after the surgery, eliminating the need for sedatives and allow early exercises. Intravenous antibiotics are started just before surgery and continued for about 5 days after surgery.