Restore Clinic   Knee Replacement Surgery
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  Dr. Harsh Shah
• Hip Information
• Knee Information
• Hip Services
• Knee Services
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:: Knee Information
Key Benefits
Excellent pain relief
Short hospital stay (usually less than a week)
Early return to function (as early as three weeks after surgery)
Predictable and favourable outcome
Improvement in the power of thigh muscles

Table of Contents
• Introduction

• Schedule
• Routine Clinic visits after surgery
• Pre-operative instructions, before surgery
• Post-operative instructions, in the hospital
• Home exercises after Total Hip Replacement
• Special Information

These instructions are designed to inform you about Total Knee Replacement. Initial instructions are to be followed before the surgery, during your stay in the hospital and after surgery when you are at home.

The success of the Total Knee Replacement surgery requires active participation of the patient. For a long term successful result, understanding and adherence to these guidelines is imperative.

The joint replacement program at the Restore Clinic has been carefully planned in the sincere hope that your new artificial joint will serve you for lasting pain relief and improved mobility. By the time you return home, you will be familiar with precautions and exercises which protect your new Knee and encourage stability and healing. Your surgeon, physical therapists, and nurses will instruct and assist you in learning these precautions and exercises.


Blood Bank
Pre-operative appointment with your surgeon
Pre-operative appointment with your medical doctor
Pre-operative appointment with Physical Therapy
You must arrive at the hospital the previous evening
Day of Surgery
First clinic visit after surgery to have sutures or staples removed
Routine Clinic visits after surgery

Six Weeks
Six Months
One Year
Then every year
Pre-operative instructions, before surgery

Stop all aspirin and/or anti-inflammatory medications like Ibuprofen, Diclofenac Sodium, lndomethacin, Piroxicam and Naprosyn etc two weeks before surgery. Use Paracetamol (Calpol) as your only pain medication.
If you are taking any blood thinning medicine, speak to your medical doctor about their use before surgery.
Continue to take all of your other regular medications like pills for your high blood pressure, heart, or diabetes.
Take 1,000 mg of vitamin C daily and a multivitamin/multimineral daily.
Report any infections immediately, especially urine and teeth.
Be sure to arrange for added assistance for when you go home.
Go for a pre-operative physical therapy evaluation at the hospital that will be arranged for you.
Do not eat or drink anything after midnight the night before surgery. Your surgeon or medical doctor may instruct you to take some of your regular medications with a sip of water.
Remove the following: makeup, nail polish, hairpins, jewellery, hairpieces, dentures, eyeglasses, contact lenses and hearing aids.
Post-Operative Instructions, In the Hospital

You will be restricted to bed rest for the first 24 to 48 hours. You will be out of bed and into a chair on the morning of the second or the third day after surgery.
There will be a special splint between your legs. This will be removed after 24 to 48 hours.
There will be one to three tubes coming out of the side of the thigh from the Knee to drain excess blood.
You may require a blood transfusion.
Medications to expect:
  a) Your regular medications you took before the operation.
  b) Intravenous antibiotics for the first 48 hours.
  c) Pain Medications- you will receive either injections or continuous infusion to control the pain of surgery. From the second day onwards, regular pain killer pills are usually sufficient
Blood samples will be drawn from you frequently so your surgeon can determine if you need a blood transfusion or any adjustment in your medications.
Use the special breathing exercises to clear your lungs to prevent pneumonia
Do bedside exercises as directed by your surgeon or physical therapist.
Physical therapy will start early in your hospital stay. Your surgeon and physical therapist will discuss your goals. When these are satisfactorily met, you will be able to go home.
Safety is important in all aspects of your activities. If you have any questions concerning any precautions ask our knowledgeable nursing staff, your physical therapist or your surgeon
Post-Operative Instructions, At Home

You will need to use a walker or crutches for approximately six weeks.
Follow all the instructions of the physical therapist. You will be given information concerning exercises and precautions.
Do not drive for six weeks.
Do not plan airline travel for three months.
You may walk unlimited distances.
Take one regular strength aspirin (325 mg) in the morning and at night for six weeks.
You will be given a prescription of pain pills to take by mouth as needed.
Continue to take the vitamin C and a multivitamin daily for six weeks.
Return to the office for suture removal at two weeks.
Home exercises after Total Hip Replacement

These exercises may cause some discomfort. If pain increases with exercise, discontinue the exercise and contact your surgeon or physical therapist.

Gluteal Sets
While lying down on your back, tighten your buttock muscles. Hold tightly for 5 seconds. Repeat 10 times.

Quadriceps Sets

This is an isometric exercise: there is no movement involved. Tighten the quadriceps muscles by pressing the back of your knee flat, tightening the kneecap (patella). Look for a visible contraction, especially on the inside of the thigh by the knee. Hold for 5 seconds. Release. Repeat 10 times.

Ankle Pumping

Increase range of motion and circulation by first pointing your toes downward, then up, in a slow steady motion. Repeat 10 times.

Heel to Buttock, Long Sitting
Bend your affected knee approximately 45' as you slide your heel towards your buttock. As tension develops, hold for 5 seconds and then slide heel to the starting position. Do 10 repetitions.
Terminal Knee Extension, Supine
Lie on your back with a towel roll under your knee. Straighten your knee (still supported by the roll) and hold 5 seconds. Slowly return to the starting position. Repeat 10 times. To do an advanced form of this exercise, add 5 pounds at the ankle before beginning.
Special Information

Joint replacements can become infected at any time after the surgery from the first post-operative day to many years down the line. You can take the following steps to help prevent infection:

Take antibiotics before dental or any medical procedure.
See your doctor to treat all suspected urinary tract infections.
Look for signs of infection in the hip including pain, redness, swelling or increased warmth.
Your new joint replacement may trigger airport metal detector alarms. We will give you a certificate that verifies that you had a hip replacement.
Keep in mind that you need to protect your hip replacement to ensure a long lasting, successful result. Follow all instructions concerning any activity restrictions.
Dr. Harsh Shah - Joint Replacement Specialist
Appointments No. : 0960 181 8844