If you are healthy and have no serious medical conditions, you may consider doing your surgery in our Outpatient Surgery Center, without going to a hospital. This may be much less expensive for you, have fewer risks and lead to a more speedy recovery.
If you have serious medical issues such as obesity, severe hypertension, unstable angina or diabetes, your surgery might be best done in the hospital.
Once you and your doctor decide that a personalized knee implant is the right treatment option, you will be sent for a CT scan, your surgery will be scheduled and your very own customized implant will be designed. It takes 4 weeks from the time of your CT scan to design and manufacture the implant and instrumentation, so procedures are commonly scheduled shortly after the expected customized implant arrival date.
Knee surgery is a very common procedure. A total knee replacement can take 60-90 minutes to complete.
Regional Anesthesia consisting of Spinal Anesthesia and Peripheral nerve blocks , in addition to sedation, are done by the anesthesiologist. Long acting local anesthesia, lasting up to 72 hours, is administer by the surgeon to the wound. General Anesthesia is usually not used. You should not expect any pain during surgery and for an extended time afterward.
As you recover from your sedation your nurse will be there to assist you. Pain is usually minimal but additional pain medicine is available if required. You will begin exercises immediately, lifting and bending your knee.
When your feeling returns to your leg, a few hours after surgery, you should be able to sit with your legs dangling over the side of the bed and stand and walk, putting as much weight on your leg as comfortable. Full weight bearing and motion as tolerated is encouraged as soon as possible. Most patients can walk to the bathroom a few hours after their operation.
Every case is different, but you should expect to feel significant pain relief within week. Be sure to follow your surgeon’s recommendations for pain medication and physical therapy.
Braces ordinarily are not needed. A knee immobilizer brace may help some people to walk safely immediately after surgery; this is intermittent and temporary until the anesthesia has worn off and strength has returned.
You may drive when you are able and safe. In the case of right knee surgery, this usually takes about 2 weeks; sooner when the left knee is involved.
Your return to work will be dependent on your job requirements and endurance. Typically, patients return to office work in 2-3 weeks; jobs that require longer periods of standing may require longer periods of time.
You will need medication to control pain (usually some form of narcotic) and to prevent blood clots from developing (aspirin or other medicine).
The wound should be kept dry, covered with antibiotic ointment and a dry sterile dressing following surgery. You can shower and wash the wound with soap and water after a few days if there is no drainage. Keep the doctor advised of any redness or drainage.
You may have a low grade fever for a few days after surgery (up to 101degrees). Tell your doctor if you have a fever or if it does not resolve promptly.
For most patients, physical therapy is part of the pre/postoperative program and is of great help in guiding and fostering a speedy recovery. After surgery, it begins immediately and in sequence, consists of measures to control and eliminate swelling, regain full motion (both bending and straightening) and strength as soon as possible. It begins in the home and can be followed up in an outpatient therapy facility. Some patients can do this on their own with advice along the way.
Prevention of swelling after surgery is most important to speed healing, prevent pain and stiffness and the development of blood clots. You must elevate the leg as high and as much as possible, with the foot higher than the knee, and the knee higher than the heart! This is most important immediately following surgery and for the next 10 days.
Lay down and elevate your leg as high as possible for as much time as possible when you are not up and walking; do not let your knee swell! This will speed healing and prevent stiffness. Do straight leg raising exercises.
The Monterey Peninsula Surgery Center (831) 649-9300 has developed a detailed program which begins when you decide to have outpatient surgery. The program provides classes which instructs the patient and support personnel, engages the home health and physical therapy help, obtains equipment and outlines the pathway which leads to a successful recovery.
The Monterey Peninsula Surgery Center (831) 649-9300 has a complete Outpatient Program for Knee Replacements which includes pre and postoperative planning (they can be reached at (831) 649-9300). The Community Hospital of the Monterey Peninsula (831) 625-4994 offers a free class on joint replacements every other Tuesday from 2:00 – 3:30 p.m. in the Rehabilitation Department (831) 625-4994. Dr. Dauphiné’s staff will help you sign up. There is no charge and no prescription required.
Insurance will, barring a few exceptions, cover most of the cost of knee replacement. Out-of-pocket expenses do vary, so please check your individual insurance coverage. At Richard Dauphiné, M.D.’s Orthopedic Clinic, we accept most insurance plans.
Straight leg raising exercise, walking, “toe-raises” and “heel-slides”.