Download You and Your Knee Joint Replacement

You and Your Knee Joint
Replacement
Joint School
Surgical Rehabilitation Team
Housekeeping
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Length of Session
Questions during the session
Fire
Toilet Facilities
Moving around to relieve discomfort
Enhanced Recovery Program
Planning and actively participating in the
steps to success before and after your
operation can help you to:
Leave hospital, sooner
Make you feel better, sooner
Return to normal living, sooner
My role in My Enhanced
Recovery ….
‘ I had always thought my role before
going into hospital before an operation
was to give myself up to other people and
to shut off my mind to what is happening
to me… if I knew what I know now, I
would have taken more of a role in my
recovery’
Do I need a knee
replacement?
You may need a knee replacement if:
• Your arthritis causes pain, stiffness,
instability or loss of function that
severely affects your daily life and
activities
• Other, non-surgical treatments haven’t
worked
What are the alternatives to
knee replacement surgery?
Diet
• Losing weight will reduce the strain on your knee
Exercise
• Even though this may be difficult because of the
pain, there is usually some form of exercises you
can start gently to improve the strength and
flexibility of the knee.
Medication
• Pain killers can reduce the amount of pain in your
joint, while anti-inflammatory tablets may help if
your knee is swollen; although as with all
medications, there is a risk of side effects
What are the possible
advantages?
The likely advantages of having knee
surgery are:
• Pain relief
• Improved mobility
• Improved quality of life
4 out of 5 people who’ve had knee
replacement surgery are happy with their
new knees
Expected Outcomes
• Pain
– 10-20% of patients have unexplained ongoing pain
• Range of Movement
– Important to complete regular exercises to
move knee after surgery
– Should be able to get knee straight and
bending just past 90°
What are the possible
disadvantages?
The disadvantages of having surgery can
include:
• Some limitations in movement
• Finding kneeling uncomfortable
• Risks associated with surgery, including
pain that won’t go away
Preparing for Surgery and
Admission
Video time!
• https://www.youtube.com/watch?v=8GD
q1tSYem8
Any questions?
• Focus on topics covered by the video –
there will be further opportunities for
other questions later on
Health Check
• Make sure your general health is as good as
it can be – i.e. Blood pressure, diabetes,
recurrent urine infections
• Arrange to see your dentist before your
surgery to check your dental health
• Skin condition of your whole leg (including
foot)– if there are any ulcerations or breaks in
skin your surgery will be cancelled
Before coming into Hospital
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Pre op drinks
Use Hibi scrub 5 days before
Nasal cream
Shower in the morning prior to surgery
Clean clothing
Medication
Eating and Drinking
Drinks
• Stop drinking 2 hours prior to surgery (non fizzy)
• Pre op drinks on the morning of surgery
Food
• Stop eating 6 hours prior to surgery
Medication
• Do not take your medication on the morning of
surgery ( unless otherwise advised)
Admission Basics
• Welcomed by the nursing staff on surgical
centre who will check you in
– Eating and drinking
– Vital observations
• See the surgeon and or his registrar
– Sign your consent form
• See the Anaesthetist and discuss your
options for anaesthesia
Your knee replacement
What will my recovery
involve?
• Recovery room
• 2012 Ward – new ward specially for
elective orthopaedic patients
• Reviews by:
Orthopaedic Team
Pain Team
Nurses
Physiotherapy
Occupational Therapy
Rehabilitation Assistants
Discharge Home
Most people are in hospital for 2-3 days
after their surgery
Criteria for discharge home:
Pain under control
Wound healing without complications
Eating and drinking
Walking
Post-discharge
• Your knee will likely be very swollen
after your surgery
• The area around it may be red and sore
– this is a natural response to the
surgery
• If you are concerned, call us or district
nurses, rather than coming straight to
A&E.
What are the possible complications
of knee replacement surgery?
Most knee joint operations are problem-free, but
complications arise in about 1 in 20 cases. Most of
these are minor and can be successfully treated
• Blood clots
– Anti Embolic Stockings
– Foot pumps (use of flowtrons)
– Medication (injects or tablets)
– Keep moving!
Possible complications cont…
• Wound infection
– Hand washing
– Dressings will only be changed if necessary
Do not touch your wound
How long will the new knee
joint last?
• For most people (80-90%) the artificial
knee should last about 15-20 years
• Younger patients are likely to need a
repeat knee operation at some point in later
life
Looking after your new knee
• Your knee will continue to improve for as
much as 1 year after your operation as:
– Scar tissue heals
– Muscles are restored from exercise
• Avoid any high impact activities such as
running and jumping
• Exercise is an important part of recovery and
low impact activities are recommended, such
as walking, cycling, swimming, golf
National Audits
• National Joint Registry (NJR)
• Patient Reported Outcome Measure
(PROMS)
• Surgical Site Infection Surveillance
(SSI)
You will be contacted by phone or reviewed in person about
any wound issues you might of had
Any Questions?
Rehabilitation after your Knee
Replacement
Surgical Rehabilitation Team
Incorporating hospital and community health services, teaching and research
Introducing SRT – who are
we?
SRT: Surgical Rehabilitation Team
A team comprised of:
- Occupational Therapists
- Physiotherapist
- Rehabilitation Assistants
- Consultant Orthogeriatrician
Before Surgery
• We will discuss your home environment
with you and how you manage day to
day
• Talk to us if you feel you will have
problems managing things, if you live on
your own for example
After your surgery
• We will come and see
you on the ward after
your operation (same
day or day after) to try to
walk with you for the
first time
There is lots of evidence to say
that the sooner you start walking
and moving the better
Don’t worry – SRT will help by:
 Taking things slowly the first time you get up
 Making sure you have had your painkillers
before we move you
 Giving you a walking aid and showing you
how to use it properly to help with your pain
While you are in hospital we will
also…
• Practice going up and down the stairs (if
needed)
• Show you how to do your exercises and
progress them
• Advise you on how to manage your normal
activities if you are having difficulties
• Practice functional tasks such as dressing
and getting in / out of bed
Exercises
• The aim is to have a strong,
flexible knee
• There are no restrictions on
movements
• Practice your exercises 10
repetitions each, 4 times a
day
• It’s good to practice them
before you have the
operation too!
You’re at home – now what?
• SRT will be in contact with you the next
working day and if you are a City and
Hackney resident we will come and visit you.
• If you are out of area, we will call you. We will
also refer you to your local rehabilitation
team.
All are invited to attend our weekly circuit class
Managing at Home After Your
Operation
• Washing
– It will be easier to have a sit down wash for the first
week or so. We can discuss equipment to help you
do this.
– If you have a shower you can use this but be careful
of your wound dressing
• Getting dressed
– Dress the operated limb first and use your handy
reacher
– We can practice this with you
Continuing Your Rehabilitation
• Exercises
• It is very important you keep doing these four
times a day.
• Goals
• Your goals are up to you! We can help you
achieve them by practicing with you.
• Eg, walking with one crutch, being able to catch a
bus, being able to dress independently.
SRT Rehabilitation Group
• Every Thursday in the RNRU
gym- 12:30-14:00.
• Run by us, it’s not scary!
• For SRT patients in City and
Hackney with knee or hip
replacements.
• Warm up, exercise stations and
cool down.
• Don’t worry- we can help you
get there if you are concerned!
Any questions?
• You can contact the SRT office on:
020 8510 7423
Monday-Friday 08:30 – 16:30 & Saturday 9-2
• Leave a message if there is no reply, we check
our phone regularly.
• We work together and regularly liaise with
orthopaedic nurse and consultants, you can
contact us with any concerns about your hip.