Here’s my list of most commonly asked questions about knee replacement surgery.  I get these all the time.  Let me know if there is something I’ve missed !

Questions Prior to Surgery

Implant is made up of mostly titanium with some cobalt chrome and polyethylene plastic.

Dr. Hacker uses the Stryker Triathalon Knee System with Mako Robotic Navigation.

The incision will be on down the center of the knee and will be about 4 inches long. If he uses the robotic system for either a total or partial knee you will have two additional incisions for the navigation reflector arrays

This will be addressed during the pre-op when we go over the consent form

You may notice some numbness on the outside portion of your knee. This is usually due to the cutting of some the skin nerves that supply sensation to that area. The nerves will typically regenerate but the sensation can take about a year to return. In a very small proportion of patient’s this can be permanent

Dr. Hacker will make adjustments during the time of surgery to help address this. Correcting a large deformity may make you taller. Typically there is no change in leg length during knee surgery

There are two different options for Anesthesia: General or Spinal with light sedation. These options will be discussed with the Anesthesiologist. Be sure to tell him or her if you have had trouble with anesthesia in the past.  There a pros and cons to both.

Yes, a small amount of cement will be used to ensure the parts can’t move after surgery.  In some cases antibiotics are placed into the cement

This will be addressed at the pre-op visit and you will receive a phone call from the Hospital with this information. Typically, they want you to take as little as possible as you can only take one sip of water

One week prior to surgery we want you to avoid any medications that can thin your blood. These medications include: anti-inflammatories (i.e. Advil/ibuprofen, Aleve/Naproxen, Meloxicam, etc. The only anti-inflammatories allowed are Celebrex and Diclofenac/Voltaren- These do not have as much blood thinning effect.) aspirin, fish oil, multi-vitamins, and herbal supplements. Of course, you will need to stop any blood thinner before surgery.  Discuss this at your preop visit and be sure you know the exact day to stop taking a medication before surgery.

Quad strengthening prior to surgery will help speed up recovery. We will also have you do a visit with PT prior to surgery to help adequately prepare. There is plenty of data to support the importance of a ‘pre-hab’ program.

Depends on amount of use. Typical joint replacements last for at least 15-20 years, although they could last much longerl

Yes, Local anesthesia will be used and injected into the knee joint itself. You will have the option of getting a nerve block which you will discuss with the Anesthesiologist.

No. They will have your home medication list and will dispense the appropriate meds from the hospital’s pharmacy.

You will receive a front wheel walker while in the hospital. A discharge planner in the hospital will help set this up. PT in the hospital will help teach you how to use appropriately.

California law requires that we notify you of this, however, we do not recommend it. The chances of needing a blood transfusion are less than 5%. If you do decide to donate blood you must do so at least 2 months prior to surgery. If done too close to day of surgery you will deplete your own supply making you at higher risk for needing a transfusion.

Risk of infection is less than 5%. There are many ways to minimize this risk which will be discussed at pre-op and at the total joint class. One important way to avoid infection is to keep the incision covered with the bandage that was applied in the OR. DO NOT change it at home unless told to do so.  Call the office if there are any issues.

You will not need to take antibiotics prior to surgery. You will get a large dose through an IV in the OR prior to surgery, and often a few more doses before you go home.

They will go over this in joint class. It is a good idea to get a toilet seat riser and a shower chair.

The physical therapist will work with you on how to get up the stairs safely while you are in the hospital and instruct you how to use the walker appropriately.

Usually you will need some routine blood work and an EKG. You will get an rx for these tests and it will be explained at your pre-op.

Questions during your hospital stay

Typically the surgery will last 1.5-2 hours

Difficult to answer as everyone is different. You will have some local anesthesia which should help for the first couple days. You should expect to be sore. You will be given pain medications in the hospital to help with the pain.

You will stay in the hospital overnight and most patients go home the next day. You will see a physical therapist who will make sure you have met your goals and are safe to go home. The PA’s and/or surgeon will round in the hospital while you are there.

Right away. You will get up with PT the day of surgery and use a walker.

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