Message from your doctor…
Whether you or one of your family members or friends is considering patellofemoral knee replacement, or are scheduled for surgery, I understand this can be a stressful time. You may have forgotten some of the information we discussed during our last visit, or forgot to ask me a specific question about what to expect. This site is designed to help us stay connected, and to answer some of the most common questions patients ask me about patellofemoral knee replacements.
I want to make sure that both you and your family members have timely information at your fingertips during the days, weeks, and months following your surgery…so you can get back to enjoying the activities you love.
Please take your prescription pain medication for the first 48-72 hours as directed. After the first day or two, as the pain lessens, you may decrease the frequency with which you take the medication. Remember, the medications are not necessarily meant to completely eliminate your pain, only to make it more bearable. Narcotic pain medications can cause constipation; you may wish to use an over-the-counter stool softener to help prevent this.
If you are having minimal pain and would like to switch to a milder medication, please take Tylenol/acetaminophen (extra strength or regular). Do not take Tylenol and norco together (this would be too much acetaminophen). Do not exceed more than 4000mg of Tylenol/acetaminophen in a 24 hour period.
CAUTION! If you are taking a blood thinner medication to prevent blood clots in the leg: Medications such as aspirin, coumadin, lovenox, plavix, xarelto- you should NOT be taking anti-inflammatories:
These medications together can increase risk of GI bleeding or other medical problems.
It is helpful to use ice or a cold therapy unit to decrease pain and swelling. For the first few days after surgery, please try to ice at least 5 times daily, for 20 min each time. If you have an ice therapy unit, you are encouraged to keep the ice unit on as much as possible for the first 48 hours. You may also elevate your leg on a few pillows while laying down to decrease pain and swelling. It is recommended to ice the knee after completing your physical therapy exercises.
You will have a soft dressing and ace wrap applied over your incision. It is meant to absorb any leaking blood or fluid from the joint, and to protect from infection. Leakage immediately after surgery is normal and actually helps to drain some of the fluid that accumulates in the joint during surgery. The dressings may become slightly moist or blood-stained; this is normal and usually not a cause for alarm.
You may put full weight on your operative knee immediately after surgery. Motion and weight-bearing are encouraged, even the same day of surgery. You will be given crutches or a walker to to use for safety. Your physical therapist will help you to wean from the crutches/walker when it is appropriate.
You will have knee brace to wear anytime you are up walking after surgery. The brace will support your knee until you’ve developed enough strength to safely walk without the brace. Your surgeon and physical therapist will help to determine how long the brace is needed. Typically, you will need the brace for 2-4 weeks. Eventually, the brace will be unlocked to allow full motion.
You may remove your dressing 2 days after your surgery to take a shower. Please wash your hands prior to removing your dressing. You may have absorbable sutures covered by steri-strips covering your incision. Leave the steri strips in place until they fall off on their own or until they are removed at your first post-op appointment. You may let soap and water gently wash over your incision, but do not scrub. Pat incision dry with a towel, then you may leave the steri-strips uncovered if you’d like. You may cover the steri-strips with band-aids if there is still any drainage. Please reapply the large ace wrap to protect the incisions. The ace wrap is also helpful underneath the knee brace (stops the brace from rubbing on skin).
Inspect your incision for:
surrounding skin hot/warm to touch
*call our office immediately if the above occur
You may not soak in a bathtub or go in a pool until your incision is better healed (usually 3-4 weeks).
Your first post-op visit will be scheduled 10-14 days after surgery. You will see Dr. Mehta’s Physician Assistant on the first visit. At this visit, we’ll check your incision, get a few x-rays of the knee, and answer any questions you may have.
WHEN TO CALL
Please call our office at (630)584-1400 if you develop a fever greater than 101°F, increasing pain that is not responding to pain medication, redness, increased swelling, persistent bleeding or drainage, or drainage other than clear fluid or blood.
Please do not attempt driving until you are off the pain medications. You should wait to drive until you can comfortably and safely operate the vehicle (get from gas to brake). If you had a right knee replacement, it may be about 4-6 weeks before you can safely drive. If you had a left knee replacement, you may drive once you’re off pain medication and can comfortably and safely operate the vehicle.
PREVENTION OF BLOOD CLOTS
Although the risk is very low, there is a small chance of developing blood clots into the leg after a joint replacement surgery. A blood clot in the leg is called a DVT or deep vein thrombosis. Signs of a blood clot could include calf pain and swelling. Call our office immediately or go to the emergency room if you develop calf pain and swelling to either leg.
Some patients will be asked to take a 325mg aspirin daily for 1 month after surgery to prevent blood clots. Some patients at higher risk of blood clots will require another form of anticoagulation such as lovenox injections, xarelto or coumadin pills. If you cannot take this medications, your surgeon may prescribe home sequential compression devices (SCDs) that will help keep the blood flowing through your calf muscles to prevent blood clots.
Those patients at higher risk of blood clots include: Patients who have had prior DVT, are on birth control pills, patients that smoke, or have clotting disorders.
Pulmonary embolism: A blood clot that has traveled to the lungs. This can be deadly.
Signs of a blood clot or pulmonary embolism could include:
sudden chest pain
shortness of breath
If you develop any of the above, get to an emergency room immediately or call 911.
RETURN TO WORK
This will vary, based on the nature of your job. If you have a desk job, you may return to work as soon as you are off the pain medication, comfortable driving, and feel that you may perform your job. Most patients with desk jobs take at least 1-2 weeks off work to rest and focus on therapy. If you have a labor-intense job that may require more walking, squatting or heavy lifting, you may need a few months (up to 6 months) off work. We can discuss this in more detail during your 1st post-operative visit and we can give you work status notes (including light duty if this is an option for your job).
You will start physical therapy within 1 week after surgery. Most patients will go 2-3 times/week for about 12 weeks. Please direct your therapist to www.healthy-txt.com/drmehta for Dr. Mehta’s PT protocols.
MOST COMMON QUESTIONS
Patellofemoral Knee Replacement
How long will my knee replacement last?
All implants have a limited life expectancy depending on one’s activity level, age, medical conditions, and weight. This can vary for each patient. It is important to remember that an implant is a medical device subject to wear that may lead to mechanical failure.
Because you are having a partial knee replacement, you may need a full knee replacement in the future (if the other cartilage in the knee wears down).
Am I too young for a partial knee replacement?
Age is not the only factor if you are in reasonable health and you have the desire and ability to keep living a productive, active life. The input of your medical doctor’s opinion is important when deciding whether a knee replacement is an option for you. Typically, partial joint replacements are done after a patient has tried a significant amount of conservative treatment (injections, anti-inflammatory medications, knee braces, sometimes other surgeries).
When can I resume normal activity after surgery?
You are encouraged to walk and move the knee as soon as possible. It is safe to put weight on your knee immediately (with your knee brace on) to begin your road to recovery.
Do I have any restrictions after surgery?
During the initial 3 months after surgery, you should avoid any sudden cutting or pivoting activities or deep squats. Injury-prone sports such as downhill skiiing, basketball, and other contact sports are not recommended after a partial knee replacement. Jogging and running are also not recommended. There are safer forms of cardiovascular exercise for your knee replacement. Biking, elliptical machines, and swimming are “better” for the knee and will likely avoid wear and tear on the implants.
How can I learn more about partial knee replacements?
Antibiotics after joint replacements
Current guidelines suggest that for your lifetime, you should take antibiotics prior to routine dental cleanings/hygiene, fillings, and more invasive dental procedures.
We recommend the use of antibiotics prior to these procedures because during each of these procedures, a small amount of bleeding can occur which may allow bacteria to “seed” or spread through the bloodstream and can potentially travel to the replaced shoulder joint (or any area of the body where there is hardware from a surgery). This can be dangerous if an infection were to start in the replaced joint. To prevent this from happening, we recommend you take antibiotics ½ hour prior to dental procedures.
If possible, for safety reasons, we recommend waiting at least 3 months after a joint replacement to have any routine dental work completed.
If you have upcoming dental work, please call our office at least 3 days in advance, so we can send the appropriate antibiotic to your pharmacy.
We know you are eager to return to your sports and hobbies. We want to guide you safely through that process. Please use the following as a guide.
You may start a stationary bike within 1 week of surgery. This will encourage range of motion as well as muscle strengthening
Because the incision over the front of your knee will be sensitive, it is recommended to wait 3-6 months before kneeling. It may be uncomfortable to kneel for 1 year or more.
There are safer forms of cardiovascular exercise for your knee replacement. Biking, elliptical machines, and swimming are “better” for the knee and will likely avoid wear and tear on the implants.
1 month post-op: Putting
3 months post-op: Chipping, pitching, and half-swings with your short irons
4-5 months post-op: Full but gentle swings with irons
6 months post-op: Full play with no restrictions
Invite friends and family to visit this page by sending them an email.