Knee replacement surgery

[Ihateslugs]

Not sure where to post this as I can’t see a Medical topic heading!

I have just been given a date for knee replacement surgery, the 16th December, and I now need to start planning. I live alone so I need to work out who can stay with me for a few days and also provide any longer term support. Any advice from you would be appreciated. Christmas is going to be interesting this year!

I have private medical insurance ( if that makes any difference) and apparently I will only be in hospital for one night. I have no idea what equipment I will need at home and what the hospital/my medical insurance will fund, apparently that will be discussed at my pre op visit but as that’s going to be a couple of weeks before the operation, I’d like to buy anything before that.

My questions so far are;

How long will I need someone staying with me post operation? My daughter can come here for three nights then maybe my sister for another couple but as I live in a bungalow, I am hoping to be able to cope alone after that. I do have a cleaner every two weeks so I’m not worried about keeping the house clean.

I will be stocking up with some decent ready meals from Cook which I can just microwave and already have grocery deliveries booked in the run up to Christmas so I will have plenty of food that’s easy to prepare.

I know I won’t be able to drive for a while but how mobile might I be in terms of getting a lift to places? I am not fit at all, over weight and in too much pain currently to do much exercise but I intend to pay for extra physio sessions at a gym with hydrotherapy to get mobile as soon as possible.

I am on blood thinners after a TIA a few years ago and was told by the surgeon that I will need to stop taking them a couple of weeks pre op as I’ll be given stronger blood thinners to take after the operation. Has anyone experience of self injecting these? Are the similar to the weight loss injections I currently take ie single dose pens with a very fine needle that just goes under the skin? Otherwise I might have issues self injecting!

I know I need to stop taking the weight loss meds before the operation and for two weeks afterwards apparently but I’m ok with that as I am not sure about continuing anyway as the side effects I get are pretty awful!

I would love to hear from anyone who has had knee replacement surgery recently, especially those who went privately as I’m not sure if that will mean a difference in the equipment I get given, I seem to remember my mum having to buy some aids which friends who used the NHS were given.

Im not looking forward to the operation, I’ve not been in hospital other than when I had my children many years ago and am terrified. If all goes well with my recovery, I’ll be having my second knee done in February so I’ve for weeks of recovery to look forward to, I need to be well prepared.

My MIL had a full knee replacement in February. She was told beforehand that for the first two weeks she will be in a lot of pain and regret the op, this was correct. After that initial two weeks she was much better. She was NHS and wasn't given any special equipment aside from crutches. You will need someone to take you for your aftercare and physio appointments.

Consider a raised toilet seat, blocks to raise sofa / chair, a long handled grabber, long handled shoe horn and sock aid to help if you cant bend well. A perching stool for the kitchen and an apron or jumper with a big pocket to carry things as you will be on crutches for a while. Ice packs in the freezer. Make sure you do all the exercises you are given and take all the painkillers regularly. Get moving asap and don’t be tempted to be an ‘ invalid’ do as much for yourself as possible. It was handy having someone around for a couple of days mainly to do hot drinks and meals as being on crutches was a bit tricky but to be honest after a few days i was ok just using one in the house. Getting out and about was fine too just learn how to manoeuvre the crutches. Good luck, its painful to start with but much better than the pain before from the dodgy knees. Oh the needles are very similar to the weight loss ones, a pen thing so you should be fine with them.

It sounds like you may need to get some clarification re. the medications - what you've described re stopping the medications doesn't sound like standard advice. I would ask to speak to an anaesthetist sooner rather than later.

My dad was the same. Op, you’ll hate the physio to start with but it’s critical you do some every day as it definitely gets you up and around quicker and will help your recovery
I bought him exercise stretch bands (resistance bands) to help manoeuvre his leg on / off bed and the sofa which helped loads in first two weeks, could also use a dressing gown cord or similar

Step had a full knee replacement in the summer. He was quite unwell due to the pain for the first few weeks. It was worse than before for about three to four weeks.

Agree with raised toilet seat, a raised high backed chair, plenty of ready meals, toast and soup. You might not feel like much. If you are not nimble, you may find a zimmer helpful for the first few weeks. Step found long trousers impossible, so you may need a few skirts or long jersey shorts. He also felt the cold (in July!). A commode in your bedroom might help. Crocs were also a Godsend.

He had his op on the NHS. He ended up spending three nights in hospital due to a burst stitch and persistent bleeding. I drove him home from hospital and have an SUV; he'd have had trouble getting into a lower car. Privately I think there is swifter access to better physio.

By September he was off crutches, by October he was back on the golf course. He is glad he had it now. He had the other knee done when 71; this one at 83 took more out of him.

I think you will need someone helping you for the first week. I wouldn't discount booking yourself into a nursing home for convalescence for a couple of weeks if you are on your own.

Limbo cover for the wound for showering was helpful but mother could help him put it on.

I’ve had both knees replaced.
The things I will stress are …

• Do the pre-op exercises to get your muscles as strong around the knee capsule as possible in advance.
• You absolutely must do the post op exercises because if you don’t you will have wasted your surgeon’s time.
• You can’t damage the joint but the muscles & tendons will seize up if you don’t keep them soft in the knee capsule. They need stretching!
• The post op exercises are horrendously painful! You must do them so paying for extra physio will pay off.
• Buy the gel ice-pack wrap-around knee pads from Amazon. You will find ice is a terrific pain reliever. Use ice regularly.
• Take pain relief prophylacticly. Don’t wait for pain to worsen. Leave off pain relief as soon as you can post-op.
• Keep ambulant up on your crutches.
• Don’t sit about! I was walking short distances outside within 4 days, on crutches. I went down to one crutch after 3 or 4 weeks.
• Ask hospital for a knee protection sheath do you can shower.
• I was back to cooking meals within a week. Knee would swell so I’d lie down after cooking, with leg elevated.

Everyone’s recovery’s different. You must work hard at it.

Mind over matter got me through both and I’m totally pain free, back at the gym, can shop in the High Street for hours 🙄, and walk in the woods & lanes around where I live with pain free enjoyment.

Good luck!

Which meds are you referring to, the blood thinners or Mounjaro? I queried both of them yesterday as the guidelines re Mounjaro and operations are to stop four days before so I was surprised when he said two weeks before and after. It is certainly something I will raise at my pre med visit. The consultant did say that the anaesthetist will make the final decisions re what method he will use ie spinal block or general, based my my heath and medical history.

The blood thinners were apparently because the meds I am on are a lower dosage than the ones I need to take. I was concerned that there will be a gap between coming off the ones I use and taking the hospital ones ( after the op?) but he said it was a calculated risk.

I certainly will raise any issues, if I need to, I can speak to his secretary with any additional issues before I see him again - which I think will be on the day of the operation.

So much useful advice here, thank you. I had thought of getting a few of the things mentioned like a long handled shoe horn, protection for using the shower and a gel ice back knee wrap but p,entry more things to think about. I already have a picker upper thing and a wheeled walker with a tray which helps me get about my bungalow now ( to carry things mainly) and I use two walking sticks so am fairly adept at manoeuvring them! I need to look at a toilet seat and chair raisers but I might wait until after my next visit as there will still be time to get things from Amazon.

I am fully committed to the exercises, I’ve already started doing them and will push for quick physio, i think it will be at a gym close to me so I should be able to get taxis if I can’t get a lift.

Interesting about not being able to wear trousers, I do have a few pairs of old joggers which are now a bit big as I’ve lost weight so I could always cut one leg into shorts if needs be!

I will be reading any more advice very keenly

obvs speaking in general terms - no on here can give specific advice.... most recent guidelines are to just stay on the mounjaro if it's just for weight loss unless there are additional reasons to stop it. If they're saying not to take it for a couple of weeks post op (again, unusual) they'll need to advise what dose to start up on again - it may not be what you're on at the mo. Re the blood thinners, different drugs have different guidelines for pre-op stopping, but the longest I can think of is 7 days....2 weeks sounds a little unusual.

I've had 5 joint replacements. Both hips, both knees and an elbow. My knees were hardest. You need to get on top of the pain, you need to accept help and you 100% need a leg lifter. They are a couple of quid off amazon.

Let yourself rest. After the first 10 days it gets easier by the day and your bend improves as well. Once the staples or stiches are out you will feel a lot better. They have changed my life.

Edited to add - I managed leggings fine. Jeans are a bit sore over the incision for a while.

Leg lifter added to my list! It’s getting longer by the day but it’s great to have personal experiences of what is useful.

The pain is something I will have to work through, everyone has said how painful it will be but if I want my second knee done quickly, I have to show good outcomes from my first one, I will work hard and keep moving!

I understand the reason for stopping Mounjaro for long enough for it to be gone from my digestive system, as it slows down digestion which can cause problems if a general anaesthetic is used. Even if they start of with a lumbar injection, they need to be ready for worst case situations when anaesthetic is then needed. I guess I’ll discuss that with the anaesthetist as my pre op checks. I can also check with the pharmacist where I buy my Mounjaro, he has said that a gap of two weeks would mean starting again at 2.5 mg. I need to do more research.

Re blood thinners, I only know what the consultant told me but then again, I might have heard him wrong or misunderstood. I think it is something I will run past him again.

Thanks for drawing my attention to such things, it’s helpful to think about what I need more information about.