If you are reading this article, my assumption is that You or a loved one are planning to have a Total Knee Replacement surgery. The information I am about to share is based on that assumption, and is the result of what I have seen work, after knee replacement surgeries, in terms of quick recovery, better pain management and improved mobility. After spending the past six years (I am a home health administrator) managing the recovery of 100s patients that undergo joint replacement surgeries, the following are what I have seen produce the best results in terms of preparation for the surgery.
What Does Really Work?
Like anything in life, proper preparation guarantees the best outcome and for knee replacement proper preparation is the difference between recovering in days, and spending months in painful after surgery follow ups and corrective procedures. Here are five things you can do to get the best results when it comes to knee surgery:
1. Propulica the Surgeon!
All orthopedic surgeons are not created equal. Choose an orthopedic surgeon with a proven record, in knee replacement surgery. Propuplica is a non-profit organization that allows you to make an informed choice about any surgeon, by accessing detailed
previous performances and rates surgeons accordingly. It rates surgeons based on their historical complication rates and more importantly it tells you how they fair against their peers. After you are referred by your Primary Care Physician (PCP) to a surgeon, my advice is that you run their name through this tool and you will find yourself much more informed about the surgeon. Remember your PCP might be referring you to a friend or a colleague, whom he or she had a long standing relationship which could affect their judgement, and even if their recommendation is on point, having this objective tool to validate their referral, will put you at ease about the surgery.
2. Ask Questions!
Once you settled on a surgeon, set an appointment for initial assessment. While the job of the surgeon is to review your medical condition and asses your medical needs, your focus should be on interviewing them. Remember you are hiring them and not the other way around, so don't be intimidated and prepare a list of questions to ask. It's important that you engage the surgeon and have at least a pre-written 10-15 questions that you need answers for. If you are a smoker for example or a diabetic, ask them what extra steps or precautions you need to be aware of, to guarantee the best outcome. Giving them your past medical history, is not enough, so make sure you get your questions answered by the surgeon, in person and verbatim.
3. Exercise is King! I mean that!
Now that you have chosen the right surgeon for the job, you need to fully comply with their orders. One of those orders will be a list of pre-surgery exercises you will need to follow, on a daily basis prior to the surgery. These exercise are essential to your recovery as they can help strengthen your knee, improve flexibility, and help you recover faster. I can't stress enough how important it is to follow these exercises, to have the best results. Here is a link to some of the common exercises recommended for pre surgery preparation. I am only including the link for illustrative purposes and it's imperative that you follow your surgeon's recommendation when it comes which exercises to do.
4. Tweak your home for (surgery) success!
To make your home safer and easier to navigate during recovery, Mayo Clinic recommends that you consider making the following improvements to your home prior to going in for the surgery:
• Create a total living space on one floor since climbing stairs can be difficult.
• Install safety bars or a secure handrail in your shower or bath.
• Secure stairway handrails.
• Get a stable chair with a firm seat cushion and back, and a footstool to elevate your leg.
• Arrange for a toilet-seat riser with arms if you have a low toilet.
• Try a stable bench or chair for your shower.
• Remove loose rugs and cords.
5. Accept and Avoid Rule!
Accept Physical Therapy!
Depending on your medical condition, the surgeon will recommend either home health therapy after the surgery, outpatient therapy or both (usually in succession), again do your homework and chose your providers based on their past performance. Once again you are hiring so choose wisely. Medicare's home health compare for example, is a great tool that you can use to rate a home care agency based on their health care outcomes, as well as their patient satisfaction rating. For outpatient therapy, health grades has ratings tool you can use to help you chose the right outpatient physical therapy for your knee.
Finally let's address the 800-pound Gorilla in the room! Knee Infection! Nothing hampers your recovery like a nasty infection. In knee replacement, they are very easy to avoid, yet they are the number one reason why rather a smooth ride to recovery town, becomes very bumpy all of a sudden. To avoid post-surgery infections, include an infection plan in your pre-surgery planning. Infections after a knee replacement are not common, but are nightmarish when they occur so avoid them at all cost. Make sure one of the questions you ask your surgeon during the interview is: What systems do you have in place to make sure I don't get knee infection after the surgery? Any good surgeon will walk you through their infection control plan which should include: pre, during and post-surgery plans. Dr. Howard J. Luks who is an orthopedic surgeon has an excellent article on knee infection prevention, that anyone who is planning to undergo a knee replacement surgery, should read.