How do I prepare for a knee surgery?

The most important part about a surgery is your active participation in making sure your body is primed for surgery, and your conscientious effort in going through rehab and physical therapy. How well your body gets prepared, and how well you recover is entirely dependent on you. Here are four things you need to know while waiting for the day of your surgery.

1. Listen to your orthopedic specialist

Your orthopedic doctor will advise you on exactly what to do. Some of the key items you may be expected to do include:

  • reducing the swelling in your knee area through the RICE (rest, ice, compress, elevate) method
  • control any pre-conditions you have (blood sugar level, etc)
  • keeping the affected leg mobile with pre-operation physiotherapy and stretches
  • wear a knee brace to stabilize your affected knee
  • move around on crutches to reduce weight-bearing on affected knee
  • get plenty of rest

You may also be asked to visit the doctor closer to the date of surgery for him to make a final assessment of your condition and readiness to go through with the surgery. It is also important to note that if you fall sick and remain so on the day of your surgery, it is highly likely the operation will be postponed. So keep yourself healthy and rest well.

2. The doctors will explain to you the risks involved

Every surgery has risks. It is important that you fully understand the risks, and clear any doubts you have with your doctor before agreeing to the procedure. There are various risks for a knee surgery:

  • If you’re using a donor graph (allograph), there is a small risk of the body rejecting the graph
  • If you’re using a graph / tendon from another part of your body, there is a chance that area will experience slight weakness
  • If you have pre-existing conditions and you’re on medications, there may be other risks to note
  • Surgery-related risks include blood loss, blood clot and infection

You will also be talking to an anesthetist (also a doctor!) who will explain sedation and the corresponding risks for the different types. For knee surgeries, you will hear about:

  • general anesthesia (GA) – you will be asleep throughout the surgery
  • regional / local anesthesia – you may be awake or sedated during surgery and cannot feel pain
  • a combination of both, to help you cope with the pain post-surgery

The risks of general anesthesia and the side effects you may experience differ for every patient.

3. Fasting before surgery, stopping medications

You’re always required to fast before a surgery. This may be between 6 to 12 hours. If you didn’t fast, there is a chance the food and acid from your stomach will backtrack into your lungs. General anesthesia relaxes the muscles in your digestive tract, so it’s important to keep your stomach empty so nothing will flow into your lungs.

You can have 1 or 2 sips of water, but that’s it. Remember, the instructions from your doctor are important to follow.

Sometimes, your doctor may suggest you stop taking your medications before the procedure. Follow the instructions carefully. If you are allowed to take your medication, and you need wash the pills down, remember to take very small sips as necessary.

4. Know that there will be pain!

I was given a combination of GA and nerve block anesthesia (local anesthesia) on my thigh to help me cope with the pain during my ACL surgery. I did not feel pain in the first 24 hours, and I was already walking with elbow crutches within hours of my surgery, unaided!

I absolutely regretted exerting myself so soon after the knee surgery. When the regional anesthesia wore off the next day, I was not ready for the pain (even though I had oral painkillers). I decided to fully rest in bed a couple more days before I felt ready to walk around the house.

My experience with GA and local anesthesia was great. There was no pain, to post-surgery side effects – all I remember was being hungry an hour after waking up. My high school buddy (we’re the same age) was very nauseous post-surgery, and vomited several times. An older relative, who went through total knee replacement for both knees, experienced dizzyness and vomiting. She also could not urinate a few days after surgery, and was using the catheter for almost a month.

It’s important to prepare yourself mentally and physically for an upcoming knee surgery, so remember to ask as much as possible. The best people to ask questions are your doctors, and it wouldn’t hurt if you know someone who’ve gone through the same surgery to share their experience.