Timeline for Knee Replacement & Resurfacing Surgery (What to Expect)

Surgery Scheduled with Joshua Hickman, MD

  • Read entire packet of information
  • Visit website www.joshuahickmanmd.com
  • Make a list of all current medications including dosages and times taken. This must be brough to your preoperative appointment.
  • Recieve primary care physician clearance for surgery if instructed by Dr. Hickman's office. If recommended by Dr. Hickman schedule Prehab with a physcial therapist. This should be completed before your preoperative appointment.

Two Weeks Prior to Surgery

  • Stop all anti-inflammatory medications. (Aspirin, Diclofenac, Naproxen, Ibuprofen, etc.)
  • Make sure to attend your preoperative appointment with any questions you may have.

Day Before Surgery

  • Hospital will call with instructions of arrival time, etc. 
  • Bring your own loose-fitting clothing for therapy
  • Nothing to eat or drink after midnight
  • Bring a list of medication including dosages and instructions to the hospital
  • Bring this Mountain Orthopaedic packet with you to the hospital
  • If you use a CPAP machine bring that with you as well
  • Scrub the knee with the scrub brush given to you at your preoperative appointment

Day of Surgery

  • Upon arrival you will have lebs drawn and IV placed
  • IV antibiotics will be given 30 minutes prior to surgery and for 23 hours after surgery to prevent infection
  • You will be given spinal anesthesia (we work to perfect the optimal anesthesia and pain control as well as decrease nausea)
  • You will receive a nerve block, which significantly decreases pain after surgery
  • Surgery time will be 1 hour and 15 minutes
  • You will be given minimal sedation to relax and sleep through the surgery
  • No tube will be placed down your throat. You will breathe on your own during surgery
  • We will wear special suites and practice sterile techniques in an effort to prevent infection
  • A small incision is made to preserve muscle. The implant will perfectlly match your anatomy and will allow for normal function and motion
  • A drain is placed for blood recovery allowing us to use your own blood for reinfusion. It is very rare to receive a blood transfusion
  • Bulky dressing and ice is placed
  • You will be in the recovery room for 45 minutes
  • Specialized nurses trained in joint replacement recovery will welcome you to the floor. Our staff takes pride in serving your needs and routinely is ranked at the highest level of quality care
  • Blood from the drain will be washed and returned to you by IV, this is your own blood and eliminates the need for pre-donation blood and results in minimal need for transfusion
  • The drain will be removed
  • Your diet will consist of solid foods and you will have several menu choices
  • There are no restriction on light to normal activities
  • Issues such as driving, bathing, getting in and out of vehicles, putting on clothes, and routine daily activites will be discussed 
  • Important Tasks on Day 1
    • Sit up in bed, eat regular food, and drink
    • Urinate on your own (if not within 4 hours of arrival on floor, notify the nurse)
    • Deep breathe
    • Stand and get out of bed with staff assistance
    • Walk the halls with assistance
    • IF THESE TASKS ARE ACCOMPLISHED YOU MAY GO HOME - 40% GO HOME THE FIRST DAY

First Day After Surgery

  • Dressing removed
  • Physical therapy in the morning and afternoon
  • Discharge planner will meet with you regarding home therapy or rehab center treatment
  • You will recieve a blood thinner to prevent blood clots and you will need to take as directed
  • You will recieve pain medications orally in the hospital as will as an IV anti-inflammatory medication
  • You will go home with pain medication. GET OFF PAIN PILLS as soon as possible. Narcotics will not be refilled after 4-6 weeks
  • An occupational therapist will discuss issues from home with you including driving, getting in and out of vehicles, getting dressed, and other helpful home tips
  • Please notify the staff of any issues with urinating but keep in mind that difficulty with bowel movements is normal (it could be several days before you have a bowel movement)
  • You will recieve instructions regarding your incision, medications, compression hose, and bathing

1-3 Weeks After Surgery

  • You should not have a dressing. If spots or drainage occur cover with sterile gauze and light tape (this is common)
  • You may get your incision wet with soap and water, but do not soak it
  • Peel off tape strips and clean incision 2 weeks after surgery
  • No hot tubs or under-water baths for 4 weeks
  • Outpatient Physical Therapy is preferred
  • You may start outpatient physical therapy anytime you feel ready, but no later than 10 days after surgery
  • Remember, WALK, WALK, WALK, and then ICE and Elevate
  • May cross legs. When bending past 90 degrees, keep legs apart and elbows between legs
  • You may participate in activity as tolerated
  • Fever around 100 degrees in the first week is normal
  • It is common to have bowel difficulty, however, notify our office if you go several days after leaving the hospital without a bowel movement
  • Leg swelling to some degree is normal
  • Some bruising and swelling and redness is normal. It is common to have some numbness around the incision
  • Worrisome findings include: drainage from wound, redness that increases, shortness of breath or chest pain, fever of 102 or higher, and dramatic new leg swelling
  • CALL DR HICKMAN AFTER HOURS IF YOU HAVE CONCERNS - Dr. Hickman or someone from his staff is available 24/7 for questions or concerns. 
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  • IF YOU GO TO A REHAB CENTER YOU SHOULD STAY NO MORE THAN 14 DAYS. GO DIRECTLY TO OUTPATIENT PHYSICAL THERAPY AFTER REHAB. A PHYSICAL THERAPY PRESCRIPTION IS IN THIS PACKET UNDER ORDERS

3-6 Weeks After Surgery

  • It is common to be stiff and sore at the end of the day
  • It is common to be stiff after sitting
  • Anti-inflammatories (Ibuprofen or Naproxen should be taken twice a day as long as you have cleared with your primary care physician)
  • You should need less pain medication and ompletely off it by week 6
  • There are no restrictions on activity, in fact increasing your activities is good for your recovery
  • You should have completed physical therapy by 6 weeks after surgery
  • Worrisome findings include: drainage from wound, redness that increases, shortness of breath or chest pain, fever of 102 or higher, and dramatic new leg swelling

3-4 Months After Surgery

  • Less stiffness, however stiffness can still exist
  • Sore at the end of the day
  • Activity should be near normal and you can increase to heavy activities without any restrictions