Search

Preparing for knee replacement surgery post-COVID

At Stadium Clinic, Bristol’s orthopaedic clinic, we know that preparation for surgery is always worthwhile. The Covid-19 pandemic presents additional challenges to patients having knee replacement surgery, so below I have listed some areas to think about. Although please bear in mind that your medical team will support you with any decisions you take.





Post Covid Challenges


Delay


Your surgery has probably been delayed due to the pandemic. It may be that your fitness has suffered? If you have other health conditions (such as diabetes), are they as well controlled as they can be? With reduced access to the GP, have you been receiving the usual monitoring and treatments for other health conditions?


Covid-19 and surgery


There are a range of opinions and some research relating to the risk of simultaneous surgery and Covid-19 infection. Mortality might be increased when the surgery and Covid-19 are combined. Both Covid-19 and surgery are challenging to your body and we should do everything we can to avoid the two occurring simultaneously.


Access to Physiotherapy


Is face-to-face physio from a sports injury clinic available in your area? If the answer is ‘no’ then that needs to be factored into decision making. At the time of writing it is available in Bristol.


Peri-operative isolation


This varies according to location, health and type of surgery. Usually, it is between three and fourteen days before and after surgery. The purpose of the isolation is to reduce the risk of having surgery and Covid-19 at the same time.


Covid-19 testing


Most hospitals will test you with a lateral flow or PCR test before surgery.


Vaccination


Most organisations recommend avoiding surgery around the time of vaccination, although this time period varies.





Other challenges


Here are some things that are always worth thinking about when you are waiting for a knee replacement from your arthritis clinic or orthopaedic clinic.


Rehabilitation planning


You must contact a physiotherapist and plan your recovery before the surgery! This will make a big difference to the outcome. You don’t want to come to the post-op surgery clinic with a stiff knee and story tale of difficulty in accessing physio.


Practice with the mobility aides


Will you need crutches or a frame for a few weeks, have you tried them? How will you manage the stairs? Try them out before surgery.


State of mind


How long do you believe the recovery to be? Are you hiding from this question? Ask the surgeon. If you know anyone else who has had this exact surgery ask them, though remember that experiences vary significantly.


Prepare the home


There a lot to consider, make a checklist.

  1. Toilet and kitchen: Is the bedroom on the same floor as the essential amenities? You will probably be ok on the stairs but it will be difficult for a few days. Some patients set up a bed in the lounge if that is on the same floor as the toilet.

  2. Toilet and chair height: Low chairs and toilets can be difficult to get up from. Particularly important for hip replacements where a low chair can increase the risk of dislocation of the hip.

  3. Tripping hazards: Carpets, rugs and cables? Do some reconnaissance and tidy up these hazards.

  4. Food! What will you eat and drink? Can any preparation be made in advance, food and drink will be the building blocks for your recovery.

  5. Companionship: A human being not only keeps an eye on us and brings you cups of coffee but also keep us company. There will be ups and downs, don’t be left isolated

  6. Work: How long will you need off? Everyone is different, jobs differ. In general, don’t expect to be doing any desk duties for at least 2 weeks. You won’t be buzzing around at speed for 6-8 weeks and you certainly won’t be doing any lifting, carrying or climbing ladders for 12 weeks.

  7. Driving: Manual or automatic? Left or right? Things to consider include your ability to execute an emergency stop and what drugs you are taking. In general, don’t expect to be driving for 8-12 weeks.

Prepare your family and friends


Don’t assume that they know as much about your surgery as you do. You won’t be driving them to town or doing their shopping for a while. You certainly won’t be doing their laundry or cleaning. Can somebody reliable stay with you for a few days after surgery?


Be actively involved with decision making


Take part in the decision making. Your surgeon will discuss various strategies such as minimising the risks of blood clots. It’s always a balance between avoiding too much bleeding and swelling caused by the blood thinners vs the risks of blood. There isn’t a perfect answer and the risks are relatively low but they are yours to take.


Prepare your workplace


Does your employer understand the surgery? Get them on board before it takes place. You can get back to desk work once you are off the strong painkillers, light duties within a few weeks and any work requiring driving, walking or lifting is going to take several months. Talk through the work requirements with your surgeons.


This list is not completely exhaustive, so make your own and let me know of your experiences.

I hope your surgery goes well.


Damian Clark


If you’re suffering from knee pain and looking for an early arthritis clinic, contact us for a consultation today.