knee replacement A GUIDE FOR PATIENTS

knee replacement A GUIDE FOR PATIENTS
ENHANCED RECOVERY AFTER SURGERY (ERAS)
knee replacement
A GUIDE FOR PATIENTS
Please bring this booklet with you to all
appointments and when you come in for surgery
2
contents
PREPARING FOR YOUR SURGERY
Welcome 4
Individual surgeons specific instructions
5
What you can do to prepare for surgery
6
Risks of surgery
8
Pre-admission assessment
10
Types of anaesthetic
11
Before your surgery 13
Map of Burwood Hospital
14
YOUR STAY IN HOSPITAL
Your operation
15
Day 1 after your operation 16
Day 2 after your operation 17
Day 3 after your operation – going home 18
AT HOME
When you return home
19
Household tasks
21
Useful contact numbers / organisations
23
Space for questions and notes
24
3
welcome
THIS BOOKLET IS DESIGNED TO PROVIDE YOU
WITH INFORMATION ABOUT HAVING A TOTAL KNEE
REPLACEMENT.
It will explain how you can prepare for your surgery, what to expect during and
after your surgery and how to prepare for your discharge home from hospital.
It is recommended that you read this booklet thoroughly before your surgery
and write down any questions you may have in the space for questions on Page
24.
The better prepared you are for surgery, both physically and emotionally, the
quicker you will recover from it.
Your knee is a complex sliding / gliding / rotating joint controlled by ligaments. In a
healthy knee, smooth cartilage (known as articular cartilage) covers the ends of your
bones - this acts as a shock absorber, and if it remains healthy, you are able to walk easily
without pain. There is also even spacing between the bone which allows easy range of
movement.
In a problem knee, the cartilage space narrows and eventually bone rubs on bone. The
usually smooth surface becomes roughened and causes pain and stiffness.
The main reason your knee needs replacing is due to osteoarthritis. The knee is affected
by osteoarthritis more than any other joint.
Your knee has three compartments. One or more may be resurfaced in your knee
replacement operation.
Burwood Hospital uses the Enhanced Recovery after Surgery (ERAS) pathway. ERAS is a
programme that is dedicated to assisting your recovery so you can go home from hospital
sooner and return to your normal activities more rapidly.
Recovery from surgery is not the same for every patient. Some patients recover faster
than others depending upon age, health status, personal motivation and response to
rehabilitation. Once you are mobilising safely and medically well you will be discharged
home. For many patients this will be after 3 nights (4 days) following their knee surgery.
Support from family / whānau and friends is important for your recovery.
Please read the information in this booklet and watch the Joint Replacement Surgery
videos. These videos can be found on the Health Information for Canterbury website
(www.healthinfo.org.nz)
We encourage you to bring along one key person to your appointments, so they know what
is happening and can support you.
For this programme to be successful we need you to play an active role in
your own recovery.
4
INDIVIDUAL SURGEON’S SPECIFIC INSTRUCTIONS
5
WHAT YOU CAN DO TO PREPARE FOR SURGERY
CHECKLIST
In your information package is your CHECKLIST AND GOALS FOR PATIENTS HAVING
HIP OR KNEE REPLACEMENT SURGERY. It is important that you read and fill in this
checklist as it will help you plan for your surgery, prepare you for your hospital stay
and your safe discharge home.
Please continue to fill in this checklist and bring it with you to all appointments and
when you come in for surgery.
SMOKING
If you smoke we strongly advise you to stop smoking prior to and after your surgery.
Continuing to smoke doubles your risk of complications and slows healing after your
operation. If you need help to quit smoking, please contact your GP or Quitline (0800
778 778) or visit www.quit.org.nz. We have a ‘No Smoking’ policy in our hospital
and throughout our hospital grounds. To minimise withdrawals from nicotine, free
nicotine patches are available for the duration of your hospital stay.
ALCOHOL
We encourage you to minimise your alcohol consumption prior to and after your
surgery. Alcohol consumption significantly increases the risk of complications, slows
healing and can affect sleep quality after your operation.
EXERCISE
Building muscle strength in the weeks leading up to your surgery will speed up your
recovery. This includes arm and stomach exercises that will make getting in and out
of bed easier. Walking, cycling or swimming are also good exercises to build strength
and fitness.
MEDICATIONS
It is important that you follow the instructions about your medication(s) given to you
at your preadmission / anaesthetic clinic.
HEALTHY DIET
Make sure you are eating a healthy diet. Your body needs good nutrition to recover
well. If you are overweight, a total knee joint replacement can be more difficult to
perform due to there being more tissue around the knee. Recovery can also be more
difficult as there will be additional strain on your muscles and joints.
It can be hard to lose weight, especially with reduced mobility, but exercise and
changes in diet even without weight loss can reduce your chance of complications
after surgery.
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CHANGES IN MY HEALTH OR SKIN
We need to know at least two days before surgery if you have any of the following:
A cold or cough.
Skin problems – such as a sore (unhealed area), reddened swollen (infected)
areas, insect bites, agraze, pimple or eczema, especially around your operation site.
Burning pain or passing urine more frequently than usual, or a urinary infection treated by GP.
You are generally unwell - such as diarrhoea, vomiting or high temperature.
If you have been admitted to hospital since your last appointment.
Any alterations to your medication(s).
Any of these conditions could lead to the postponement of your operation. For your
safety it is important that we know about them prior to your operation.
Please phone us on the following numbers to discuss any concerns:
Office Hours:
Anaesthetic Co-ordinator:
(03) 3836836 Ext 99959
After Hours:
(03) 3836836 and ask for the Burwood Hospital Duty Manager.
WHAT TO BRING TO HOSPITAL
The CHECKLIST AND GOALS FOR PATIENTS HAVING HIP OR KNEE REPLACEMENT
SURGERY is a useful guide to prepare you for surgery. Please start filling in this
booklet as soon as you receive your pre-admission appointment.
VISITING HOURS
Visiting times are between 3 – 8 pm. Please check visiting times outside these
hours with the charge nurse.
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risks of surgery
WHAT ARE THE RISKS OF SURGERY?
Your surgeon will discuss with you the risks of surgery specific to your knee
replacement.
Knee replacement surgery is usually very successful, however it is a major procedure and as
such there are some complications that occasionally may occur. This booklet is not designed
to frighten or scare you, but to help you make an informed decision regarding your proposed
surgery. Some illnesses, smoking or obesity may increase your risk of complications. Though
complications are uncommon, when these occur they may delay or limit your full recovery.
INFECTION
The wound on your knee can become inflamed, painful and weep fluid. This may be caused
by infection. The majority of wound infections can be treated with a course of antibiotics and
often settle down following treatment. Your knee replacement may need to be revised if the
infection does not resolve. The risk of developing an infection following a knee replacement is
less than 1 in 100 patients.
DEEP VEIN THROMBOSIS (DVT)
This is the term used when a blood clot develops in the deep veins in the back of your lower
leg. Nursing staff will also give you medications to help reduce this risk and your surgeon may
request you have foot pumps initially following surgery.
Walking and keeping active as soon as you are able will help the blood flow and reduce the
risk of DVT. Nursing staff and physiotherapists will assist you with this.
PULMONARY EMBOLISM (PE)
This can happen when a part of a blood clot formed in your leg vein breaks off and travels
to your lung. The risk of developing a life threatening pulmonary embolism is very low.
Treatment involves additional medications and requires a longer hospital stay and may
require transfer to Christchurch Hospital.
DISLOCATION AND FRACTURE
Rarely breakage or dislocation of the artificial joint or bone fracture around the prothesis
occurs. Additional surgery may be needed.
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LOOSENING AND WEAR OF THE KNEE REPLACEMENT
The components of your knee replacement may loosen over time and may require further
surgery. A loose prothesis may occur due to infection, trauma, osteoporosis, or
wear of the polyethylene. However knee replacements, whether partial or total may wear
over time, requiring replacement of the bearing surfaces.
NERVE DAMAGE / NUMBNESS
It is usual to experience permanent numbness around the scar which can make kneeling
uncomfortable for the first year after surgery. Major nerve damage associated with knee
replacement is very rare.
PERSISTENT PAIN, STIFFNESS AND DISSATISFACTION
Although the outcomes following knee replacement surgery are generally good, not all
patients are happy with the result of their knee replacement.
Some patients continue to experience pain and stiffness. A degree of stiffness is still likely
following surgery.
BRUISING AND SWELLING
There is always swelling from blood / fluid build up inside the knee. This swelling can
fluctuate for a number of weeks, and gradually softens and resolves.
DYING FROM SURGERY
Death following knee replacement surgery is extremely rare.
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Pre-admission assessment
You will receive an appointment to attend a preadmission assessment. This will be
at the Outpatients Department at Burwood Hospital.
It is important that you are assessed prior to your operation to make sure you
recover quickly and reduce the risks associated with your surgery.
Most people will have their first appointment to assess their fitness for surgery with a
nurse in a pre-admission clinic.
At your pre-admission assessment appointment, you will be given the Occupational
Therapy Environmental Information Form found with this booklet to complete.
Please bring in all the medications you are currently taking including herbal products
/ alternative medications and supplements.
During your assessment the pre-admission nurse will ask you about your general
health, your medical history, and that of your family including any anaesthetics you
may have had. You will have investigations, such as blood tests, a heart tracing
(ECG), urine tests and X-rays.
This information will help your healthcare team consider any problems that may
either affect the risks to yourself or the likelihood of complications from the
anaesthetic or surgery.
The pre-admission nurse will give you time to ask questions about the possible
complications and give advice and education on your admission, the operation and
activities following surgery. Nothing will happen to you until you understand and
agree with what is being planned. If you do not want surgery or if you want more
information or more time to decide, please let the nurse know. You may change your
mind at any time.
Some patients need to be seen in a separate clinic by an anaesthetist prior to
surgery. If this applies to you, the pre-admission nurse will organise this. This
anaethetist might not be your anaesthetist during your surgery. If you do not need to
see an anaesthetist in clinic prior to surgery, you will meet your anaesthetist on your
day of surgery.
OCCUPATIONAL THERAPY
You will receive a telephone call from the Occupational Therapy Department 7 –
10 days before your surgery. Your occupational therapist will have received the
Occupational Therapy Environmental Information Form you complete. You will be
asked routine questions about yourself and your home, and how you are managing
currently, and your discharge plans for returning home after your surgery.
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Types of anaesthetic
Your anaesthetist will discuss different types of anaesthetic with you and plan
which type will be best for you. You will be asked to sign a consent form to have the
anaesthetic.
There are 2 common types of anaesthetic, a full general anaesthetic (GA) or a spinal
(epidural) anaesthetic block (SAB).
SPINAL ANAESTHETIC (SAB)
During a SAB, a sedative is usually given before a local anaesthetic (numbing drug)
is injected between the back bones at the lower end of the spine through a very
fine needle (like a bee sting). This drug quickly numbs you from your waist to toes
so you will not be able to move or feel your legs. During surgery you will be closely
monitored and most patients ask to be sedated. Often you will not remember much
due to the sedating drugs. Your surgery will take about 1 - 1 1/2 hours, whilst the
numbness usually lasts 4 - 6 hours.
Even if you are sedated during surgery you may be aware of your surroundings at
times, including noise.
Most patients are pleasantly surprised how well they feel after they have had a
spinal anaesthetic.
GENERAL ANAESTHETIC (GA)
As part of a GA, a drug is injected into your vein via an IV drip that makes you
unconscious so you do not remember anything about the surgery. When you are
under this anaesthetic the anaesthetist puts a tube in your mouth and throat to
ensure your breathing is controlled. Advantages of a GA is that you have no memory
of the surgery.
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WHAT ARE THE RISKS OF ANAESTHETICS?
Both types of anaesthetics are very safe but as with everything in life there are also risks
and complications can occur. Some complications can be serious and result in transfer to
Christchurch Hospital for specialised care.
The risks will be different for everyone depending on their general health, age and previous
problems (if any). If you have any concerns about any of these complications write them
down and talk to your anaesthetist.
SIDE EFFECTS AND COMPLICATIONS
VERY COMMON (1 in 10)
COMMON (1 in 100)
UNCOMMON (1 in 1000)
RARE (1 in 10,000)
VERY RARE (1 in
100,000)
Feeling sick and vomiting after
surgery
Slow breathing (depressed
respiration)
Damage to the eyes
- GA
Dizziness, blurred vision
An existing medical condition
getting worse
Nerve damage – SAB
Feeling faint
Headache
Chest infection - GA
Difficulty passing urine needing a
catheter
Muscle pains - GA
Damage to teeth - GA
Itching
Awareness (becoming conscious
during your operation) - GA
Aches, pains and backache
Serious allergy to
drugs
Pain during injection of drugs
Bruising and soreness
Confusion or memory loss
Sore throat - GA
Damage to lips or tongue (usually
minor) - GA
Deaths caused by anaesthesia are very rare,
about 1 in 60,000 for over 60 year olds.
CONSENT FORMS
Prior to surgery you will need to sign a consent form. This form will say that you agree to
the operation and the collection of specimens and technical data. A full explanation of the
surgery and risks will be given to you before you sign the consent form. You will also need to
give consent for anaesthesia, blood transfusion and joint registration.
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before your surgery
ASPIRIN
If you have been given an aspirin tablet by the pre-admission nurse (attached to your Pre-op
Medication and Fasting Instruction leaflet), please take it at the time instructed on the form.
CONFIRMATION OF REPORTING TIME FOR SURGERY
You will receive a telephone call from the Burwood Admitting Unit prior to your surgery to
confirm the time to arrive for your operation and clarify any questions you may have.
The day before your surgery
FASTING INSTRUCTIONS
If you do not follow these instructions your surgery may be delayed or
cancelled.
IF YOUR PROCEDURE IS IN THE MORNING
No food after midnight (this includes sweets, milk and chewing gum).
We encourage you to drink water up to 6.00 am.
You may be given a special carbohydrate drink in the Admitting Unit before
you have your operation.
IF YOUR PROCEDURE IS IN THE AFTERNOON
No food after 7.30 am (this includes sweets, milk and chewing gum).
We encourage you to drink water up to 11.30 am.
You may be given a special carbohydrate drink in the Admitting Unit before you have your operation.
MEDICATION
In the days leading up to your surgery, please ensure you take the medication(s) you have
been advised to take at your pre-admission / anaesthetic clinic (please refer to the Pre-op
Medication and Fasting Instruction leaflet).
KEEPING WARM
Please wear something that keeps you comfortably warm while you are waiting for your
operation.
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WHERE DO I GO BEFORE SURGERY?
Please report to the reception desk at the Admitting Unit at Burwood Hospital
at the time given to you.
Surgical Service (Ward GG)
Other hospital wards
ENTRY 1
MAIN ENTRANCE
BEST ENTRANCE
FOR VISITING
P
P
P
Staff Parking
VISITOR
PARKING
ADMITTING UNIT
GG
P
BU
RW
O
OD
RD
ENTRY 2
MAIREHAU RD
ENTRY 3
ENTRY 4
ENTRY 5
BEST ENTRANCE FOR
DAY OF SURGERY
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your operation
IN THE ADMITTING UNIT
The admitting nurse will prepare you for your operation and ensure that all your paperwork is
completed. Your surgeon / registrar and anaesthetist will visit you here prior to your operation.
Your surgeon / registrar will draw an arrow on your leg to be operated on. They will discuss the
consenting process surrounding your surgery and answer any questions you may have.
You are also likely to have an intravenous (IV) drip or cannula placed in your arm so that you can
be given medications.
IN THE OPERATING THEATRE
You will be wheeled to the operating room on a bed, as shown on the videos where the surgical
team will be ready to look after you. The team includes your anaesthetist and an assistant, your
surgeon and your operating theatre nurses. Once everything is ready, you will be given your
anaesthetic and the surgeon will perform the operation. Your anaesthetist will be with you all
the time during your surgery. Please be aware that when you arrive in the operating room it can
be very noisy.
IN RECOVERY / POST ANAESTHETIC CARE UNIT (PACU)
Following your operation, you will be transferred to the recovery room. Nursing staff will check
on you frequently, closely monitoring your condition to make sure you are safe and comfortable.
YOU MAY HAVE
An intravenous (IV) drip in your arm – this is used to give you fluids, antibiotics and pain medications.
A facial mask or nasal prongs to give you oxygen.
Foot pumps on for the first 24 hours, until you are mobile.
You will be encouraged to start your exercises and drink as soon as you wake up.
When recovery staff are satisfied that you have recovered safely from your surgery and
anaesthetic, you will be taken to the Surgical Service (ground floor, Ward GG).
Ward GG is divided into two areas, the Progressive Care Unit (PCU) and the ward. Many patients
will spend their first night in PCU.
ON RETURNING TO THE SURGICAL SERVICE (Ward GG)
You now have a new knee and your recovery has already started.
Many people will be helped to get out of bed on the day of surgery including using the commode.
You will be monitored regularly and encouraged to drink and eat as soon as you are able.
EXERCISES
It is very important you do limb and chest exercises. These will help prevent clot formation and
help clear your lungs. Aim for approximately 10 repetitions per hour while you are awake.
Foot and ankle exercises: Pump your feet up and down, and in a circular motion.
Quadricep exercises (these are the muscles in front of thigh): Push the back of your knee into the bed, tightening your thigh muscles and hold for 3 seconds.
Gluteal/ buttock exercises: Squeeze your buttocks together and hold for 5 seconds
Chest exercises: 5 deep breaths per hour.
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day 1 after your operation
The day after your operation, the aim is for you to become as independent as
possible whilst also staying safe.
You will receive help with tasks such as washing, dressing and walking to the toilet.
The day after your operation you can expect the following to happen:
You will continue to do limb and chest exercises regularly as shown in the Joint Replacement Surgery videos (Day of Surgery Section).
You will be eating and drinking normally.
You will be expected to sit in a chair for your evening meal.
Nursing staff will assist you with washing and dressing as required.
You will get dressed in your own night wear or clothes.
Your wound will be monitored and any drains will be removed.
You will have a crepe bandage wrapped around your knee. This will usually remain on for 24 - 48 hours following surgery.
Your physiotherapist will visit you to assess your walking and provide you with the best walking aid for your needs and you will commence your exercise programme.
You will go for regular walks with assistance and appropriate walking aid.
You should expect some pain after surgery, however you will receive regular pain relief medication to minimise your pain.
You will be taken on your bed to the x-ray department for a check x-ray of
your knee.
A blood test will be taken.
Your IV drip will be taken down.
You will get out of bed to the toilet or commode with assistance.
You will receive tablets to help prevent constipation or nausea if required.
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Day 2 after your operation
On the second day after your operation you can expect the following to happen:
You will be given regular pain relief medication.
You may have your crepe bandage removed from your knee. Please note
your knee will be swollen.
You will have a wash or shower and get dressed in your own clothes.
You will go to the toilet as independently as possible.
You will sit in a chair by your bed for your meals.
You will be expected to walk to the bathroom and go for regular walks
outside of your room.
Your physiotherapist will visit you to check you are able to undertake your exercises independently and can walk safely. They will also check you are safe to go up and down stairs (if you have steps at home). You will
be given the Knee Replacement Rehabilitation pamplet for your home
exercise programme, and information about your walking aids.
Your occupational therapist will assess your ability to manage everyday
tasks such as dressing and transferring on and off a bed, chair and toilet.
Your occupational therapist may loan you any further equipment you may need at home for a short term 8 week loan.
17
Day 3 after your operation - going home
After the third night in hospital many people will be discharged.
Usually this is done by 11 am in the morning.
You can expect the following to happen:
You will continue to receive regular oral medication.
You should be able to shower / wash, dress and go to the toilet independently.
You will go for regular walks outside your room and continue with your chest and leg exercises.
Your nurse will check your wound and discuss any cares required.
Your knee may remain swollen for 1 - 2 months following surgery. Continuing with your exercise programme will help reduce this swelling over time.
If your physiotherapist and / or occupational therapist were unable to complete your treatment yesterday, this will be completed this morning.
If you need any home support, this will be discussed with you and organised if you are eligible.
Nursing staff will discuss your discharge arrangements to ensure everything is in place for a safe return home.
Your nurse will discuss your discharge plan with you and give you your DISCHARGE
INFORMATION envelope. This will include a:
Discharge letter.
Follow-up appointment.
Prescription for any new medications.
Joint replacement card.
Discharge instructions card with contact telephone details for the first 48 hours following discharge.
Care & Removal of Stitches or Staples pamphlet.
Keeping Yourself Safe from Falls pamphlet.
Constipation – Following Surgery pamplet.
Please ensure that all medications and belongings that you brought in with you are
returned to you.
Support from family / whānau and friends is important for your recovery. The more
they are informed about your surgery and what you need, the more helpful they can be.
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When you return home
OPERATION SITE / WOUND CARE MANAGEMENT
Bruising and discolouration are common after surgery. Before discharge your nurse
will check your operation site / wound and discuss the care. Please refer to the Care
& Removal of Stitches or Staples pamphlet that is in your discharge package.
ONGOING HEALTH CONCERNS
If you have any concerns regarding your health within the first 48 hours after your
discharge from hospital, please contact us on (03) 3836834
or seek advice from:
Your GP or an After Hours Surgery.
The Emergency Department at your nearest hospital.
The following signs and symptoms are especially important:
Chest pain.
Calf pain or calf swelling.
Shortness of breath.
Fever or chills.
Ongoing nausea or vomiting.
Bleeding.
If your wound becomes red, painful, inflamed, or has any discharge.
CONSTIPATION
Constipation can be a serious problem. It is important that you contact your GP if you
have not passed a bowel motion for 5 or more days or earlier if you are concerned.
Please refer to the Constipation - Following Surgery pamplet for advice.
DIET
You may eat what you like unless you are on a special diet. We suggest you eat more
fruit, vegetables and fibrous foods. We also encourage you to drink plenty of fluid.
CRUTCHES / WALKING FRAME
Unless told otherwise by your surgeon, you can gradually reduce your reliance on
your crutches / walking aid provided you can walk without a limp. It may take a few
weeks to regain your balance and confidence.
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EXPECTED ACTIVITIES AFTER SURGERY
EXERCISES
Depending on your surgeon and surgery you may require ongoing physiotherapy.
Your physiotherapist will discuss this with you before you leave hospital.
You will be given a home exercise programme. It is very important that you continue
with these exercises at home. Please refer to the Joint Replacement Surgery videos
‘Exercises’ chapter to view these exercises.
The aim of surgery is for you to be able to gradually resume normal everyday
activities.
Please discuss with your surgeon any physical activity / sport that you may want
to return to. Strenuous activity should not be resumed until you discuss it with your
surgeon.
Avoid short and long haul flights in the first 6 weeks unless necessary, as you are at
a higher risk of a blood clot (DVT / PE).
Your knee may remain swollen for 1 - 2 months following surgery. Continuing with
your exercise programme will help reduce this swelling over time.
RETURNING TO WORK / HOBBIES
Following your surgery it is important not to take on too much too soon. Plan your
day so that you spend small amounts of time doing different tasks. Remember that
you need to rest when you are tired, preferably with your leg elevated.
Most people can usually return to sedentary jobs between six and eight weeks
following surgery. If your job involves stooping, bending, heavy lifting or operating
heavy machinery, it may be unwise to return too quickly.
If in any doubt, do not return to work without discussing it with your surgeon.
When returning to hobbies it is important to think about the actions you are doing
and how long the activity will take to complete.
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Household tasks
YOU ARE LIKELY TO FIND HOUSEHOLD TASKS DIFFICULT
WHILE YOU ARE STILL USING CRUTCHES OR A FRAME
You will probably need help with cleaning bathrooms, floors, vacuuming and
changing bed linen. Please ask your family/whānau and friends if they can help you
with this.
DRESSING AND UNDRESSING
Wear loose-fitting clothing.
It is recommended that you sit in a chair or on the side of the bed.
Dress the operated leg first and undress the operated leg last.
You may find it useful to use an easy reach.
MEAL PREPARATION
Avoid lifting heavy saucepans. Slide them across the bench instead.
The contents of your cupboards and refrigerator should be arranged so that essential
items are within reach without bending or stretching (between shoulder and waist
height).
If you live alone you may need a trolley to move heavier items across the room.
Your occupational therapist can provide loan equipment if needed.
You should think about using a stool to sit on while preparing food, washing up and
using the stove top.
Avoid using the oven if it is not waist height.
Small items can be carried in a backpack or an apron with pockets.
Think about using a frozen meal or meal delivery service.
LAUNDRY
Wash small loads of clothes over the week, rather than one heavy load.
Adjust the clothesline to avoid stretching or try using a clotheshorse for smaller
items.
SHOWERING
Use a shower chair or stool that has been adjusted to the correct height.
Do not have a bath. If your shower is over your bath, there is equipment available to
ensure safe transfers during showering.
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SHOPPING
Consider shopping for groceries on the internet.
Shop with someone who is happy to carry items for you.
Avoid shopping during peak times.
Do smaller, regular shopping trips to avoid heavy shopping bags and trolleys.
Have items packed into several smaller bags for easier carrying.
If possible, use a trolley to push your groceries rather than carry them.
If you must carry shopping, divide the weight evenly into at least two bags with one
in each arm, or try using a backpack.
CLEANING
If you have a Community Services Card you may be eligible for home help.
GETTING IN AND OUT OF THE CAR
If possible, get into the car on flat ground. This allows room for your mobility aid.
Ensure your seat is high enough to allow you to sit with your hips higher than your
knees. You may need to place a cushion on your seat to make it higher and firmer.
Have the passenger seat pushed as far back as possible with the back of the seat in
a recline position.
Back up to the seat as if you are backing up to a chair. Reach for the seat back or
dashboard, not the car door.
Gently lower yourself down to the seat, sliding your operated leg forward.
Shuffle yourself backwards into the seat as far as possible, leaning back against the
seat until you are able to bring both legs into the car.
Getting out of the car is done in the same way, only in reverse.
Tip: Sitting on a plastic bag makes moving your bottom around much easier.
DRIVING
You may not be able to drive for up to 6 weeks following your surgery. You should
discuss this with your surgeon. Before you return to driving you need to be able to get
in and out of the car safely and also control the vehicle in an emergency.
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Useful contacts / organisations
USEFUL CONTACT NUMBERS
USEFUL ORGANISATIONS
ANAESTHETIC CO-ORDINATOR
HEALTHINFO
SURGICAL SERVICE (GG)
QUITLINE
(03) 3836836 Ext 99959
After Hours:
(03) 3836836
and ask for the Burwood Hospital Duty
Manager
Burwood Hospital
(03) 3836834
OCCUPATIONAL THERAPY
DEPARTMENT
Burwood Hospital
(03) 3836845
PHYSIOTHERAPY DEPARTMENT
Burwood Hospital
(03) 3836833
Health information for Canterbury
This website has further information about
knee surgery including videos and other
useful links.
www.healthinfo.org.nz
0800 778 778
ARTHRITIS NZ
www.arthritis.org.nz
0800 663 463
MEDICAL ALARM (ST JOHNS)
0800 785 646
AGE CONCERN CANTERBURY
(03) 366 0903
0800 803 344
ASPIRE CANTERBURY
(03) 366 6189
www.aspirecanterbury.org.nz
GET BONE SMART
www.bonesmart.org
HEALTH NAVIGATOR NEW ZEALAND
www.everybody.co.nz
ACKNOWLEDGEMENTS
The primary source of this information has been derived from the National ERAS
Collaborative http://eras.hiirc.org.nz
This booklet also has contributions from Burwood Surgical Service and Taranaki District
Health Boards.
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space for questions and notes
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Ref: 3675ERAS Knee Replacement Patient Information - Surgical Orthopaedics
Authorised by: Nurse Manager, Burwood Surgical Services
May 2017
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