You have been identified as a patient on the waiting list for a total knee replacement. Here you will find all the information you need to prepare for your surgery and get the most out of your new knee.
Some of the information in this document has been provided by Versus Arthritis — the UK's largest charity dedicated to supporting people with arthritis. Please take some time to read all the information in Section 1 and familiarise yourself with the exercises in Section 3. You should aim to complete these exercises 2–3 times per week until your surgery.
Once you are confident with these exercises, you should also aim to complete at least one of the videos from Section 4: Let's Move for Surgery each week.
What to do now
- Your operation, your appointment or your admission
- NHS — my secretary, Evy Sennett: 01924 543584
- Private — Spire Methley Park Hospital switchboard: 01977 518518
- Your exercises or prehab programme
- Your physiotherapy team NHS patients can message them through PKB, the patient portal, or call the NHS hospital switchboard on 01977 747391.
- Anything else, or if you cannot get through
- enquiries@bagouri.uk Please include your name and a telephone number, and we will get back to you. Email is not checked out of hours, and it is not a secure way to send personal or medical details — so please ask us to call you rather than describing a problem in writing.
- If it is urgent, or you feel unwell
- NHS 111 — in an emergency, 999 Please do not wait for a reply by email.
Section 1: Your journey to the operation
Once you are listed for surgery, the Pre-operative Assessment Team will contact you to arrange a full assessment. This will include a review of your medical history, medications, and necessary investigations such as blood tests and swabs. The purpose of this assessment is to ensure you are medically fit for surgery and to minimise the risk of any delays or cancellations on the day of your operation.
When you receive your surgery date, you will be asked to attend an appointment with the Advanced Clinical Practitioner (ACP) at least two weeks before your operation. During the ACP appointment, your medical and physical health will be reviewed, and you will have the opportunity to discuss any concerns. Important information will also be provided regarding fasting, skin preparation, wash packs, and medication guidance (including what to continue and what to stop before surgery). If any concerns about your fitness for surgery are identified, these will be discussed with you to help optimise your health, prevent cancellation on the day of surgery, and achieve the best possible outcome.
As part of the ACP clinic, prior to seeing the ACP you will be asked to complete a questionnaire about your current health and function. This information contributes to the National Joint Registry audit and helps us monitor outcomes following surgery.
You will also meet the Physiotherapist, who will carry out a physical assessment, explain the exercises you need to start before surgery, and advise you on any home adaptations that may support a safe and early discharge after your operation. Exercise is an essential part of your recovery, so it is important to follow the advice provided. If you have any questions or concerns about your exercises, please feel free to ask the physiotherapy team during your hospital visits.
Sugar
High sugar intake around the time of surgery increases your risk of infection by lowering your blood cells' ability to fight infection. It is better to avoid high-sugar drinks and sweets during this period.
Smoking
Smoking is proven to increase the risk of developing complications and infections that may lead to failure of your surgery and the need to go back to theatre. This operation may be a good opportunity to quit smoking — if you need help, please let us know and discuss it with your GP.
Blood clots
Your risk of blood clots increases after surgery. You will be provided with medications and tight stockings to help reduce your risk. It is also advisable to keep hydrated and active during this period.
Section 2: Background information
Staying active is important if you're waiting for or recovering from surgery. If you're fit and strong, your surgery has the best chance of success, and you'll likely recover quicker.
Over time, exercise can also increase your mobility, help your balance and boost your mood. We know it can be difficult to take the first step. You might be nervous or not know what exercises to try when you're waiting for surgery. That's why Versus Arthritis created Let's Move for Surgery.
Why movement is so important before surgery
In this video you will learn more about the mental and physical benefits of keeping active while you wait for surgery. Keir, Sue, Lin and Leony, who all live with arthritis, describe their experiences and the impact that keeping moving had on their lives and their joint replacement surgeries.
Why movement is so important before surgery — youtu.be/gHNuMVmZdC4
Keeping track of your symptoms. If you are an NHS patient, there is a symptom tracker inside PKB, the hospital's patient portal. Please use it to keep a diary of how you are getting on — as often as you find useful, and at least once a month until your operation.
Section 3: Knee replacement exercises
These exercises are helpful for problems and pain affecting the knees.
Before you get started
- Remember to stay hydrated while you're exercising.
- Make sure you have plenty of space around you to avoid injury.
- It's a good idea to start slowly and build up gradually if you're new to exercise.
- If you have any concerns about these exercises, please message our friendly Physiotherapy team.
Knee exercises for arthritis and joint pain — youtu.be/nMkxh1Alz2A
Section 4: Let's Move for Surgery
You should aim to pick at least one of these videos to complete weekly, in addition to your total knee replacement exercises. However, these exercises have been designed to be done daily and to fit around your usual routine.
Knee replacement exercises for before and after surgery — youtu.be/LzJWxnNubSY
Section 5: How to keep active while waiting for surgery
Physiotherapist Milly provides advice on some of the best ways to keep active ahead of surgery, including: how to get started, how to make exercise work for you, how to form an exercise habit, and the importance of listening to your body and your healthcare professionals. Sue, Leony and Keir also share what worked for them as they prepared for surgery.
Keeping active before surgery — youtu.be/61kXUWlfLO4
Section 6: Why it is important to keep your joints moving before surgery
This animation illustrates the benefits of exercising and what happens to our joints when we exercise.
Why joints need to keep moving — youtu.be/J8RhxS_QydA
Section 7: Risks of the procedure and approach
In clinic we discussed the benefits and the drawbacks of this operation, and the approach we plan to use. We also discussed the risks. No operation is without risk, and the list below is not exhaustive — but these are the ones we talk through with every patient.
Risks that come with any major operation
- Infection. This can be serious. Rarely it can threaten your life or your limb, and it may need further surgery to treat — which can include removing the new knee.
- Bleeding.
- Injury to a nerve or a blood vessel.
- Risks related to the anaesthetic.
- Blood clots in the leg (DVT) or the lung (PE).
- A heart attack or a stroke.
Risks specific to knee replacement
- Pain or stiffness that lasts longer than expected.
- Loosening. Over the years the new joint can wear, and can work loose from the bone.
- Fracture — a break in the bone around the new knee.
- Instability — a feeling that the knee gives way, and rarely the joint coming out of place.
- Injury to a ligament, such as the medial collateral ligament (MCL), which is one of the ligaments that steadies the knee.
- Injury to a tendon, such as the patellar tendon, which connects your kneecap to your shin.
What recovery normally feels like. Most people have pain and stiffness for around 6 to 8 weeks after the operation. This is expected, and physiotherapy and painkillers help. In some people the pain and stiffness last longer than that.
Your scar
You will have a scar after the operation. It may be sore, it may feel numb, and in rare cases it can become very sensitive to touch. If that happens, massaging the scar with a moisturiser or E45 cream usually settles it.
What you have been given. A consent form, to take away, read and think about before you sign it; an information booklet; and a telephone number to call if you have questions.
If anything here is unclear, or you change your mind about any part of it, please get in touch before the day of your operation.