Dr Sanjiv,I am planned for routine total knee replacement end of the year.What do I have to do prepare myself for best outcome of operation?Total Knee Replacement Malaysia patient guide for pre operation preparation

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Dr Sanjiv my mum is planned for right total knee replacement ,I have a few questions for you?

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Is there any diet restrictions before operation?

There is no diet restriction before operation.Our unit will try to cater for different types of cuisines and requirements during your stay in hospital.

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Should she stop all medication especially her hypertensive and diabetic medication before operation?

No,the patient would benefit from continuation of medication and will be advice upon admission to the unit.

What time do I need to start fasting and why?

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Patient would be required to nil by mouth 6hours before operation just in case general anaesthesia is needed to delivered.Total knee replacement(TKR) are usually done by regional anaesthesia eg spinal anaesthesia which usually sufficient time to complete surgery. Patient will be continuously hydrated with intravenous fluid throughout the pre operation period.

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When can I stand after my operation?

Routine I encourage my patients to stand at the end of the day on same day of surgery as it helps in preventing blood clots and deep vein thrombosis.

Would I need blood transfusion and has the blood been screened for hiv and other diseases?

Routinely patients planned for TKR would not need transfusion .

What can I do to make the surgery successful even before operation?
Patient would benefit from learning foot pump exercises and exposed to mobilisation with walker to have a smooth post operative recovery.

What is the importance of standing after operation?
Standing after TKR is important to improve blood circulation and avoid dreaded deep vein thrombosis (Blood clots).

How do I go to urinal if I have a catheter in me right after operation?
There is no need to go to toilet as catheter will drain urine.Catheter is usually kept in situ after operation when post operation anaesthesia is given.

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I’m allergic to stainless steel .do I have to declare it?is it important?
Allergy to different kind of trace elements are important as it can cause allergic reason and complicate recovery and affects the implant longeivity.
Usually the treating surgeon would order for allergy screening test and will use an hypoallergic implant or specific implant that would reduce the chances of allergy or early wear/loosening.

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When can walk upstairs myself after operation?
Usually by week 1-3 you should be able to ambulate with ease.

Timeline Activity Treatment
Day 1 Get plenty of rest and walk a short distance with help. Try to bend and straighten your knee, using a CPM machine if needed.
Day 2 Sit up and stand, change locations, walk a little farther, climb a few steps with help, and possibly shower. Try to increase your knee bend by at least 10 degrees and work on straightening your knee.
Discharge Stand up, sit, bathe, and dress with minimal help. Walk farther and use stairs with a walker or crutches. Achieve at least 70 to 90 degrees of knee bend, with or without a CPM machine.
Weeks 1–3 Walk and stand for more than 10 minutes. Start using a cane instead of crutches. Keep doing exercises to improve your mobility and range of motion. Use ice and a CPM machine at home if needed.
Weeks 4–6 Start returning to daily activities like work, driving, travel, and household tasks. Keep doing your exercises to improve your mobility and range of motion.
Weeks 7–12
Start returning to low-impact physical activities like swimming and stationary cycling Continue rehab for strength and endurance training and work to achieve a range of motion of 0–115 degrees.
Week 12+ Start returning to higher impact activities if your surgeon agrees.

Feel free to contact the website or staff nurse for a consult on knee arthritis or total knee replacement in Petaling Jaya Malaysia at rampalsurgerypatients@gmail.com.

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