Will I need any tests before I have a knee replacement?
About six weeks or so before your operation you will have an appointment for a 'pre-admission' or 'pre-assessment' clinic. At this clinic a nurse will assess your fitness for your knee surgery.
There are several tests that may be needed and they include:
- Blood tests - to check that you aren't anaemic and that your kidneys and liver are working well enough for you to undergo the operation.
- Urine test - to make sure you haven't got a urine infection and that there isn't any glucose in your urine.
- Blood pressure.
- Infection screen - this includes looking for meticillin-resistant Staphylococcus aureus (MRSA). MRSA is a germ (bacterium) that is difficult to treat and can cause complications of a knee replacement.
- A heart tracing (electrocardiogram, or ECG).
You may have the chance to speak to an anaesthetist, physiotherapist, occupational therapist or social worker at this clinic but this isn't always possible.
Are there any other things to consider?
Risks and benefits
Make sure that at some point before your operation, you have the opportunity to discuss all the potential risks of the surgery for you. This should be clear and in plain language that you understand fully. If you have other medical problems, such as heart disease, diabetes or a tendency to deep vein thrombosis or if you are obese, you should also have explained to you how these things may increase the risks of the operation for you.
What type of anaesthetic will I need?
There are two different types of anaesthetic for this operation:
- A spinal anaesthetic
- A general anaesthetic
At the pre-assessment clinic you can talk about the type of anaesthetic for your knee replacement. An anaesthetist will explain to you which type of anaesthetic is most suitable for you but your preference will always be taken into account. Most people have a spinal anaesthetic.
Care after the operation
Please give some thought as to how you will be looked after once you have had the operation, well in advance. Most people like to be independant, but you are going to need support with day-to-day activities for a while. If you have an able-bodied partner, this might fall to them, but otherwise you may need a friend or relative to come and stay with you for a while. Some people may arrange to stay in a care home until they have their mobility and independence back.
Further reading and references
Mini-incision surgery for total knee replacement; NICE Interventional Procedures Guidance, May 2010
Carr AJ, Robertsson O, Graves S, et al; Knee replacement. Lancet. 2012 Apr 7379(9823):1331-40. doi: 10.1016/S0140-6736(11)60752-6. Epub 2012 Mar 6.
Hofstede SN, Nouta KA, Jacobs W, et al; Mobile bearing vs fixed bearing prostheses for posterior cruciate retaining total knee arthroplasty for postoperative functional status in patients with osteoarthritis and rheumatoid arthritis. Cochrane Database Syst Rev. 2015 Feb 4(2):CD003130. doi: 10.1002/14651858.CD003130.pub3.
Ferket BS, Feldman Z, Zhou J, et al; Impact of total knee replacement practice: cost effectiveness analysis of data from the Osteoarthritis Initiative. BMJ. 2017 Mar 28356:j1131. doi: 10.1136/bmj.j1131.
What is done in a MUA ? Is it an orthoscopic procedure ?denis18446
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