Full knee replacement

[George2467814]

Am booked for this op on 9/3/17...a little concerned to be told I shall be on Ibruprofen or similar following surgery to reduce swelling and inflammation. Also Co-codimal for pain relief for some weeks I'm told. Just hope they sort out my Warfarin Bisoprolol etc as I don't want AF big time while knee is mending. Anyone had similar op?

[Goldfish_]

Haven't you already had the answer?

healthunlocked.com/afassoci...

[CDreamer in reply to Goldfish_]

That related to Wafarin, not NSAIDs.

[Hidden]

Hi there George,

I had a partial knee replacement, right knee, medial compartment on 6 Nov 2015. I have AF, I am on Warfarin and Bisoprolol too. Surgery was under general anesthetic.

To the best of my knowledge if you are on warfarin you cannot take Ibuprofen or similar. You can only take Co-Codomol and I take 30/500 - prescription grade here in Britain.

The only change to my medication diet was Warfarin. I had to stop warfarin one week before surgery so that by the morning I went on the slab my INR was normal. After surgery, back in my room, the hospital team gave me two separate injections of a bridging anticoagulant - Fragmin. That evening I returned to my normal dose of Warfarin for that day (5 or 6 mg) and just carried on with my normal daily doses of Warfarin until my INR returned to 'In Range'. It took me 19 days to return to 2.0

I had no AF event at any time. But then my AF is controlled by both medication and diet and my last AF event was April 2015.

I was in hospital for 3 days and was not allowed home until I got a 90 degree bend in my operated knee and a reasonably straight leg. I had PT all the time in hospital, was on crutches and had to show I was mobile and could walk up and down stairs on crutches. I managed this but the pain was unreal, in hospital I was given a liquid morphine which didn't do anything for pain control and then they tried Tramadol - that did nothing either. I took my own supplies of Co-Codomol and that worked. After the dressing was removed - about 10 days after coming home I got a sports injury massage therapist to massage my incision line - the idea being to stop scar tissue forming inside the knee. I then did this at home myself using Aloe Vera Gel 99% and did it all the time I was exercising. Gradually I cut back the Co-Codomol till at 8 weeks I was back driving my car again and back at work driving a bus at 11 weeks. I was 71 at the time of surgery.

At no time did I have a problem with anticoagulation or with AF.

I have already given you more detailed comments on this - did you not get them ?

John

[George2467814 in reply to Hidden]

Very interesting as Intoo had partial knee replacements in 2002/3 so they have lasted well despite golf bowls cycling and swimming....but in those days I did not have AF that came along just 5 years ago. So this full replacement is a new experience.

[Cindy92159]

I am on Warfarin and have had both knees replaced in the last 11 months. Your Dr. will give you a drug like lovonox to "bridge" between surgery and restarting the Warfarin. He should give it to you for a period of seven days prior to surgery.

[George2467814 in reply to Cindy92159]

Thank you so much

[Barb1]

I have had 2 hip replacements and constantly had to remind staff that I could not take any NSAID s as I had AF. You should take paracetamol and codeine or the combined tablet Cocodamol.

[George2467814 in reply to Barb1]

Yes I agree .

[icklebud99]

Hi George 2467814. You cannot take ibuprofen if you are on Warfarin or other anticoagulation drugs as it can cause stomach bleeds. Surprised you were told this. I have had both hips replaced 6 months apart and stayed on AF drugs, Bisoprolol and Flecainide during operation but stopped Riveroxiban (anticoag) 5 days before op. I am on Tramadol and paracetamol for osteoarthritis in my spine which I continued to ease the pain of the hip replacements. Had no problem with AF during or after the op. Hope this helps.

[George2467814 in reply to icklebud99]

Glad it's ok for you will discuss with Hospital before surgery .Many thanks

[Plai]

Not had the op (yet) but my knee flared up and the doctor has given me naproxen for a week to calm it down. Apparently naproxen is not contra indicated with apixaban but my doc feels I should not take it long term. Ask your hospital and your gp about it. Also co-codamol is ok to take with apixaban as it is not an nsaid like ibruprofen and diclofenac. I suspect you shouldn't be off the warfarin or another anti coagulant for long. You may need to inject an anti coagulant. I have friends were expected to do this to avoid blood clot after replacement ops. Ask as many questions as you can from the health professionals.

[George2467814]

Thank will do just that.....