Knee replacement

[rothwell]

I am due to have knee replacement surgery in the near future but am worried about this as have read that there can be increased risk of problems for people who have AF such as wound infections, need for blood transfusion, post operative problems . Also worried about the fact that I take Apixaban. Have any of you afibbers had a knee replacement op?

[IanMK]

I’m not aware of the issues you mention. I would expect your surgeon and/or anaesthetist to discuss your medications, allergies and other health conditions with you beforehand. They should advise you whether or not to stop taking the Apixaban before the procedure.

Try not to worry about it or you may worsen your AF.

[Finvola]

If you type knee surgery into the search box at the top right, it will bring up some threads and posts which you may find reassuring.

[BobD Volunteer]

I think you are reading too much in the wrong places. There should be no difference because of AF although you will likely have to stop the anticoagulant for a day or so. We do have a member who had his done last year so he may respond.

[caznear68]

Hi Rothwell,

I had total knee replacement 3 years ago, feel reassured that all will be well, I had it done by spinal injection which I was so worried about but would do it again!!

I have AF which was also a big worry but all was well.

Tell people there what your fears are and they will be able to calm those for you. Just take your time and please do the exercises they give you when you come home they are vital to getting full movement back and also make sure you take the meds they give you as this helps with the exercises

all the best

carol

[Hidden]

Hiya rothwell,

I was diagnosed with paroxysmal AF in Jan 2010, aged 65. On 6 Nov 2015, aged 71, I had a partial knee replacement, right knee, medial compartment.

Look, we are all different and react differently to all types of surgery and treatments etc. but I feel you are worrying a little needlessly, although I do really understand where you are coming from.

By far and away your biggest worry will be post op, getting your flexion and getting your leg to work again and dealing with the initial pain. AF will cease to be of any concern for you.

Now, I have no idea where you are in this wide wide world but I am in Cornwall, UK and I was operated on by a brilliant surgeon as an NHS patient in a private hospital.

I am on Warfarin and have been continuously since Jan 2010. I was told to stop Warfarin a week before surgery. No sweat.

I was given a general anesthetic ( some people are given an Epidural ... and I don't know the criteria for either), but I was more than happy to be spaced right out. When I was back in the ward ( my own private motel room) I was given two doses of Fragmin by injection into the tummy area. Then I was told to restart my Warfarin with my usual dose, which is around 8 pm. This I did. No sweat. Fragmin is known as a bridging anticoagulant. I understand it to be very fast acting and is designed to prevent blood clots - a constant issue with AF as I'm sure you'll realise.

I was up and walking on crutches within 3 hours of surgery and discharge home on the 3 rd day after surgery. At no time was AF an issue for me.

Being on Warfarin I was 29 days from the day I stopped until my post op INR blood test which saw me back in therapeutic range again.

Your incision area will be well wrapped up and you'll be required to have the dressing removed at about the 3 week mark post op. You'll not be able to bath or shower as you won't be able to get your dressing wet.

There is shedloads more advice I could give you but I'll stop here as, depending where you are it may not be relevant.

Good luck - don't worry - you'll be fine. You got any questions just ask away or PM me.

John

[rothwell]

Thank you.

[jedimasterlincoln]

Normally we tell patients to stop Warfarin etc 5 days before, and you'll have an INR on the morning of admission. I've not dealt with pre-op hips/knees very often since moving into the spinal unit but we sometimes have patients 2 days + post operative and AF isn't usually a barrier or a worry