Good morning all, After a second visit to the Consultant yesterday, it was confirmed that a knee replacement should be done whilst I am a fit and healthy 74 year old, in spite of being in constant AF, bit of a pain, I am now wearing down the bone on one side of the knee, ouchy. My question, one of my biggest worries is that I am on Apixaban, the Consultant is not at all happy about it, says it’s a poison! It can exacerbate bleeding after an op. Any experiences please?
Knee op: Good morning all, After a... - Atrial Fibrillati...
Knee op
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A poison???? How does the consultant justify that? EP and cardiologist both said it was the safest anticoagulant.
I think you should seek a second opinion. I would be very dubious about relying on a consultant who comments like that on a well tried and tested medication.....any anticoagulant is likely to cause more bleeding which is why you may be asked to stop taking it for a short period.
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Odd behaviour since the first license for apixaban was to prevent blood clots post knee replacement I believe. Suggest change you consultant.
HiI had both knees replaced in August this year. You will have to stop apixaban a few days beforehand and they may give you short acting AC as you are in constant AF This needs to be discussed with your cardiologist well in advance. I had to stay off apixaban for a couple of days afterwards but they gave me a different AC by injection each day. I had some AF (4 hours) on the evening after my op while in intensive care- just 4 hours- so at a time when I was not anti coagulated and was fine. The hospital will have a protocol; which they will explain and it was very well organised. It is an advantage taking AC after surgery as reduces risk of DVT. If you want to Direct message me when you get to the operation and have any questions then do but the main thing at present is to do all the pre op exercises as they make a great difference. John on here has had his knees done and gave me some good advice.
Agree with Bob ad Flapjack that it's worrying you consultant dean;t know the protocol re AC
I would have serious doubts about any consultant who came out with such claptrap! As Bob said it was indeed first put forward for orthopaedic surgery to prevent post operative clotting. Also anticoagulation is standard practice in some countries, such as France , after any fracture. I found this out when I broke my leg when running down a mountain way back in 2004 when I could do such sporty things. Only back then it was abdominal injections for 14 days. Ouch.
I had a total knee replacement last October whilst on apixaban I had to come off 3 days before and I think went back on in 24 hours but at half dose for 2 weeks, but they did give me an anti clotting drug in hospital but can't remember what it was. It seems that it did delay my recovery a little because the inflammation was more so couldn't move my knee enough and early enough after the operations to do the strenuous exercises in the first few weeks. I also heal very quickly and always have, even on anticoagulants. So that didn't help it meant that after 3 months I had Manipulation under anaesthetic MUA to bend my knee to get more movement I had really good physio for half an hour every week to ten days for 3 months after the operations and did do all the exercises lots of times a day - which is important with my wife's help to try and get my knee bending enough - it was painful so be prepared. I am not saying this will happen to you as we are all different. My consultant said the same as yours that he didn't like anticoagulants but you know just like everything else they do their job. The same with a knee replacement once you recover you will be over the moon - free from pain and hopefully able to do things you haven't for a long while. I can now kneel down in the garden go for walks without pain and so on and so on. For your recovery do your exercises lots of times a day just a few and often. Oh and remember to take your pain killers as directed don't try and do without them its the only way to stay on top of the pain. My physio advised taking them 20 mins before doing my exercises to help me and that was good advice.
All the very best for your op.
btw the manipulation under anaesthetic worked brilliantly. It didn't cause pain afterwards - even though I had got my GP to prescribe more painkillers and from there on recovery was brilliant so if you have to have it then don't worry it works brilliantly. I was 76 having my op and am happy as anything to be back at the gym doing my usual routine - though obviously not whilst in lockdown but I have a bike and treadmill and weights at home to do what I can. It's so good that I can walk now without pain and can get out weather permitting to do exercise in the open air.
I would just like to thank all those who have replied in response to my question and worries about a knee replacement