Full knee replacement

[plopper]

I'm going to have a full knee replacement. Anyone have any afib problems during or after?

[Jalia]

I await the replies to this with interest as my surgeon wants me to undergo this as well! I am trying to hold out 😬

I had total hip replacement 4 months ago and this had no effect on my AF. The anaesthetist did ask for me to have a cardiac consultation and echocardiogram prior to the op.

[Hidden]

Hi there,

I had a partial right knee replcement (medial compartment) in Nov 2015.

No sweat !

A few things though ..... I am on Warfarin ( Coumadin) and had to stop it 6 days before surgery. After surgery when I was returned to my room I was given two injections of Fragmin ( a bridging anticoagulant ) then resumed my normal Warfarin dose that evening at my normal time. No sweat. No AF.

The fact that I was on Warfarin and self test made life easier because I could show the anaesthetist all my INR readings as far back as he wanted to see.

The tricky stuff starts when you get home trying to juggle a normal life with the exercise demands you have to buckle down to and do religously. Although NHS gave me a brochure on exercises and when to do them and how frequently I found YouTube had some very good short vids of exercises.

Anecdotal evidence suggests that knee replacements are much more demanding - IN EVERY WAY - from hip replacements. You must focus on the exercises - if you don't it will impact on your later recovery and ability to walk properly again later on.

I was advised to consult a massage therapist ( over and beyond what the NHS wanted me to do ) and as soon as the dressing was removed ( about 10 days post op ) and I was given the all clear regarding no infection I did this. She gave me deep massage on, over and around the incision line this had the purpose of minimising scar tissue and preventing it from forming deep inside. If this develops your ability to do exercises will be severly reduced and it will affect your recovery.

I was back driving my manual car in 8 weeks and my manual bus in 11 weeks. Never looked back. At no time did AF ever raise its ugly head. But then my AF is highly controlled anyway with medications and diet.

If you think of anything just ask away.

John

[Desanthony]

No problems at all with my persistent AF. Had my second successful cardioversion about two months before with 12 weeks of amiodorone 6 weeks before and 6 weeks course after cardioversion.

Was told to stop apixaban for 36 hours before op and then on half dose for a month after the op. All surgeons may have different ways of handling the medication. This caused no problem with AF at all.

I did need to have manipulation under anaesthetic (MUA) about 5 months after the op as I couldn’t get the movement in the joint they expected me to get. The surgeon blamed that on the fact that he couldn’t give me anti inflammatories because I was on apixaban but I had warned him before that I healed quickly and the quick healing would mean that a slow approach to physio might result in this happening so can’t say it was just because he couldn’t give anti inflammatories or if it was because of my natural healing processes - probably a mix of both maybe? I had no trouble with wound healing, bleeding or bruising - plenty other people on the ward had more bruising than I did and they weren’t on apixaban. I had physio every week at the hospital for 6 months and did my exercises as often as I could and then again and again - you really can’t do the exercises often enough. Best tip was take your pain killers and 20 mins later when they have kicked in do your exercises so you won’t get too much pain whilst doing them. Take the painkillers as prescribed regularly don’t think you can do without them far better to take them and get your exercises done properly than to try and be “brave” and skip the painkillers and not do the exercises often enough or well enough.

To be honest I had good enough movement before the MUA and got to a 90 degree bend and probably enough for most but because they had got 130 degrees when they had finished the operation they thought I should get more. A quick overnight stay and manipulation under anaesthetic and I had 120 degrees of movement - this was no problem - no pain or anything - only kept in overnight because went in at about 6 for the MUA at the end of the surgeon’s list - probably had I gone in earlier in the day I would have been out the same day. I had been told I would not be able to kneel down after the op which I have to do a lot of when gardening because of a bad back and neck but now I kneel down to do the weeding and planting. I am so pleased to now be able to walk without using a trolley thing - which is what I often had to do in the 9 months or so I was waiting for the operation and wish I hadn’t left it so long before getting it done. I was 76 when I had the op and wish I had done it years previously as my knee had been bad for probably 6 years - though my dodgy hip had to be dealt with first. The difference this has made to my posture etc is amazing and has taken a lot of stress off my back and neck to the extent that I take fewer painkillers for my chronic back and neck pain which had just got worse and worse whilst my hip and knee were deteriorating.

I did go back into AF about 2 months after the op about 3 weeks after I came off the amiodorone. Then had another cardioversion which lasted for 15 months.

Hope this helps.

[pottypete1]

My wife had a full knee replacement in February.

It was very painful for about 3 weeks.

After that it gradually became more easy.

Walking comes soon but don’t do too much too soon.

However as Hidden said, the most important thing to do is the exercises they give you. Do them religiously at least twice a day.

I cannot comment on the AF question you ask because it is me who has the heart problems not my wife.

Hope it all goes well for you.

Pete

[rosyG]

I had a short episode after surgery, while in ICU, for both knees ( both on same day) but I get AF if my potassium falls and of course one fasts for so long- it's worth making sure the anaesthetist is aware as they could check your levels and top up if need be. You'll be put back on anti coagulation as soon as safe so it shouldn't be a problem

[Carolx in reply to rosyG]

Good Morning That must have been very hard work.

I didn’t think they did both knees at the same time.

I’m waiting for double knee replacement. I have early stages Dilated Cardiomyopathy and was told by my surgeon at Guys hospital they will have to do one knee at a time.

[Jalia]

Wow rosyG, both knees at same time 😱....were they full knee replacement ? I've been hearing how painful the op is so can't imagine 2 at the same time!

[Carolx in reply to Jalia]

I thought the same as you Jalia. I was told they can’t do both my knees at the same time, as I’ll need to be able to walk to be discharged.

[rosyG]

Hi Carol,I had to be assessed by the anaesthetist to see if fit enough to have both done at the same time. Hi Jalia, my surgeon felt that it would be hard for my other knee to support the new knee as both were bad The risk of complications is 1.5 with two knees at the same time but that compares with 2x1 when done separately The reason I was keen to do it was that in August 2020 there was no vaccine and covid numbers had dropped to 3 in Epsom where I live and we knew numbers would be much higher in the winter to come.

The pain is quite manageable . The pain killers after surgery didn't suit me so I had panadol only for a couple of days and later Co Codamol I'm a real baby so you would be fine! Swelling etc is difficult for a while so lots of icebags needed and lots of rest and lots of exercises before surgery.!

[Desanthony in reply to rosyG]

I forgot to mention buy in loads of ice bags so that you have one or two on the freezer and one being used.

[SuziElley]

Had mine done under a spinal anaesthetic and no problems at all, apart for pulmonary embolism after the surgery…….

[rosyG in reply to SuziElley]

that's a shame Are you ok now? were you put on anticoagulants`/

[LaceyLady]

I had a partial knee replacement November 2019, no problems. You make sure the surgeon/consultant knows all your health conditions.

[SuziElley]

Fine. Still on Apixaban but partly because of atrial tachycardia and partly as a result of the PE.

[plopper]

Went and got a second opinion and was told I didn't need a knee replacement. Trying physical therapy and if that don't work arthroscopic surgery.