I'm due for a knee replacement shortly but am still on clopidogrel after a MI in April. The Osteo surgeon will want me to stop clopidogrel

[Redneck1]

for ten days prior to surgery.Is this possible ? I desperately need the TKR as I am very immobile, which doesn't help the heart condition.

[warfarin1]

You should talk to your surgeon about this, however the following is an extract from Southampton University Hospital Trust info for patients.

What should I do with my warfarin / aspirin / dipyridamole / clopidogrel if I am due to have surgery?

The doctor will decide whether, on balance, it is safer for you to stop or to continue with your medicine. This will depend on several factors including the type and complexity of the surgery you are due to have and the reasons why you are on the medicine. If the doctor wishes you to stop taking these medicines then you will be told this when you are put on the waiting list or prior to surgery.

What should I do if I take aspirin, dipyridamole or clopidogrel?

If you are advised to alter your aspirin, dipyridamole or clopidogrel medication: Stop taking the tablets 10 days before your operation Start taking the normal dose again the day after your operation

What happens if I forget to stop taking my aspirin, dipyridamole or clopidogrel?

If you forget to stop the tablets we may not be able to do the operation because of the risk of bleeding. In this situation another date for surgery will need to be arranged.

[Redneck1 in reply to warfarin1]

Thanks for that. I have spoken with the Surgeon and he is in contact with the cardiologist, I was just trying to pre-empt the situation. I am so frustrated that I am unable to get around much with the knee problem.

[FatherofHan]

You need to discuss this with your cardiologist also.

The need for the clopidogrel after your is very dependant on what the cardiologist did at the time of the heart attack. If a stent was put in your coronary artery then the cardiologist may be a little concerned about stoping the clopidogel so early

[Redneck1 in reply to FatherofHan]

Thanks, as you will see in my answer to warfarin I am in a 'Catch 22' situation where I am unable to exercise very much due to the 'shot' knee and the lack of exercise impacts adversely on the cardiac condition. You are correct with the stenting, albeit there was only one fitted and the cardiology team are totally satisfied with the outcome and my progress and have now discharged me from their care.

I honestly believe that the lack of mobility was a prime factor in the MI because 18 months ago I was happily walking 3 miles a day to get the 'paper and I would go cross country walking with a friend for anything between 5 to 11 miles on one day in the week. I imagine that stopping the clopidogrel will only be for a fairly short period to aid clotting of the TKR wound and I would then be safe to resume it. So, to my mind it boils down to what's the best cardiac outcome, no exercise for another six months or take a chance that the stent might get a little furred ? Not easy.