If you have been advised by the medical team caring for you that you may benefit from having a knee replacement then the following information will help ensure you are as prepared as you can be for your surgery and recovery.

• Pre-assessment information - You will be invited to attend the pre-operative assessment clinic before your operation. You will meet one of the specialist nurses who will ask you questions about your health and arrange appropriate tests such as blood tests and an ECG (heart tracing). This process is designed to make sure you are as physically ready for surgery as possible and also gives you information about what to expect so you can take time to think about whether you still want to go ahead.
• Knee replacement surgery advice
• Unicompartmental knee replacement advice

• Your spinal anaesthetic
• Anaesthetic choices for hip or knee replacement
• Receiving a blood transfusion
• Preventing hospital-associated blood clots
• MRSA
• Enhanced recovery for elective surgery

• It is important for you to continue any physical activity that you are currently doing, if able. It is known that the benefits of engaging in physical activity pre-surgery will positively influence your recovery. There are also additional exercises which may help to strengthen specific muscles and increase your movement in preparation of surgery. You should do these exercises before and after your surgery, to aid your recovery. These can be viewed below
• The physiotherapist will visit you either the afternoon of your operation or the next morning. We aim to have you up walking on the same day as your operation or the next morning. Physiotherapy will also provide an exercise program which will be the same exercises you were given at your pre-assessment appointment. 
• Total knee replacement advice and exercises.
• Partial knee replacement information and exercises.

Home environment 

It is essential to take time now to organise yourself at home so you will be able to manage safely and independently once you return home. Please read and act upon the recommendations and advice listed below prior to your hospital admission. 

Chairs

• Ideally your chair should have a firm seat, supportive back and arms to push up on.
• If your chair is low, you should make alternative arrangements. For example, you could raise your chair with an extra cushion or folded blanket under the existing cushion. Alternatively, borrow higher furniture prior to admission.

Beds

• Ideally your bed should have a well sprung mattress and should not be too low.

Toilets 

• Your Occupational Therapist will address any issues regarding the height of your toilet with you at the pre-op assessment or telephone consultation. 

Equipment 

• If you are provided with equipment on loan to support your toilet transfers, you will need to arrange the collection from the following suppliers which will be determined by your GP address. 
• For Berkshire GP's contact NRS Berkshire on 0344 8936960, 
• For Buckinghamshire GP's contact NRS Buckinghamshire on 0345 1238248
• For Surrey GP's contact Millbrook on 0330 1241247
• For Hampshire GP's contact TCES community on 01256 476800

Washing 

• When you first return home it is advised that you have a strip wash at a basin rather than getting into a bath or shower. You may want to consider having somewhere to sit while you wash, this could either be sitting on the toilet seat or using a suitable high stool/chair. 
• You may use a shower within a cubical when you are confident you can step into the shower safely and do not need a mobility aid to maintain your standing balance. It is advisable to have someone with you the first time you access your shower. 
• You may be able to use an over bath shower if you can be supported by a family member to step into the bath. We do not advise you attempt to step into or out of the bath by yourself. It is not advisable to attempt to sit down in the bath. 
• Following surgery do not attempt to lean forward to wash below your knees. Using a long- handled sponge to wash your feet or ask someone for help. 
• Hair may be washed sitting on a stool leaning backwards at a bowl or basin. You will require assistance with this. 

Dressing

You must bring take clothes to wear in hospital that are loose fitting. These are easier to get on and off, and it will also promote a sense of normality and be more comfortable when doing your rehabilitation. Please bring in flat non-slip footwear. 

• When getting dressed sit on a chair or bed. You will find it easier to dress the operated leg first and to undress it last. Avoid bending forward to reach your feet and do not bring your operated leg up to allow you to put shoes/socks on this side. 
• The Occupational Therapist will demonstrate useful dressing aids and ways to dress. It may be useful to have long handled shoehorn and grabber to support lower limb dressing. These can be purchased online or mobility shops 

Daily life

• Move essential items around the home to a height you can reach comfortably. 
• Place tea/coffee, mugs and kettle together in one place on the kitchen worktop to reduce the need to mobilise around the kitchen unnecessarily.
• Plan to have easy to prepare meals in the first few weeks after your surgery, this may include tinned items or frozen meals. Keep essential food items in easy to reach places e.g. milk at waist height in the fridge. 
• Initially after discharge, you will not be able to carry items around the home if you are using a walking aid. You may need to consider sitting in the kitchen to have meals/drinks, or a bag carried across your body to transport items to the lounge/dining room in sealed containers. 
• Ask relatives or friends to help with heavier domestic tasks, i.e. laundry, vacuuming, making beds, housework and shopping, for the first few weeks after your operation. 
• Remove all loose-edged mats to prevent tripping. 
• For your comfort avoid bending down to the floor to pick items up. Consider purchasing a helping hand to enable you to pick up light items such as post or newspaper etc.

Animals 

• If you own pets, consider the needs of your animals prior to admission and make any necessary arrangements for their care. Please note you may find it extremely uncomfortable in the first few weeks to bend down to the floor to tend to your pet. 

Leisure activities  

• When participating in leisure activities be aware of the limitations of your hip and adjust them accordingly

*If the operation was on your knee you don't need to worry about your hip angle.

Advice on getting in and out of a car

Everyone is an individual and every sport challenges your new knee in a different way. Your physiotherapist will be able to guide you as to when you can return to your activity.

You need to be able to perform an emergency stop safely before resuming driving. You will need to contact your insurance company and notify them of your recent surgery to ensure when you return to driving you are covered appropriately. On average, most people return to driving at six weeks once they have seen the physiotherapist or consultant. 

• Walking aids. 
• Slippers or trainers – please no mules. Please note your feet and ankles may swell following surgery so your regular footwear may not fit. 
• Loose fitting daytime clothing. 
• Loose fitting nightwear and dressing gown. 
• Personal toiletries. 
• Long handled aids – shoehorn, Helping hand, clearly labelled with your name. 
• Current medication in labelled boxes. 
• Any splints/braces you usually wear. 
• Glasses, hearing aid, dentures etc. you usually wear. 
• Money in small amounts for Patient line telephone and television – Frimley Park only.
• Please do not bring valuables into the hospital.