Total Knee Arthroplasty ERAS
In a total knee arthroplasty (also called knee replacement surgery), damaged parts of the knee joint are removed and replaced with artificial implants. It's most commonly a treatment for osteoarthritis, a condition characterized by the breakdown of joint cartilage.
Our total knee arthroplasty ERAS program is designed to help patients return to health more quickly after undergoing the procedure.
The objectives of our Enhanced Recovery After Surgery (ERAS) programs are to:
- Make this an optimal surgical experience for you, our patient
- Incorporate innovative pain medications to improve your postoperative pain control while decreasing your narcotic needs
- Prevent potential surgical and anesthetic complications
- Reduce the amount of time you are in the hospital, with the goal of discharging you home after one to two days
- Decrease the likelihood that you will have to return to the hospital after discharge
- Return you to a higher level of function and ability than before your surgery
- Your surgeon will meet with you to explain surgical plans and set expectations for your surgery.
- If questions arise, contact your surgeon via MyChart or call the Orthopaedic Clinic: 214-645-3300.
- You will receive instructions for surgery and medications via a phone call prior to surgery. You might also be scheduled for an appointment in our Pre-Surgical Testing Clinic to meet with our anesthesia team or have bloodwork drawn.
- We may request testing or records from your other physicians.
- Call our Pre-Surgical Testing Clinic with any questions: 214-633-4202.
- Lifestyle modifications:
- You must stop smoking for one month prior to surgery, and we encourage you to stop consuming alcohol for one month prior to surgery.
- We encourage you to increase your physical activity prior to surgery as tolerated. You will receive specific instructions during your pre-surgery physical therapy visit regarding exercises to do at home. You will also be asked to attend a joint bootcamp where you will learn more about your surgery, recovery, and the steps to help you along the way.
- Eat a balanced, healthy diet high in protein and remain hydrated throughout the months leading up to surgery. Your physical strength before surgery is important to recovering well after surgery.
- Three days before surgery:
- Apply mupirocin nasal ointment (betadine swabs if you’re allergic to mupirocin). This is done to minimize risk of infection.
- On the night before surgery:
- Do not eat solid foods after 11 p.m.
- Shower with Hibiclens® (which you will receive at your clinic visit).
- You can drink clear liquids (such as water, Gatorade, or Sprite) until two hours before your surgery start time.
- On the day of surgery:
- Shower with Hibiclens®.
- Drink either a bottle of water or 20 ounces of Gatorade on the way to the hospital, at least two hours before your surgery start time.
- In the pre-op area, you will receive non-narcotic pain medications (celecoxib and acetaminophen) to reduce your postoperative pain. If you are at high risk for nausea, you might be given medicines before surgery to decrease this risk.
- Most patients receive a nerve block before surgery. The nerve block uses local anesthetic to decrease your pain after surgery.
- You will receive either spinal anesthesia or general anesthesia.
- With either option, you will be comfortable and “sleeping.”
- Unless you have back problems, blood clotting problems, major heart problems, or are on blood thinners, a spinal would be the preferred option.
- Your anesthesia team will monitor you very closely during the surgery and will insert additional intravenous (IV) lines if necessary.
- You will receive multiple medications during surgery to treat pain and nausea.
- There will be a specific and tailored anesthetic protocol to decrease the stress on your body, improve pain, and accelerate your recovery.
Post-Anesthesia Care Unit (PACU) and After
- You will wake up in our Post-Anesthesia Care Unit (PACU).
- Physical and occupational therapy will be an essential part of your recovery. When possible, you will start physical therapy on the same day as your surgery.
- Beginning on the day of surgery, it will be important for you to get out of bed and walk with help from your nurse or therapist.
- Unless instructed otherwise by your nurse or surgeon, you should be able to eat a normal diet a few hours after surgery.
- You will take scheduled non-opioid pain medications during your recovery and have narcotic medications available for breakthrough pain, if necessary.
Important Contact Information
- Pre-Surgery Testing Clinic: 214-633-4202
- Orthopaedic Clinic:
- Dallas location on Inwood Road: 214-645-3300
- Richardson/Plano location on Waterview Pkwy.: 214-645-4116
- Anesthesiology website