Total Knee Arthroplasty ERAS
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