Tip:
Highlight text to annotate it
X
You doctor has recommended that you undergo knee replacement surgery. But what exactly
does that mean?
The knee is one of the most complex and one of the most important joints in your body.
Let's take a look at the way the knee joint works.
The knee is made up of four bones. The femur, which is the large bone in your thigh,
... attaches by ligaments to your tibia.
Just below and next to the tibia is the fibula, which runs parallel to the tibia.
The patella, or what we call the knee cap, rides on the knee joint as the knee bends.
When the knee becomes diseased due to arthritis or other injury the bones rub together causing
pain and can even restricting the ability to walk.
No matter what the cause, one of the most effective ways to fix a damaged knee is to
replace it surgically.
In this procedure, the ends of the femur, tibia and patella are replaced with a metal
joint which restores freedom of movement.
Knee surgery is a major operation, but your doctor believes that the procedure --followed
up with physical therapy and time to heal -- will result in reduced pain and greater
mobility.
On the day of your operation, you will be asked to put on a surgical gown.
You may receive a sedative by mouth and an intravenous line may be put in.
You will then be transferred to the operating table.
In the operating room, a nurse will begin preparation by shaving your leg.
The surgeon will then apply antiseptic solution to the skin and place a sterile drape around
the operative site.
Next, the anesthesiologist will administer anesthesia by injection and using an inhalation
mask.
After you are unconscious, your doctor will make a vertical incision in your leg above
your knee.
Using retractors to pull back the skin, the surgeon will make a second incision in the
muscle in order to expose the damaged knee joint.
Next, your doctor will remove the patella, or knee cap, and flex your leg to expose the
surface of the joint.
Preparing the surface of the joint involves removing the damaged or diseased parts of
the bone and then cutting and shaping the surface to allow the best fit possible for
the artificial joint.
Once your doctor is satisfied with this preparation, the team will drill holes in the femur and
tibia.
They will also prepare the inside surface of the knee cap, and then coat the bony surfaces
with a special cement.
The metal pieces of the new joint are then installed on the tibia and femur, as well
as the knee cap pad.
Finally, your doctor places a spacer on the tibia surface.
After a final check to make sure all components fit and that the leg can move freely, the muscle
and other tissues are closed with sutures.
Following surgery, sterile dressings are applied.
To aid in healing, your knee may be stabilized with a brace and you will be encouraged to
use crutches during the recovery process.
Germs are present always on your hands and they can be transferred to:
* other parts of your own body, * to the family member for whom you are caring
* your patient * and to any clean object that you touch.
By washing your hands correctly:
* you remove germs from your hands. * Handwashing is the single most important
way you can prevent infection from occurring and
* prevent the spread of infection.
You must carefully wash and dry your hands:
* Before and after each time you care for your family member or your patient.
* Before and after you handle your patient's and your own food and drink.
* Before and after you manipulate any contact lenses.
* Before you apply and after you remove gloves * After you use the toilet.
* After you cough, sneeze or blow your nose. * After contact with anything that could be
soiled or have germs on it. * After you pick up any object from the floor
* Handwashing takes a minimum of 10-15 seconds, * longer if your hands are soiled.
* The longer you wash, the more germs are removed.
* The friction generated by rubbing your hands together removes the germs from your skin
and * running water can then wash them away
* Every time you wash your hands, take your time and don't rush.
* Do the handwashing carefully and thoroughly.
Use liquid soap from a dispenser. Bar soap holds germs on its surface.
Make sure you have paper towels and a waste receptacle nearby.
Remove all jewelry from your hand except a wedding band and push your watch and sleeves
up, away from your hands. Turn on warm water.
Point your fingers down to prevent water running onto your arms and wet your hands.
Apply soap from the dispenser. Point your fingers down and rub your hands
vigorously together in a circular motion. Star counting seconds at this point.
Intertwine your fingers to clean all surfaces of the fingers.
Rub your fingernails against the palm of the other hand to get soap under the tips of the
nails. If your nails are soiled, clean under them with an orange stick or brush.
Keep your hands down and continue to rub them together in a circular motion until the end
of your count for 15 seconds. Keep your hands down and rinse them from the
wrist to fingertips. Pick up a clean paper towel and turn off the
water, still keeping your hands pointing down.
Discard the paper towel into a waste receptacle Pick up another clean paper towel and carefully
and completely dry your hands. Discard the paper towel into a waste receptacle.
The key points to remember are:
* that friction is critical for removing germs * and the friction should be applied for at
least 15 seconds. * Always keep your fingers pointed down
* and turn off the water with a paper towel.
The supplies you will need to have easily accessible in the bathroom include:
* Clean clothing * skid-proof plastic bath mat
* 2 washcloths * 2 towels
* soap * shampoo
* plastic pitcher * skin lotion
* comb and brush * disposable gloves
* and a sealable plastic storage bag
Ensure that the bathroom is pleasantly warm, around 70. Place the skid-proof plastic bath
mat in the tub and fill one-third of the tub with warm water. Test the temperature of the
water with your hand. Wash and carefully dry your hands.
Put on your disposable gloves. Help your patient undress and place soiled
clothing in the plastic bag in the laundry hamper.
Help your patient sit on the edge of the tub. If there is a grab bar on the back wall of
the tub, have the patient hold it with one hand.
Swivel and lift both legs into the tub. From the back, support your patient under
both arms and help him slowly lower his body into the water.
Encourage your patient's independence and have him do as much of the washing as possible.
You may need to assist in such areas as the patient's back and to rinse off all soap with
the shower extension or a pitcher. If it's shampoo time and the patient cannot
do it himself, you can have him hold a dry, folded washcloth
over his eyes to protect them. Pour clean, warm water over the patient's
head using a pitcher or a shower extension. Rub in shampoo and massage the patient's head.
Rinse off the shampoo with clean warm water using a pitcher or a shower extension.
Dry the hair If possible have the patient stand and help
him dry his upper body. Otherwise, dry his upper body and arms with him sitting in the
tub. Let the water out of the tub.
With the towel over his upper body, help the patient sit on the edge of the tub.
Support the patient and help him swivel his legs over the edge of the tub. He can rest
for a while, if need be. Help dry the rest of the body, paying attention
to under the arms and other skin creases and between the toes..
Apply body lotion to the skin and help the patient dress.
After making your patient comfortable, return to the bathroom, place soiled towels and washcloths
in the laundry bag, clean the tub and mop the floor.
Remove your gloves, discard them into a plastic storage bag. Seal the bag and place it in
the trash. Carefully wash and dry your hands.