Frequently Asked Questions Concerning Total Knee Arthroplasty


Patients are rightfully trying to become more educated about their surgery and recovery. They often obtain (mis)information on the Internet or from friends. They need to be informed about their surgeon’s individual postoperative protocol, and they need to have their anxieties relieved when “things happen” during their recovery.

For years, measures had been in place at our hospitals to try to address this. These measures included a preoperative dialog with the surgeon, and a preoperative teaching class was available that could be attended at the time of the preadmission screening tests.

What was missing was a document that the patient could refer to regarding events that might arise before, during, and after their hospitalization. To address this need, G. Erens and I created a brochure to be given to each patient when surgery was scheduled. Initially, the answers given to each question were our own responses. The concept became attractive to all members of the arthroplasty staff, and the brochure was modified for use by everyone. A disclaimer was attached to remind patients that they were being given general information and they should always contact their personal physician with any questions or concerns.

Many patient website portals are being established by individual orthopedic practices and hospitals to address preoperative and postoperative patient communication. These will usually contain many of the patient questions and issues discussed in the following section. Each surgeon or practice can customize these questions and answers. Commercially available websites are also becoming established.

Categories of Questions

Questions from patients were collected in three categories: preoperative, perioperative, and postoperative. Perioperative questions were divided into those that might arise in the hospital and those more likely to be asked soon after discharge.

In addition, three very frequent concerns of patients—depression, insomnia, and constipation—were specifically addressed.

Some things that normally occur after total knee arthroplasty (TKA) might be alarming to patients unless they are aware that their symptoms are within normal limits. These events include an intermittent clicking sensation inside the knee, an area of skin numbness on the outside part of the knee, swelling after exercise and at the end of the day, warmth around the knee, and palpable sutures under the skin that are not apparent until the swelling begins to resolve.

Worrisome things also can occur during recovery that are definitely abnormal and require an immediate call to the physician. These include increasing redness around the wound, increasing pain and swelling, fever over 101°F, any drainage from the wound, calf swelling or pain, ankle swelling that does not decrease or resolve overnight, and bleeding gums or blood in the stool or urine.

The Answers

This section provides possible answers to frequently asked questions. These are not meant to be definitive answers; rather, they are guidelines that different surgeons might modify to fit their own practice routines.

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