Steps before Total Knee Replacement Surgery

• Discussion with Family Physician
• Consultation with Orthopedic Surgeon
• Waiting list
• Scheduling of surgery date
• Additional consultations
• Preoperative hospital visit

In order to have a total knee replacement the patient has to go through certain routine steps. First, you need to discuss your arthritis with the Family Doctor. Your doctor will typically initiate the non-surgical treatments. Once you feel that such treatments are not adequately controlling your symptoms you should discuss with your family doctor whether you should consider surgical options.

If the decision is made that you may be a candidate for a knee replacement, your family doctor needs to arrange a referral to an Orthopaedic Surgeon for a consultation (self-referrals are not practiced in the Canadian health care system). Before seeing the orthopaedic surgeon, make sure that you have up-to-date knee x-rays (MRI is rarely if ever required). Please make sure to pick up the CD with the radiographs at the radiology facility where the imaging studies were done before the consultation date and bring them with you for the consultation.

During the consultation, you will be examined (interview, physical exam and review of the imaging studies) and the surgeon will tell you whether you are a candidate for a total knee replacement. Remember that the decision to have or not to have the surgery is yours. The surgeon is there to help you make that decision.

Once you have decided that you would like to proceed with the replacement, you are placed on the waiting list. Waiting lists are an unfortunate reality of our Canadian health care system and are due to limited access to the operating rooms and other hospital resources.

Once you have moved up on the waiting list, you will be contacted by the surgeon’s office to come for a scheduling appointment. Prepare yourself for it! You should have a list of questions about the surgery. That may be the last time you will see the surgeon before the day of surgery. During that appointment, the office staff will give you a date of your surgery and will set up additional appointments if necessary. They may include a consultation with Internal Medicine or Anaesthesia specialists and others.

Within a few weeks of the surgery, the hospital and/or the surgeon’s office will contact you for a pre-admission clinic appointment. During that appointment, you will learn a lot about your hospital stay. You may meet with a nurse, physiotherapist and a pharmacist. You will be given various instructions regarding your preparation steps right up to the day of surgery.