What happens before the operation?

Patient assessment – your personal medical history

Your doctor will firstly ask you to give details of your complaints:

he will want to know where it hurts and where the pain radiates to. He will also ask about the intensity of the pain, its duration and any factors which intensify or ease the discomfort.

Question: What other questions will the doctor ask me?: - Have you suffered from knee disease in the past or do other members of your family suffer from joint pain?
- Do you have any allergies, in particular to antibiotics?
- Are you aware of any metabolic, cardiac or pulmonary disorders?
- Do you regularly take medication, and if so what kind?
- Have you undergone surgery before?
Tip: Ideally you should have taken some time beforehand to think about any illnesses and operations – on request, you can then present the doctor with a list of important details from your medical history. A list of medications which includes details of when and how much of each medication was taken is also very important. Some types of medication must be discontinued or changed prior to a surgical intervention. These include some anticoagulatory preparations, pain killers, diabetes medication as well as certain plant-based medication. Please consult your family doctor in good time before the operation!

Physical examination – where does it hurt?

The doctor will firstly examine your knee, pelvis, hips and spine and, when doing so, will palpate various muscles and bone structures. He will then perform a few movement tests in order to gain an impression of the mobility of the knee joint. He also examines the painfulness of various movements in the knee joint, such as rotation, bending and stretching.

X-ray – focus on your knee

Using the X-ray image, the doctor is able to recognise the changes caused by gonarthrosis: owing to a loss of cartilage the intra-articular space between the femoral condyle and the tibial plateau is either no longer uniform, narrower or indeed no longer visible. The bone structure of the femoral condyle and tibial plateau, and in some cases the kneecap, appears irregular and altered whilst in very advanced stages the sections of the joint are deformed.

Preoperative discussion – your chance to ask any questions

On the day before the operation, the surgeon will usually talk to you in detail about the operation. He will explain the surgical method and the type of prosthesis to be used. The prosthesis model selected depends on the nature of your bones, your body weight and your level of physical activity. The surgeon will have normally decided beforehand which prosthesis model and type of fixation to use on the basis of your X-ray and data. The anaesthetist will also talk to you on the day before the operation to explain the potential risks involved with the anaesthesia. He will also perform a few minor examinations; he is particularly interested in your heart and lung functions and any possible allergies. He will then talk to you about the type of anaesthesia to be used.

Question: What do I need to tell the doctor?: In the majority of cases, the surgeon will ask you about your state of health on the day before the operation. Do not hesitate to inform your doctor of any complaints which you consider minor, such as colds and skin infections, even if you are not asked. Although harmless, these illnesses need to be cured before a surgical intervention.

Autologous blood donations – find out more!

Under certain circumstances, large amounts of blood may be lost when performing a knee prosthesis operation. A blood transfusion then becomes necessary. An autologous blood transfusion using the patient's own blood which was donated at an earlier date essentially rules out the risk of infections such as Hepatitis C and HIV. As a rule, there is sufficient time between the diagnosis and the knee prosthesis operation (around two to six weeks) to discuss this issue with your attending doctor. Use this opportunity to be advised about the option of an autologous blood donation.