Total Knee Joint Replacement
Where Your Surgery Will Take Place
Your total knee replacement will take place at either:
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Southern Cross North Harbour Hospital, or
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Allevia Hospital Ascot
About two weeks before surgery, you’ll receive hospital admission details by email.
Please complete and return all admission forms electronically at least one week prior to your procedure.
Medications and Supplements
For 10 days before surgery, please avoid the following:
Anti-inflammatories such as Aspirin, Cartia, Brufen, Voltaren, Synflex, Naprosyn, Nurofen, Diclofenac, or Celebrex, and any supplements containing aloe vera, gingko, or arnica, as these can increase bleeding risk.
If needed, you may take Panadol, Codeine, Tramadol, or Gabapentin for pain relief.
Important:
Stop taking Warfarin, Pradaxa, Dabigatran, Rivaroxaban, or Plavix five days prior to surgery.
In the Weeks Leading Up to Surgery
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Take care not to injure yourself, especially the leg being operated on.
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Any skin sores or infections can delay your operation. Contact your GP or Dr Hugh Blackley if this occurs.
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Have blood tests done 5–7 days prior to surgery.
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Pack loose, comfortable clothing to wear after your operation.
If you live out of Auckland, you may be admitted the night before surgery. Otherwise, you’ll arrive two hours before your scheduled time.
Operating times are approximate and may vary — staff will inform you of any changes.
Preparing Your Body
Just like training for a marathon, preparing your body before surgery improves recovery.
Arm Strengthening:
Sit in a sturdy chair with arms. Push down to lift your body slightly, holding for a few seconds. Repeat 10 times daily. This strengthens your arms for using crutches and getting in and out of bed.
Leg Strengthening:
Sit upright and straighten your operated leg, holding for five seconds before lowering. Repeat five times, several times a day.
Swimming or Exercycle:
Gentle movement in water or on a stationary bike helps maintain mobility and strength before surgery.
Preparing Your Home
Make your home comfortable and safe for your recovery:
Furniture:
Use chairs with arms and proper height — your hips should be level with or above your knees when seated.
Bedroom:
If possible, sleep downstairs with easy bathroom access. A firm bed at knee height is ideal.
Bathroom:
A raised toilet seat and non-slip mat are highly recommended. If you have a shower over a bath, use a bath bench as you won’t be able to step in and out for several weeks.
Kitchen & Lounge:
Keep everyday items at waist level to avoid bending. Have a supportive chair in your lounge and a footstool for elevation.
Safety Tips:
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Remove loose mats and clutter
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Avoid slippery floors
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Watch out for pets and children
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Wear supportive shoes (avoid scuffs or jandals)
Pre-Admission and Day of Surgery
You’ll be asked to fast before surgery. That means no food for six hours and no fluids for two hours prior.
Bring all current medications to the hospital.
Upon arrival, your nurse will:
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Take your temperature, pulse, blood pressure, and weight
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Show you around the ward and review your health information
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Provide a special antiseptic soap for pre-surgery washing
You’ll then meet your anaesthetist, who may prescribe a mild sedative to help you relax.
Your physiotherapist will also review exercises, safety precautions, and how to use crutches correctly.
When everything is ready, a nurse will accompany you to the theatre. The operating suite will be cool for sterility, but you’ll be covered with warm blankets for comfort.
After Surgery: Your Recovery and Rehabilitation
What to Expect After Your Operation
The operation usually takes 1.5 to 2.5 hours. You’ll wake in the recovery room with an oxygen mask and IV line, then return to your room once stable. Your legs may feel numb from the spinal.
Antibiotics will be administered for 24–48 hours. You’ll begin gentle foot-pumping exercises and start standing with assistance as soon as possible as early movement reduces the risk of complications.
Pain Management
Some discomfort is normal. Your nurse will help manage your pain with medication and ask you to rate your pain from 0 (none) to 10 (severe).
Before you go home, you’ll receive prescriptions and detailed guidance from your anaesthetist, including a number to text if you experience pain issues after discharge.
Hospital Recovery Timeline
Day One
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Blood tests and vital sign checks
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Physiotherapist-led walking with crutches and basic knee exercises
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Begin foot pumping hourly to improve circulation
Goals:
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Foot pumping hourly (30 seconds)
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Hourly thigh/leg exercises
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Stand, walk, start knee bending (aim up to 90° if tolerated), practice stairs
Day Two (Most Patients Discharge)
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IV lines removed, pain managed by tablets
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Showering permitted with waterproof dressing
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Possible use of a knee bending machine (CPM) to encourage flexion.
Goals:
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Walk/exercise every 1–2 hours
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Walk to toilet, shower, and do stairs
Day Three (If Staying Longer)
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More walking and exercises
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Practice stairs and transfers independently
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Prepare for discharge before 10:30am
When leaving, arrange for someone to collect you. Bring home your exercise programme and medications.
Getting Home Safely
When transferring into a car:
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Push the passenger seat back fully
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Avoid twisting on the knee
Once home, continue regular movement, following your physiotherapist’s guidance.
Caring for Your New Knee
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Avoid twisting on the knee.
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Bend your knee daily—motion is crucial.
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Local physiotherapy twice weekly from immediately after discharge, then weekly to six weeks.
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Arrange transport initially; most feel comfortable to drive at 2–4 weeks (confirm with your team).
Possible Complications and How to Prevent Them
Deep Vein Thrombosis (DVT):
Take your prescribed blood thinners and walk every hour while awake. Contact your GP or surgeon immediately if you experience chest pain or breathlessness.
Infection:
If your wound becomes red, swollen, or oozes fluid, contact your surgeon promptly.
Normal Recovery Sensations
It’s common to experience:
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Knee pain or clicking (normal around the new joint; can radiate down the shin)
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Swelling/bruising to the knee and ankle, especially after time on your feet
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Thigh aching with walking
These symptoms are common and settle over weeks to months with regular pain relief and exercises.
Recovery takes time — but each day brings progress. With persistence and rehabilitation, you’ll regain comfort, confidence, and independence.