ARTHRITIS OF THE KNEE JOINT

Once you have decided to proceed with surgery, there are a number of things that need to be taken care of before the day of the operation:

1. Schedule the date for your surgery (see below).
2. Store your blood at the blood bank. (see Blood Transfusion for Total Knee Replacement).
3. Start taking iron and vitamin supplements (see Blood Transfusion for Total Knee Replacement).
4. Make an appointment to see the internist (see below).
5. Have the necessary lab work done (see below).
6. Stop taking certain medications in the days before surgery (see Knee Surgery and Your Current Medications).
7. See Dr. Huddleston for a final visit to make sure everything is in order (see Final Office Visit Before Surgery).

Dr. Huddleston’s assistant will arrange scheduling. Dr. Huddleston is usually scheduled ahead for about four weeks. The surgical assistant will also assist you with getting your blood storage program started, and with selecting an internist if you do not have one on staff at the hospital where you will have your surgery.

This is major surgery so medical evaluation by an internist is needed before we proceed with the operation. The internist will also see you daily while you are in the hospital to make sure that any medical complications which may develop are promptly recognized and treated.

It is best when your own internist is on staff at the same hospital as Dr. Huddleston. If not, we will select an internist for you who is familiar with joint replacement patients, and works with Dr. Huddleston on a regular basis. An appointment with the internist is usually made 5 to 7 days before surgery, unless you have some serious medical problems that need more time to correct. If you have any infection (teeth, bladder, prostate, kidney, uterus, etc.), it should be treated and cleared up before undergoing joint replacement surgery.

DUTIES OF THE INTERNIST:

1. Dictate your complete medical history and physical examination into the hospital transcription system.
2. Order and evaluate necessary lab tests, including: complete blood count, chemistry and electrolyte panel, urine analysis, coagulation profile, electrocardiogram, chest x-ray and any other necessary tests needed to be sure that surgery is not too risky for you.
3. Prescribe any special medications (if any) before and after surgery including anticoagulants to prevent blood clots).
4. Transmit the results of all your lab tests to Dr. Huddleston's office at least two days prior to the surgery date.
5. See you in the hospital after surgery on the day of surgery, and then daily thereafter while you are in the hospital.
6. Order and monitor (with blood tests) anticoagulant medications needed to help prevent deep vein thrombosis after surgery.
7. Continue to administer and monitor the anticoagulant medications for four weeks after the operation.

If your own internist (or an associate) is not able to see you everyday while you are in the hospital, he or she can still perform the pre-operative evaluation and clearance for surgery, and fax the report to Dr. Huddleston (fax 818-708-7129). We will then assign an internist to see you and follow along daily while you are in the hospital, and will hand your care back to your own doctor after you leave the hospital.