Joan Said:

Can you have a spinal when the surgery is partial knee replacement.?

We Answered:

Your two options for a partial knee replacement in regards to anesthesia are general anesthesia or neuraxial (spinal, epidural) anesthesia.

General anesthesia means you are completely asleep. An IV will be placed and you will be drifted off to sleep. After you are asleep, a breathing tube will be placed into your windpipe or directly behind it (depending on factors such as your weight, the left of the procedure, and your history of heartburn or reflux). After the breathing apparatus is placed, inhaled agents will be used to keep you asleep and pain medication for pain relief. The disadvantages of general anesthesia include possible sore throat following surgery, increased chance of nausea and vomiting, and sometimes a groggy feeling. The advantage is that you are complete asleep.

For neuraxial anesthesia, you have two choices: a spinal and an epidural. A spinal is a one-time shot that is placed immediately prior to surgery; since it is a one-time shot, it has a time limit (anywhere from 30 minutes to 150 minutes depending on the drug used). On the other hand, an epidural is a small catheter the size of a pencil lead that remains ajdacent to your spinal column for a continous secretion of local anesthestics (similar to local anethestic at a dentist office). The advantage of epidural over a spinal is that it can be dosed for a period of time after your procedure to help with post-operative pain. The disadvantages of spinals and epidurals is dural headache (1/200) and also that the spinal/epidural not working. Reactions to the anesthetic and nerve damage is actually very rare.

Other options include regional anesthesia which would include numbing two nerves with two separate one-time shots. I also think an epidural with a light general anesthetic works well, especially people who are nervous and do not want to me awake but who still want the post-operative pain control of an epidural. Even with a spinal or epidural, most patient get some sedation so they are in a "twilight" sleep.

The decision for your anesthetic plan will be a decision made by your anesthesiologist and surgeon. Not all surgeons like epidurals for various reasons (eg. some feel they interfere with therapy or their postoperative exam). Although it is good to be informed and to know what you want, make sure you are flexible so you are not disappointed the day of surgery.

Joel Said:

I had partial knee replacement surgery on Friday, and I'm just NOT interested in sex?

We Answered:

Right after the surgery you should your testosterone should go back to normal.

But since you are on those pain killers (which are amazing by the way! Go Vicoden! Mmm. . . Codeine) *ahem* anyway those pain killers lower your testosterone level that's the very nice feeling in your legs.

So as soon as your doctor recommends you are done with them you should be fine

Joanne Said:

What is the normal recovery time after having a partial knee replacement?

We Answered:

I work in inpatient rehabilitation and I see a lot of people with knee replacements. I know that you have probably heard this before, but your recovery will depend on a lot of factors:

- Pre-surgery level of function: Are you currently using a walker or a cane? The more difficult it is for you to get around now, the longer you will take to rehab. How strong are your arms? You may not think that this will make a difference, but you will need good arm strength in order to effectively use your assistive device (i.e. - walker and/or cane when you are first recovering)

- Age: The older you are, the longer your recovery

- Weight: The heavier you are, the longer your recovery

- Pain management: In the early stages, pain is the biggest limiting factor for individuals to make good progress. Make sure you are taking your pain medications in accordance with your therapy schedule.

- Participation in therapy: The more therapy, the quicker you will recover. Research has shown that early and intensive rehab after joint replacement is essential for a good outcome.

- Support system: Do you live alone? If so, the doctor may not recommend that you return home straight from the hospital as you will still require some assistance with basic daily living skills and mobility. If you live alone, the doctor may recommend an inpatient stay in a sub acute rehabilitation facility (this is where I work)

Overall, there is no specific time frame that I can give you. I can tell you that partial knee replacements recover quicker than total knee replacements. Usually people are able to get back to basic self care and functional mobility within 2 weeks using an assistive device (a walker and other aids to daily living as needed such as an elevated toilet seat). Remember - it is going to REALLY HURT a lot when you first get it done, but it will be worth it over time. Joint replacement, in my opinion, is really a miracle surgery for people who suffer from chronic, debilitating arthritis.

Deanna Said:

Knee Replacement Surgery Risk for "High Risk" Person?

We Answered:

I think your best bet is to talk to the anesthesiologist. He's the one who will do your sedation. I had a spinal and had no after effects from it so I highly recommend that instead of being put under. I was also mildly sedated but woke up towards the end of the procedure but didn't feel anything. But I would definitely check with him to see what your risks are since you have so much to deal with. I hope all goes well for you.

Sue Said:

I face knee replacement surgery. Will I be able to continue umpiring baseball after the surgery?

We Answered:

Depends on how bad it is. Ask you doctor stupid. How would we know?