Day of Surgery

Check in at Adventist Health Lodi Memorial Medical Center

Arrive at the hospital at the time instructed (approximately 2 to 2 ½ hours prior to surgery). Enter the building at the Outpatient Services entrance located on Vine Street between Ham Lane and Fairmont Avenue. Park in the outpatient services lot right in front of the entrance. If you require assistance, use the phone located at the bottom of the entrance ramp. Check in at the registration window after which you will be directed to the preoperative area.

Treatment in Pre-Operative Area (Ambulatory Procedure Unit)

One family member or friend can stay with you while you are being prepared for surgery in the pre-operative area. You will wash your body with warm cloths containing a special cleanser (chlorhexidine) and apply nasal and oral disinfectants. Within 1-2 hours of the surgery, we will start and intravenous (IV) line and infuse two antibiotics to reduce the risk of infection. One of the antibiotics (vancomycin) may cause itching or flushing of the upper body, which is reduced by giving you Benadryl. Sequential compression devices will be applied to compress the calf area of your lower legs to reduce the risk of blood clots. You will be asked by Dr. Howell which knee is to be operated on and he will write his initials above the knee cap in large letters for everyone to see.

Your anesthesiologist will visit you in the pre-operative area. Your medical history will be reviewed, and the options, benefits, and risks will be discussed with you. Because kinematically aligned total knee replacement has a relatively short surgical time of approximately 40 minutes, the preferred anesthetic is a general in which you are put asleep. Let the anesthesiologist know whether you are prone to nausea. They are experts at administering the right combination of medications to reduce the risk of post-operative nausea.

Treatment in the Operating Room

We use a sequence of 10 caliper measurements within .5 mm that accurately positions the implants and balances the ligaments of the knee. An antibiotic (Vancomycin 1 gm) is added to the cement that binds the implants to the bone to reduce the risk of infection. Two medicines that numb the knee for 24-48 hours (maracaine and toradol) and one medicine that reduces the risk of bleeding (tranexamic acid) are injected into the knee just before applying the dressing.

Care in the Recovery Room

Your stay in the recovery room is 60-90 minutes where you are closely monitored by a specialized nurse. Your family and friends stay in the surgical waiting room. Dr. Howell or the physician assistant will speak to the family about 70-90 minutes from the time you leave the pre-operative area. During your stay in the recovery room, your nurse will assist with managing any discomfort you may be experiencing. Oxygen will be administered through a soft tubing placed in your nose. Sequential compression devices will be used around your lower legs to reduce the risk of blood clots. Ice therapy will begin.

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