Finding out you may require a total knee replacement can be a big adjustment. Knee care provided through an Integrated Care Collaborative (ICC) at NYGH ensures your health care team at the hospital is working seamlessly together with you, your family physician, and community partners. Throughout your care, we will listen and answer your questions, and collaborate with you on your care plan.
There are many different types of arthritis. The most common need for a knee replacement is due to osteoarthritis. Sometimes osteoarthritis can be very severe; it can cause severe pain, limit mobility, and impede one's quality of life. Your family physician may refer you to the Total Joint Assessment Centre (TJAC). Based on your assessments, you may be recommended for a total knee replacement surgery on one or both knees.
Watch the video to learn tips from our health care team that will prepare you for your first visit to the Total Joint Assessment Centre (TJAC).
You should arrange for a family member or friend to be your Coach. This person should come with you to all of your appointments if possible. A Coach is not only available for support, they are also a second set of ears to help understand what to expect each step along the way.
Deciding to have surgery done can be a difficult decision for some patients. However having a knee replacement will improve your quality of life, independence, and overall health. A clinician at the Total Joint Assessment Centre or surgeon will be able to further describe the risks and complications should you have any questions.
Not every patient is ready for surgery, whether it is based on your assessments at TJAC or if you are undecided to go ahead with the procedure. There are also activities patients can do to help manage pain and symptoms while waiting for surgery. Learn more
Learn more about the Total Joint Assessment Centre.
Do you have any questions or concerns? Contact the Hip and Knee Patient Navigator at 416-756-6000 ext. 4490 or email Hipknee.Navigator@nygh.on.ca.
Learn more about the Hip and Knee Patient Navigator.
The following strategies can be used for patients who:
- Would like to manage their symptoms of arthritis
- Want to learn more about improving pain
- Are undecided about whether or not to have surgery
- Are waiting to have their surgery
Pain management: warm packs or placing a hot water bottle on your knee for 15 minutes once or twice daily helps to relieve muscle pain. Make sure that you have a thick layer between your skin and the heat source. Check your skin every few minutes to make sure you do not burn yourself. Do not use a pain relief cream or ointment with a hot pack as this could cause a chemical burn. Warm baths and pain medication prescribed by your doctor can also help.
Weight control: the force on your knee is approximately 3 to 4 times the weight of your body. Reducing your weight will reduce your pain and slow down the progression of osteoarthritis in your knees.
Diet: we suggest that you maintain a healthy diet while you wait for surgery. Foods high in protein, vitamin C, zinc, iron, and calcium are important for wound healing and for good recovery after surgery.
Smoking: if you smoke, it is important that you stop. If you are unable to stop, try to cut down on the number of cigarettes you smoke per day. Stopping or decreasing the amount you smoke will improve the condition of your lungs and help you heal.
Fitness: the best activities for osteoarthritis of the knees are swimming, cycling, and walking. Double check with your doctor to make sure you are able to participate in these activities.
Physiotherapy: may help reduce pain and improve your mobility and strength.
Activity: stop or reduce the activities that make your knee sore.
Do you have any questions or concerns? Contact the Hip and Knee Patient Navigator at 416-756-6000 ext. 4490 or email Hipknee.Navigator@nygh.on.ca.
Learn more about the Hip and Knee Patient Navigator.
Once you decide to go ahead with a total knee replacement, it is important to start planning for your surgery, hospital stay, and discharge home. Preparation is just as important as the recovery process because this will ensure the best outcome for you.
Here is a list of some of the things that you will need to prepare ahead of time:
- Please read the patient guide book before your pre-operative assessment appointment. If you are interested in going to a respite care facility (see page 11 of your patient guide book) please make these arrangements before your surgery. These facilities also require a chest X-ray and forms that must be completed by your family physician.
- It is important you participate in physiotherapy while you are in hospital and after you leave the hospital. Physiotherapy is vital to your recovery. Physiotherapy will help you improve your range of motion and strength. It will also teach you safe and effective movement patterns to assist in regaining your function. The health care team and the patient navigator will partner with you to arrange physiotherapy plans before your surgery date.
- The patient navigator will contact you after your pre-operative appointment to arrange outpatient physiotherapy, provide information about transportation for outpatient physiotherapy and information about the necessary equipment.
- Plan for someone to drive you to and from the hospital
- Arrange to obtain equipment from a medical supply store
- Set up your equipment at home and practice using the equipment
- Move your furniture so that you have a clear path for walking, especially if you might be using crutches, a walker, or cane
- Set up a high chair with a firm cushion and arm rests to sit on after surgery
- Put frequently used items at your waist to shoulder height to minimize bending down
- Remove loose rugs and other items that you could trip on
- Make sure there is good lighting so you can see the floor clearly
- Make sure staircase handrails are securely fastened to the wall
- Arrange for a support person or Coach to stay with you or be available for the first 3 days after you go home
- If you think you will need help with activities of daily living after surgery (e.g. bathing, toileting, getting dressed, etc.), contact private home care agencies. Look under “Home Support” in your local phone book or the Community Resources on this website
- Arrange for grocery delivery and stock up on healthy frozen meals
- Arrange for someone to care for your pets
Approximately a month or less before your surgery date, you will have an appointment at the Pre-operative Assessment Clinic, located at North York General.
Here you will be seen by a nurse to review important forms, have your blood tested, and have an electrocardiogram (ECG) done. You will also be seen by an anaesthesiologist and possibly a medical doctor. You will attend an educational class that is facilitated by a physiotherapist, an occupational therapist, a nurse, and a home care representative.
Do you have any questions or concerns? Contact the Hip and Knee Patient Navigator at 416-756-6000 ext. 4490 or email Hipknee.Navigator@nygh.on.ca.
Learn more about the Hip and Knee Patient Navigator.
At North York General, your health care team eases any concerns you may have before and after your surgery.
What is total knee replacement surgery?
Knee replacement surgery replaces your arthritic knee joint with an artificial one. More than 90% of knee replacements last people the rest of their lives. Most patients are very pleased with the results because their quality of life, independence and walking are greatly improved.
The procedure itself lasts about 3 hours. Following the surgery, you will be taken to the Post Anaesthetic Care Unit (recovery room) where you will be monitored by a nurse. After a few hours, you will be ready to be moved to your room on the inpatient unit.
Good pain control is important for a successful recovery. You will be asked to rate your pain using a pain scale. A pain scale helps us make decisions on how to relieve your pain. You will be asked by staff the level of your pain on a scale from 0 to 10 (0 = no pain, 10 = worst pain). We encourage you to keep your pain level less than 4.
You can expect to go home within 1-2 days after your surgery.
Do you have any questions or concerns? Contact the Hip and Knee Patient Navigator at 416-756-6000 ext. 4490 or email Hipknee.Navigator@nygh.on.ca.
Learn more about the Hip and Knee Patient Navigator.
During your hospital stay, you will meet a physiotherapist and occupational therapist. They will be giving you information that will allow you to do your own exercises and recover at home. Exercises will need to be done two to three times a day and will become easier as you become stronger. It is important to keep active after knee replacement surgery. This will keep you strong and moving well. Balance your activity and exercise with periods of rest. Gradually increase your activity e.g., more walking, and household chores.
North York General offers physiotherapy to our patients in our Knee Class located in the Rehab Gym at the hospital. This is a group rehabilitation program for patients who have had knee replacement surgery on one of their knees. The Knee Class is offered twice a week until the 6th week following surgery. Though this may be arranged for you before you go home, you may also arrange your appointments when you are discharged. Call 416-756-6000 ext. 3727 to leave a message for the Physiotherapist in the Knee Class. Learn more about the North York General Knee Class.
The patient navigator will help you arrange other rehabilitation options, if necessary.
Cryotherapy — A more effective way of icing
You may experience an increase in swelling of your operated leg, even after you are discharged from the hospital. Icing has been shown to be very effective in reducing swelling, bruising, and pain in the post-operative period. However, the use of ice directly on the skin is uncomfortable and can be dangerous as it can lead to an "ice burn." Furthermore, it is difficult to obtain a constant temperature with ice alone.
These factors have led to the development of Continuous Cold Therapy Systems which are more effective and more convenient compared to cold packs. Continuous Cold Therapy Systems are comprised of a “bladder” which wraps around the treatment area and is connected to a cooler by a hose. Chilled water is circulated through the bladder, maintaining a safe and constant cold temperature. The system will circulate water at a constant temperature for up to 8 hours. Continuous Cold Therapy Systems are available for rent or purchase.
Pain and swelling
Some pain and swelling at the surgical site is normal. This will improve over the next six weeks. Swelling may increase even after leaving the hospital. Use your pain medication as prescribed. Gradually try to wean yourself off pain medication. You can use ice packs to control pain and inflammation. Raising your leg mid-morning and mid-afternoon, as well as calf pumping exercises can help reduce swelling.
Do you have any questions or concerns? Contact the Hip and Knee Patient Navigator at 416-756-6000 ext. 4490 or email Hipknee.Navigator@nygh.on.ca.
Learn more about the Hip and Knee Patient Navigator.
The Knee Class is run by physiotherapists dedicated to the recovery of single knee replacement patients. Classes are held on Mondays and Thursdays only. You must contact the physiotherapist in the Knee class to book your first appointment. Please call 416-756-6000 ext. 4784.
Patients are eligible to attend two times a week until the 6th week postoperatively and can receive an extension until the 8th week postoperatively. Each session lasts one hour. Please bring your health card (or blue hospital card), and a support person if you need help answering questions or filling out questionnaires. What to wear:
- Wear loose comfortable pants that can be rolled up (or a pair of shorts)
- Wear or bring clean, dry and comfortable footwear, such as a walking shoe or an athletic/running shoe
- The Rehab Gym is located at the General site on 5 South, Room 172.
Do you have any questions or concerns? Contact the Hip and Knee Patient Navigator at 416-756-6000 ext. 4490 or email Hipknee.Navigator@nygh.on.ca.
Learn more about the Hip and Knee Patient Navigator.
Your first follow-up visit will be approximately 4 weeks after surgery. You will be seen in the Gulshan & Pyarali G. Nanji Orthopaedic and Plastics Centre located at North York General. You may have X-rays done and will be seen by your surgeon. The next follow-up appointment will be after 3 months in your surgeon's office. If you are having concerns or complications, you may be seen earlier than these scheduled times.
The Total Joint Assessment Centre (TJAC) will contact you, in writing, with your follow up appointments before your first, fifth, and tenth anniversary of your knee replacement. You may be followed up more frequently after 10 years, based on previous assessments. If you have concerns or complications, please contact your family doctor or your surgeon's office.
The benefits of knee replacement surgery are great and will be achieved with your effort and time.
Watch the video to learn how North York General Hospital’s health care team closely monitors your progress at the Total Joint Assessment Centre (TJAC).
Do you have any questions or concerns? Contact the Hip and Knee Patient Navigator at 416-756-6000 ext. 4490 or email Hipknee.Navigator@nygh.on.ca.
Learn more about the Hip and Knee Patient Navigator.