A total knee replacement generates weeks of careful preparation — the pre-op physical, the medication review, the joint class, the ride home arranged. And yet the question patients keep circling back to, at the kitchen table and then again at 9 p.m. three days before surgery, is rarely about the implant. It is about the room. Will I be awake in there? Will I hear it? The joint class covered it in a slide. The patient did not absorb it then, and the office that could re-explain it closed at five.
That exact question sits in PrepQ’s orthopedics answer library, phrased the way patients actually ask it: “Will I be awake during my knee replacement?” It is one of the most loaded questions in the pre-operative window, because behind it is not curiosity but fear — and a frightened patient is one phone call away from asking to postpone.
Here is the physician-written answer PrepQ delivers, by text or by voice, at whatever hour it is asked: “With spinal anesthesia you are technically awake, but you will not feel or see anything below your waist. Most patients also receive sedation through their IV, so they are in a light sleep and unaware of the procedure. If you prefer to be fully asleep, general anesthesia is an option — discuss your preference with your anesthesiologist before surgery.”
Notice what that answer does. It separates the word “awake” from what the patient is actually afraid of — feeling and seeing the operation — and it names the sedation that makes the distinction moot for most people. Then it hands the decision back to the right person: the anesthesiologist, in a conversation the patient is now prepared to have. A patient who arrives on surgery morning having already understood their options is a very different patient from one who first hears the phrase “spinal anesthesia” on the gurney.
How the answers get written, and what never gets answered
Every answer in the library is written by physicians before it enters the system. When a practice subscribes, its own doctors review and approve the answer set for their procedures — and can edit any answer to match their protocols — before a single patient receives one. A group whose anesthesia teams default to spinal with an adductor canal block can say exactly that, and that is what patients get.
Just as importantly, some questions are never answered by the AI at all. A message describing chest pain, new calf swelling, fever, uncontrolled bleeding, or a sudden inability to bear weight carries urgent symptoms, and those are escalated to the practice or to 911 rather than handled by software. Questions with no physician-approved answer route the patient to the office instead of being improvised. The platform is HIPAA-compliant, and a Business Associate Agreement is available to subscribing practices.
Why the anesthesia question matters to an orthopedic practice
Joint replacement is scheduled surgery with a long runway, which means anxiety has weeks to compound and every unanswered question finds its way to the phone. The anesthesia question in particular clusters in the final days before surgery — precisely when a shaken patient can still cancel. Offices know the pattern: the day-before voicemail that begins “I just have a quick question about the anesthesia” is sometimes a quick question, and sometimes the first sentence of a cancellation.
PrepQ’s orthopedics library covers more than 54 procedures — total knee and hip replacement, ACL reconstruction, rotator cuff repair, shoulder replacement, meniscus surgery, labrum repair, carpal tunnel release, joint injections and more — behind over 650 physician-written answers, delivered by text message and voice call, 24/7/365, in English and Spanish. When the anesthesia explanation is available at 9 p.m. instead of tomorrow, patients arrive calmer and better prepared, fewer day-of cancellations trace back to unaddressed fear, and staff open the morning working with patients rather than through a callback queue. Any dollar figure attached to that is a modeled estimate, not a measured customer result — but any joint-replacement coordinator will recognize the shape of it.
What a surgical practice needs is not an answer — it is its answer, the one its own surgeons and anesthesia colleagues stand behind, in the patient’s hand the night the fear surfaces, with the urgent cases pulled out and handed to a human being. PrepQ was built by practicing physicians, Keith Schmidt MD and Ryan Kuta DO, around that standard. Everything here is educational information, not medical advice — patients should always follow their own physician’s instructions.