CARE PLANS

Some helpful information if you are coming in for surgery:

What to expect at the hospital

The Joint Replacement Program

A successful hip or knee replacement relies on more than just good surgical technique. A whole range of factors and a number of people will influence the speed of your recovery and the ease of your whole hospital experience.

Pre-Admission Clinic

Your hospital care starts with the pre-admission clinic. I will get you to have your routine blood tests done there so that all of the results are available on the day. You will also get to meet a physiotherapist who can give you some exercises to begin working on and give you a "test run" using crutches. The more you practice before hospital, the easier your recovery will be.

The Surgery And General Medical Care

Techniques are evolving all the time along with the actual implants. Less invasive operations mean shorter incisions, less pain and quicker recovery. In almost all cases, you will be walking on the 2nd day

I will frequently get my older patients to see one of my General Physician colleagues for a "once over" before they are admitted to hospital and to give me some assistance with their care after operation. All patients will be seen by the cardiologist pre operatively.

Length Of Stay

Patients who have undergone total Hip or Knee Replacements can usually leave on the 4th
or 5th day.

In Hospital Physiotherapy

A dedicated and enthusiastic team of physiotherapists will assist you in the early days of your recovery. It is important for your heart and lungs as well as your joint replacement to move out of bed early and to exercise regularly with the proper movements. They will give you important advice about positioning your limb to limit swelling and make moving about as safe as possible. They will make sure you pass a couple of "tests" before you leave and make sure you can get around any obstacles you encounter.

My Office

My office staff will try to make your pre-operative arrangements as painless as possible. They can give you advice about the insurance and will arrange a quotation of the fees and any pre-payments. You will need to make arrangements with the office to see me for a follow-up visit after your surgery.

My Treatment Pathway

Information For Joint Replacement Patients

Preparing For Your Operation

  • Cease any "blood thinning" medication a week before surgery, for example:
  • Warfarin, Clavix, Persantin, Aspirin and anti-inflammatory medications
  • Look after your skin to ensure that you have no cuts or infections anywhere on the body, for example: avoid gardening in the weeks before your surgery
  • Give your feet a good clean with a soft nail brush
  • Bring your own regular medications to hospital – you may take any essential heart or blood pressure tablets with a sip of water on the morning of surgery

Make sure you bring all your x-rays and other tests to the hospital.

At The Hospital

I will usually see you in the anaesthetic bay prior to your operation to answer any last minute questions you may have. I will see you in the morning following your surgery and everyday atleast once. My junior colleagues and physician assistant will see you more frequently.

  • Have one of your relatives leave a contact number on the front of your hospital medical records so I can ring to let them know how things went
  • For the first 24 hours after the operation you will have inflatable calf compressors on your legs as part of the program to prevent blood clots (DVTs). These will be removed when you are mobilizing
  • The physiotherapists will get you up the very next day, also important for preventing blood clots
  • Follow all the instructions of your physiotherapists and nursing staff on the ward after discharge

Back At Home

You will be asked to come back after 1 week for clips removal. Continue the medications and exercises that has been prescribed.

You should make an appointment to see me in the office, Usually about a month after discharge, unless you were Asked to make one sooner while you were in hospital.

In an emergency, contact us to get advise

DVT Prevention

Don’t be a clot!

(Extended DVT Prophylaxis)

A blood clot in the leg or ‘deep venous thrombosis’ (DVT for short) is one of the more common complications that can occur following hip or knee replacement surgery. Without any precautions taken, DVT develops in up to 70% of patients having knee surgery and 50% of those having hip surgery. A smaller percentage of these patients may develop the more serious complication of pulmonary embolus, where a fragment of blood clot floats up to the lungs.

For many years we have been getting better at preventing DVT in hospital by using a number of measures including medication. We know, however, that the risk of developing DVT remains increased for several weeks after surgery and it is therefore desirable to continue these measures even after discharge from the hospital.

One of the most effective measures is a medication called Low Molecular Weight Heparin (LMWH), which is given by injection under the skin with a fine needle, in the same way that diabetics use insulin. This is given daily in hospital by the nursing staff. You will also be put on oral aspirin tablets when you leave home.

Things We Do To Prevent Blood Clots

  • Inflatable leggings to compress the calf veins during surgery and in recovery (Pneumatic compression device)
  • Early mobilisation and specific circulation exercises for feet and ankles
  • Anticoagulant medication: Low Molecular Weight Heparin by injection