Nov 30, 2015
What to Expect Before Knee and Hip Surgery
This article provides a general overview of the process of orthopaedic surgery for patients. Please consult your GP or surgeon for any medical advice.
Surgery can be an exciting time. You are about to finally get the long awaited relief from pain and discomfort you have been waiting for. But it can also be a time full of nerves and anxiety since you are not quite sure what to expect from the procedure. To help you understand this process, we’ve created a summary of the steps to surgery for knee and hip procedures.
First things first, it starts with a concern about your knee or hip. Visit your doctor, and if from there you need surgery, your doctor will refer you to a specialist. Once you have been referred to a specialist you will have a consultation to discuss the next steps.
Preoperative Consultation with your Surgeon
When you visit your surgeon you will need to describe your orthopaedic problem and then provide information about yourself including but not limited to:
Medical history | Family history | Current medications | Allergies and sensitivities
X-Rays, images | Operative notes and lab tests
You may also want to prepare a list of questions or concerns you have about your health and the planned surgery. We tend to let our thoughts go straight to the idea of recovery, but we often over look the pre-surgery steps that are just as important. Before orthopaedic surgery, your doctor will discuss anaesthesia with you. The selection of anaesthesia is a major decision that could have a significant impact on your recovery.
There are three types of anaesthetic: local, regional, and general.
Local anaesthesia: is an anaesthetic agent given to stop the sense of pain in a particular area of the body. The patient can remain fully conscious during the procedure when only the local anaesthetic is used.
Regional anaesthetic: is used to numb only the portion of the body that will receive the surgical procedure. This can be either in the form of spinal or regional never blocks.
General anaesthetic: is used to induce unconsciousness during the surgery. The medicine is inhaled through a breathing mask and also given through an intravenous line.
Regional and General anaesthetic are typically used in knee and hip surgery although several factors will be considered when anaesthesia is selected. Questions your doctor may ask you include: your past experience and preference, your current health and physical condition and your reactions to medications. Your doctor will also explain the risks involved. The skills and preferences of your surgeon and anaesthetist will play an important role in the selection of anaesthesia.
It is recommended not to eat anything after midnight the night you go into surgery or six hours prior to surgery. This may include liquids, food, chewing gum, mints, or smoking cigarettes. Although, if you have a surgery scheduled for later in the day it is a good idea to talk to your nurse or anaesthetist about a light breakfast. If you are having an outpatient procedure, remember you may need to arrange for a responsible adult to take you home and stay with you. You may even want to consider bringing pillows or a blanket for your trip home.
The week before your surgery it may be advised to avoid:
Aspirin | Ibuprofen | Naproxen sodium | Vitamin E | St. John’s Wort
Ginkgo Biloba | Feverfew | Alcohol | Cigarette
On the day of surgery ask your doctor if you should be taking your usual medications. You can shower or bathe the night before or in the morning before surgery. Sips of water with your regular morning medications (other than those advised to stop prior to surgery) are fine. It is best to not wear make-up, wear comfortable clothes, and be sure to remove all jewellery, nail polish and wear glasses rather than contact lenses.
If you develop a cold, persistent cough, fever or any other health-related problems, or if you need to cancel your surgery for whatever reason, make sure you notify your surgeon as soon as possible.
Day of Surgery
On the day of your surgery you will want to bring with you:
List of all your medications | List of your drug and food allergies | Insurance card
Copy of any relevant legal documents | Small amount of cash | No valuables or jewellery
Name and phone number of a primary contact while you are in surgery
The hospital will usually provide everything else, such as toothbrushes, bed clothes and slippers. When you arrive an I.D. band will be given to you and your doctor or healthcare team will ask you some questions such as if you have diabetes and take diabetic medications, blood thinners, or family history of problems with surgery such as adverse reactions to anaesthesia or other medications.
Your doctor will confirm the consent and surgical site with you and then mark the correct area on your skin. Give your cell phone, reading glasses, hearing aides and other personal items to a friend or family member before you go into the operating room. When you go into surgery you will be dressed in a hospital gown and be moved into the operating room on a mobile bed. The anaesthetic is usually administered in the operating room.
Dr. Jason Tsung does not endorse any treatments, procedures or products referenced herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon.
Aoa.org.au, (2015). Peak professional organisation for orthopaedic surgeons - AOA | Australian Orthopaedic Association. [online] Available at: https://www.aoa.org.au/ [Accessed 23 Nov. 2015].
Orthoinfo.aaos.org, (2015). Patient Guide to Safe Surgery-OrthoInfo - AAOS. [online] Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00563 [Accessed 23 Nov. 2015].
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