Your consultant will already have discussed your procedure with you in detail and highlighted any potential risks or complications associated with it. We will then send you a pre-operative questionnaire to fill in and bring with you on the day of your procedure.
When you have your pre-operative assessment, either over the phone or during an appointment, we’ll ask you some questions about your health and you’ll also have an opportunity to ask questions or discuss any concerns you may have. You’ll be given a time to arrive on the day of your surgery and some instructions about preparing for surgery.
- Don’t eat anything for at least six hours beforehand (although you can drink water up until three hours before your operation)
- Avoid alcohol for 24 hours before surgery as this may affect the anaesthetic
- For some operations such as joint preservation surgery you will need to stop smoking three months before surgery and not smoke for at least three months afterwards
- For all other major surgery, we advise you to stop smoking at least two weeks before your procedure
- For minor procedures you must avoid smoking on the day of your operation. However, it’s best to stop altogether or reduce the amount you smoke for a few weeks beforehand
- If you are diabetic, let hospital staff know and ask your GP for advice about fasting
- If you are taking blood-thinning medication, please let us know and discuss this with your GP before your procedure
- Please have a bath or shower before you come into hospital
If, for any reason, you can’t attend your surgery date, please contact us as soon as possible.
Your consultant will discuss with you not only the prospective benefits of your treatment but also possible complications and how the risk of such complications occurring can be managed. They consider what is best for each patient on an individual basis. As with all careful and responsible orthopaedic surgeons, they have regard both to national guidelines and local protocols (which will differ, depending on where your treatment is being provided). If they consider, when exercising their clinical judgment in relation to your care, that your interests would be best served by treatment that does not follow a national or local guideline, they will explain to you why your particular circumstances justify a different form of treatment. Our consultants believe that decisions about your treatment and care should be made jointly, and so they will welcome any questions you might want to ask.
It’s a good idea to wear comfortable, loose fitting clothes, cotton underwear and flat shoes. Please don’t bring any valuables such as large amounts of money or jewellery (apart from a wedding ring, which can be covered). Please remove make-up including nail varnish and/or artificial nails before you arrive.
- Your card for payment, if any hospital excess
- A list of medications you are taking as well as any allergies you may have
- Any medicines you are taking including inhalers, in their original packaging
- Spectacles, contact lens case and solutions, and hearing aids/walking aids
- Books/magazines/electronic devices to fill any spare time
When you arrive at reception you will be asked to sign any outstanding paperwork and confirm your payment details. One of our nurses will meet you and show you to your room. They will ask some more questions about your health and also check your blood pressure, pulse and temperature. They will give you a hospital identity bracelet and ask you to change into a hospital gown.
Your consultant will come and see you and discuss your procedure. He will then go through the consent process with you, highlighting any potential risks or complications associated with the procedure. After this, you’ll be asked to sign a consent form. You will also be seen by the consultant anaesthetist who will explain the different anaesthetic options; together you’ll agree the method that’s best for you (normally a general anaesthetic). You will have an opportunity to discuss any concerns about your anaesthetic with your anaesthetist before the surgery.
You are welcome to bring a friend or relative with you and they can stay with you until it’s time to be admitted to the ward.
You will be taken from your room to the operating theatre. Once in the anaesthetic room, you will be given the appropriate anaesthesia. Most patients undergoing knee surgery have a general anaesthetic. However, patients with medical problems such as heart or lung disease may be offered a spinal anaesthetic instead. Sometimes both techniques are used, with the spinal anaesthetic providing post-operative pain relief.
When you wake up in the recovery suite you will be closely monitored until you’re ready to return to your room; you’ll be offered appropriate pain relief as and when you need it. Depending on the type of surgery you’ve had, you may be able to return home once you’ve had something to eat and drink and are feeling steady.
During your hospital stay, your progress will be closely monitored by your consultant, along with a team of ward nurses and physiotherapists. When you wake up, you may have a bulky bandage around your knee (and/or a protective splint/knee brace). Depending on the type of procedure you’ve had, you may also have a thin plastic tube, or drain, to collect and measure any post-operative bleeding. These are used for more complex procedures where there is a risk of bleeding, such as a total knee replacement.
This depends on the type of surgery you have had. All patients are given an injection of local anaesthetic at the end of the procedure which helps to reduce pain for up to 12 hours after surgery. With some operations such as ligament reconstruction and knee realignment (osteotomy) surgery, stronger painkillers may be needed. With major surgery, such as a total knee replacement, an injection into the spine and/or a patient controlled painkiller infusion may be used to make you more comfortable.
This depends on the type of procedure you have had. Keyhole surgery is normally carried out as a day case procedure, although some patients prefer to stay overnight. The same applies to simple ligament reconstruction surgery. However, for more complex operations such as joint replacement you may need to stay in longer. You’ll be able to discuss this during your pre-operative assessment.
This depends on the type of procedure you have had. Keyhole surgery is normally carried out as a day case procedure, although some patients prefer to stay overnight. The same applies to simple ligament reconstruction surgery. However, for more complex operations such as joint replacement you may need to stay in longer. You’ll be able to discuss this during your pre-operative assessment.
All surgery carries risks. However, we are committed to minimising risk to our patients. Your consultant will discuss the risks of surgery with you beforehand and you’ll have an opportunity to discuss any concerns before you decide to go ahead. It’s important that you fully understand both the risk and benefits of any procedure before you decide whether surgery is right for you.
The risks of surgery vary from procedure to procedure, but can include:
- Deep vein thrombosis (DVT) (blood clot in the legs)
- Pulmonary embolism (blood clot in the lungs). Each patient’s individual risk for blood clots is assessed and precautions taken such as foot pumps for all patients (the pumps encourage good blood flow in your leg veins) and blood thinning medications for high-risk patients. The best, and simplest, way of preventing blood clots is getting up and moving about as soon as possible after surgery
- Bleeding: this is a rare complication, especially after keyhole surgery. The use of a tourniquet and/or surgical drain minimises the risk of bleeding. In a very small number of cases, for patients who have major surgery, such as a total knee replacement, a blood transfusion may be needed
- Infection: this is a rare but serious complication. Steps are taken before, during and after your surgery to minimise the risk of infection. Infection can be superficial (in the wound itself) or deep (around an artificial joint). In the vast majority of cases, the infection settles down with a course of antibiotics. However, in rare cases, further surgery may be necessary to treat serious infections
- Delayed wound and bone healing: this is more common in smokers, diabetics, very overweight patients and patients on certain medications, such as steroids
- Anaesthetic complications: serious complications are extremely rare. Post-operative nausea, a rare complication, can be well controlled with appropriate medication
Your consultant will provide an estimated cost for your procedure before it takes place. However, the final cost may increase if additional, unforeseen treatments are necessary. If you have a hospital excess, this will need to be paid directly to the hospital upon admission. Additionally, there may be separate charges from the anaesthetist. We recommend contacting the anaesthetist’s office for a quote before your surgery.
During your hospital stay, one of our physiotherapists will advise you about your rehabilitation programme, including any follow-up physiotherapy appointments. Your surgery is likely to be more successful if you understand what your limitations will be after surgery and plan in advance so that you are well supported when you return home. Carrying out your rehabilitation exercises as advised will help you to recover as quickly as possible.
This depends on the type of procedure you have had as well as your general fitness and your circumstances at home, including how much help is available. You will need a responsible adult to accompany you home and stay with you for at least the first 24 hours following a general anaesthetic.
Before you go home, we will arrange any follow-up appointments, including physiotherapy, as well as any medication you may need.
This depends on a number of factors including what type of procedure you have had, how you travel to work and what your job involves.
After keyhole surgery, it could take up to 6 weeks before you return back to work but many are able to return to work earlier. Your consultant will be able to provide more specific advice.
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