Pre-Operative Information & FAQs

Pre-assessment nursing staff will perform your pre-operative assessment which will involve taking a full medical/nursing and social history.

Routine observations will be recorded, which will include:

• Blood pressure / pulse / temperature / height and weight.
• An electrocardiogram (ECG) may be needed. This records the rate, rhythm and electrical activity of your heart. This is a simple test that takes about five minutes and does not cause any discomfort.
• MRSA/CPE swabs will taken. This is to screen for  bacteria that can cause infections. Any infection must be treated before you can have surgery.
• A physical examination, so you may need to partially undress and lie down on the examination couch. This examination will be performed by the nurse, who will listen to your heart and lungs.
• Blood tests.

Following completion of the assessment you may require further tests :

• photographs
• X-rays
• CPEX (cardiopulmonary exercise test)
• echocardiogram.

The nurse who performs your assessment will discuss their findings with the anaesthetist if required. The anaesthetist may wish to review you in the clinic to ensure you are fit for anaesthetic and discuss possible anaesthetic procedures and risks.

Maintain a healthy lifestyle. It can be beneficial to practice the exercises in the booklet given to you prior to you hospital admission. This will help you become more familiar with them and make them easier for you after your surgery.

The average stay for patients undergoing these surgeries is 3 to 4 days. This may be longer or shorter depending on a number of factors. Your consultant will advise you of how long they will expect you to spend in hospital when they discuss your surgery with you.

Some people, especially those living alone, will need some form of convalescence after their discharge from hospital based on what level of support they have available at home.

It is advisable you arrange this a few weeks before your surgery. It can be very difficult to get a convalescence place at short notice.

You will get instructions about your medications this from the nurse during your pre-operative assessment.

It is extremely important that you diligently follow these instructions. Never stop any medications without medical advice. If you are unsure, have forgotten your instructions or have any queries, please contact the hospital.

Bring your clothing, a pair of flat closed heel shoes (preferably not laced), reading glasses & toiletries.

We advise that you avoid bringing valuables into the hospital with you. Any items brought are at your own risk. You will have to remove all jewelry before going into your surgery. Unless you have been told otherwise, please bring any medication that you take regularly other than your painkillers.

Bring a mix of day clothes and pyjamas. We encourage you get dressed during the day. Wear loose clothing that will be easy for you to complete your exercises. Shoes to be closed back, low heel and if possible, slip on.

We advise that you bring shoes that are half a size bigger to accommodate any swelling after your surgery.

The main goal of treatment is to alleviate pain. There will be some pain from the surgery to start with, but you can expect to notice a benefit very soon after the operation.

After recovery, you should have greater mobility and a better quality of life. If you feel your pain is increasing, let the staff know so we can look after you. It is important for your pain to be controlled in order to achieve your physiotherapy goals.

When you go home you will be given a prescription for pain medication. The nursing staff will explain this prescription and instructions for taking the medication to you before you leave.

Ice will also help relieve any pain and swelling you are experiencing. We encourage you to use ice 5-7 times a day both in hospital and at home after you are discharged. Use ice for 15-20 minutes at a time.

Ensure there is a good layer of clothing between your skin and the ice, do not place the ice directly on the skin. If you feel any burning or blistering sensation, stop the ice as it might be too cold.

Knees: we will provide you with an ice band which wraps around your knee, you can take this home with you

Hips: while in hospital we will use bags of ice, at home a bag of peas in a pillow case. We recommend you move the ice around the hip, down towards your knee and the inside of your leg.

Yes. Where possible a physiotherapist will come and see you on the day of your surgery. Where this is not suitable, your rehabilitation will begin on the first day after your operation and will continue until discharge.

Your physiotherapist will:

• Teach you your exercises
• Guide you with getting in and out of bed
• Teach you how to walk with crutches
• Practice the stairs with you
• Provide advice about pain management and the use of ice
• Provide advice regarding follow up rehabilitation for when you go home

Exercises should be completed 3 times a day, no more than 15 repetitions and this should continue after you go home.

Each day you will increase your walking as is comfortable. We recommend a “little and often” approach or to pace your activities. At home walking will be your main form of activity so gradually increase your distance day by day as is comfortable for you.

Normally patients are able to start showering 2-3 days post surgery.

You should apply ice to the surgical area at least 5-7 times a day for 15-20 minutes both in hospital and at home. Ensure there is a good layer of clothing between your skin and the ice, do not place the ice directly on the skin.

If you feel any burning or blistering sensation, stop the ice- it might be too cold.

Yes, ice will continue to help reduce the swelling after your surgery and is beneficial to continue its use for up to 6-12 weeks after your surgery. We recommend you use the ice for 15 minutes after you have completed your exercises, returned from a walk, first thing in the morning and before going to bed at night.

Yes, we recommend that you use your crutches until your physiotherapy review so we can assess your gait pattern.

Yes, we will practice stairs during your admission.

Yes, we recommend that you follow up with physiotherapy for progression of your exercises / wean your walking aid. You can attend us here at Beacon Hospital, complete a video consult or go to your local physiotherapists if you cannot get to us here.

Hips physiotherapy follow up should take place 3 weeks after surgery. Knee physiotherapy follow up should take place 1-2 weeks post surgery.

Bruising at the surgical site is normal for a few days after your surgery. This may track down the leg also due to the effect of gravity.

Swelling of the operated leg is normal for a few weeks after your surgery. This may track down the leg also due to the effect of gravity causing you to have a swollen ankle and foot also.

Not until the consultant has cleared you. This will be a minimum of six weeks after your surgery.

Unless instructed otherwise by your consultant, you will be wearing these for 6 weeks. You can remove these for hygiene needs but otherwise they should be worn at all times for this period.

The Oxford Knee Score (OKS) & the Oxford Hip Score (OHS) are two 12-item patient-reported outcomes (PRO) specifically designed and developed to assess function and pain after Total Knee Replacement (TKR) or Total Hip Replacement surgery.

All patients attending for Hip and Knee replacement surgery are requested to complete he relevant questionnaire both before the surgery, and repeated again 6 months after the surgery.

A link to an online version of the relevant questionnaire will be sent to you via text message once your surgery has been scheduled and again for the second one, 6 months after the surgery.

Please complete the questionnaire when you receive the text via the link attached. Completing the questionnaire takes approximately 5-10 minutes.  The results are made available to your consultant in your medical chart. You can discuss this further with them during your outpatient visits.

If you have any further queries regarding the questionnaire, please speak to your consultant or contact [email protected] with the heading “Oxford score query”.