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A few weeks before surgery, you will likely be asked to attend a preadmission clinic at the hospital where you will undergo surgery. The preadmission doctor or nurse will ask you about your previous medical and surgical history and brief you on your hospital stay and what to expect after surgery.
In most cases, you will have a chest x-ray, some blood tests and an ECG to check for fitness for surgery. At this time, the hospital will begin planning your postoperative pathway after surgery such as your intentions for discharge and whether you plan to attend inpatient rehabilitation at another hospital or recover at home.
You will have been informed by the hospital or our staff of your admission time and subsequent ‘nil by mouth’ time.
The ‘nil by mouth’ or fasting time is determined by the anaesthetist, the hospital and Dr Ellis, and is related to factors such as your age and procedure. It is imperative to follow the fasting time advised to safely undergo anaesthesia.
Please shower before your admission to hospital.
Use this opportunity to check your limb that is due to be operated. Any broken skin or wound (such as a scratch from a cat or from gardening, or a rash) can cause surgery to be deferred as this may be an entry for infection. Please be careful not to injure your skin in the days prior to your operation.
If you are feeling unwell (e.g. cold/flu) and are unsure if you are well enough for your procedure, please contact our rooms. If this is over the weekend, please call the relevant hospital’s admissions department.
Most patients will remain in hospital following joint replacement for three or four nights, and in some cases up to a week.
Please bring comfortable clothing to wear around your room, the ward and during physiotherapy sessions. You will be up and walking quite soon after surgery.
The unfamiliar environment of a hospital combined with the fact that you may be on medication or fatigued can increase the likelihood of falls in hospital.
You can mitigate these risks while in hospital by:
Please provide your nurse with any tablets, medicines or prescriptions that you have been taking before admission.
Any additional medication you require will be ordered by your doctor and supplied to you.
When you are discharged, medications that you are required to take postoperatively will be supplied to you to take home.
A pressure injury is an area of skin and/or surrounding tissue that has been damaged due to unrelieved pressure. They may look minor, such as redness on the skin, but can hid more damage under the skin surface.
It is important that you relieve pressure by keeping active and changing your position frequently when in bed or sitting. If you are unable to move by yourself, staff will help you change your position regularly. Special equipment such as air mattresses and booties may be used to reduce pressure in particular places.
Inform staff if you have any tenderness or soreness over a bony area or if you notice any reddened, blistered or broken skin after surgery and during your inpatient stay.
Blood clotting is the body’s natural way of stopping itself from bleeding. Clotting only becomes an issue when it is in the wrong place and blocks blood flow. Being immobile is a big risk in developing a clot, which becomes a risk after surgery.
In addition, there are a number of risks factors to blood clotting including previous strokes, inherited blood clotting abnormalities, lung disease, being overweight, having a history of major surgery, heart failure, smoking or taking certain contraceptive medicines. Please inform Dr Ellis and hospital staff if you have any of these risk factors.
You will be prescribed compression stockings and appropriate medication following your joint replacement surgery. Please follow Dr Ellis’ instructions as to when to cease this medication and when to stop wearing the stockings. Staying mobile, taking the prescribed medicine, wearing your stockings, drinking plenty of fluid and avoiding crossing your legs will all help reduce your risk of clotting.
If you have sudden increased pain or swelling in your legs, pain in your lungs or chest, or difficulty breathing, please alter your nurse as soon as possible. If these symptoms occur after discharge, please attend the emergency department and/or contact Dr Ellis’ rooms/your GP.
While in hospital, Dr Ellis and the ward staff will speak with you about your plans for discharge.
Many patients opt to go to inpatient rehabilitation after significant orthopaedic procedures such as joint replacement. There are many options within the Sydney area, with Hunters Hill Private Hospital, Mount Wilga Private Hospital, Arcadia Rehabilitation, Royal Rehab (Ryde), Wolper Hospital, Delmar Hospital, Graythwaite Rehabilitation Centre, and Lady Davidson being a few among many.
If you opt to attend inpatient rehab within the Sydney area, you will most likely be transferred directly between hospitals by patient transport vehicle. The hospital where you have your surgery will book a bed for you and arrange your transport to your chosen facility.
Please check with your private health fund if you are covered to attend inpatient rehabilitation.
If you opt to go home directly after surgery, you may be eligible for Rehab in the Home or other home-based nursing and physiotherapy care depending on your health fund. Contact your fund and Dr Ellis’ rooms before or after surgery to organise these programs.
Some options include:
After surgery, Dr Ellis will see you at ten days post-op for a wound check if you do not go to inpatient rehab. In most cases, he will see you at six weeks post-op with a check x-ray if you have had a joint replacement. Please contact our rooms if you are unsure when to attend the rooms after your operation, as it is very important to follow up with Dr Ellis to ensure a good outcome and prevent the risk of infection and postoperative complication.
