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The day of your surgery

You will be admitted to hospital on the day of your surgery.

Medications

Medications

On the morning of your surgery, take medication as instructed by pre-assessment staff. Refer to Pre-assessment Nurse section

Keeping warm

Please bring clothing to keep you warm prior to your operation. Keeping your body warm reduces the risk of complications during surgery. Please also bring warm, comfortable clothes and supportive shoes/slippers into the hospital for you to wear in the days after your operation.

Jandals or slip on footwear are not advisable.

Where do I go before surgery?

You will have been advised of the date of your surgery by letter from the surgical booking office. You will need to report to the Surgical Admission Unit. Please ask at the main reception of the hospital if you are unsure of how to get there.

The operation itself

Getting ready for theatre

Before surgery you will be given a gown and fitted with an elastic stocking on your non-operative leg to help prevent blood clots.

Your blood pressure, temperature and heart rate will be checked. All your belongings will be taken directly to the ward where you will recover after surgery.

You will be visited by the surgeon and anaesthetist. The surgeon will check your leg, and mark with a marker pen to highlight the side for operation. A full explanation of the surgery and risks will be discussed with you before you sign the consent form. You will also need to give consent for anaesthesia and blood transfusion. You are also likely to have a drip placed in your arm.

In the operating room

You will be taken to the operating room, an anaesthetist and the anaesthetic team, several nurses, the surgeon and their surgical teams will be present.

Once in the operating room you will receive an anaesthetic as previously discussed with you by your anaesthetist.

In recovery

Following your operation, you will be transferred to the recovery room. Nursing staff will check on you frequently to make sure you are safe and comfortable.

You may have:

  • Foot pumps attached to your feet
  • An intravenous (IV) drip in your arm - this is used to give you fluids, antibiotics and painkillers.
  • A facial mask or nasal prongs to give you oxygen.
  • A urinary catheter in place - this will have been put in place during your surgery.
  • A wound drain - this is used to drain excess blood and fluid, and will be covered by a large bandage.
  • A cryocuff on your knee - if you have had a knee replacement - this is similar to an ice pack which helps reduce pain and swelling.
  • A few sips of water if you feel able to.
  • A pain pump (patient controlled analgesia) with a button to push whenever you need pain relief.

The PCA is a computer controlled machine which delivers small amounts of strong pain relieving medication at the push of a button. The PCA is prescribed by the anaesthetist with a dose that is appropriate and safe for you.

Side effects can sometimes occur but can usually be treated effectively. The most common side effects with PCA medications are drowsiness, nausea, vomiting or itching.

On returning to the ward

When the recovery staff are satisfied that you have recovered safely from the anaesthetic, you will be taken back to the ward.

On returning to the ward you can expect the following to happen:

  • Your condition will be monitored regularly particularly in the first two hours
  • You will be encouraged to drink and eat as soon as you are able
  • Your wound dressing will be checked regularly

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The day after your operation - Day 1

We encourage you to be as independent as possible after your surgery. You will receive help with tasks such as washing, dressing and walking to the toilet, but the aim is to wean off this help as soon as it is safe to do so.

Day1On day one after your operation you can expect the following to happen:

  • You will be seen by a doctor from the Orthopaedic Team.
  • Your urinary catheter will be removed.
  • Your pain pump (patient controlled analgesia) may be stopped.
  • You will receive regular oral medication to minimise your pain, nausea and help prevent constipation.
  • Your oxygen will be stopped if you no longer require it.
  • Your wound drain (if you have one) will be removed.
  • A simple blood test will be taken to check you are not anaemic (have low red blood cells or haemoglobin) after your operation.
  • Some of your bandages, if you have had a knee replacement, will be removed to reduce bulk and size.
  • Your IV fluids will stop if you are able to drink.
  • Your IV cannula will be removed once you have been given a final dose of antibiotics.
  • You may receive a small daily injection to help reduce the risk of developing a blood clot.
  • You may have foot pumps attached to your feet whilst in bed.
  • Nursing staff will assist you with washing and dressing as required.
  • You will be encouraged to sit out of bed for meals.
  • Your physiotherapist or their assistant will visit you at least once a day to help you with your exercises and assist you to walk.
  • You may receive a visit from a social worker. 

Pain relief

Good pain control helps you recover more quickly after your operation. It is important to tell the doctors or nurses if you are in pain, do not wait to be asked and do not feel afraid of

being a nuisance. If your pain is well controlled, post-operative complications are reduced, you sleep better and it helps your body heal more quickly.

Pain relief is important and some people need more pain relief medication than others. An assessment scale is used to measure your pain regularly. The nurses will ask you to rate your pain at rest and on movement. They may use a number scale of 0 - 10, 0 meaning no pain and 10 being severe pain. It is important that you are honest about your pain so that you can receive the correct treatment for you.

Occasionally, despite regular painkillers, you may experience stronger pain. This may occur during physiotherapy exercises  or walking. You will have additional painkillers prescribed to help relieve this pain but you have to ask your nurse for these. You must inform the nurses who will give you these extra painkillers. It is important that you are comfortable enough to be able to participate in physiotherapy to help your recovery.

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The second day after your operation - Day 2

You're on your way to being as independent as possible after your surgery. You will need less help with tasks such as washing, dressing and walking to the toilet, and you may be able to manage most of this on your own. 

Day2On day two after your operation you can expect the following to happen:

  • You will be seen by a doctor from the Orthopaedic Team.
  • You will continue to receive regular oral medication.
  • Your pain pump (patient controlled analgesia), if not stopped yesterday, may now be removed.
  • You will be encouraged to wash, dress and toilet yourself asindependently as possible.
  • You will need to dress in your own clothes.
  • You will sit out of bed for all your meals.
  • Your physiotherapist or their assistant will visit you at least once a day to help with your exercises and supervise your walking.
  • Your physiotherapist may also take you up and down some stairs to check you are safe to do this.
  • You may receive a visit from a social worker to assess any social needs for your discharge.
  • Your occupational therapist may assess your ability to manage essential everyday tasks. This may include transfers on and off a bed, chair and toilet. They will also ensure that you can wash and dress yourself in line with post-operative hip precautions.
  • Your occupational therapist may also issue you with any further equipment you may need at home.

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The third and following day(s) after your operation

You will be discharged (so long as it is safe) on day three after your operation around 11am.

You may be transferred to our transit lounge. This is provided for your comfort while you are awaiting discharge. A nurse will be present during this time.

Day3You can expect the following to happen: 

  • You will be seen by a doctor from the Orthopaedic Team.
  • You will continue to receive regular oral medication.
  • You should be able to wash, dress and toilet yourself independently.
  • Your physiotherapist will visit you to check you are able to undertake your exercises independently and can walk safely.
  • Your physiotherapist will also check you are safe to go up and down stairs (if you have steps at home).
  • You may receive a visit from a social worker to assess any social needs for your discharge.
  • Your occupational therapist will assess your ability to manage essential everyday tasks. This may include transfers on and off a bed, chair and toilet. They will also ensure that you can wash and dress yourself in line with post-operative precautions.
  • Your occupational therapist will also issue you with any further equipment you may need at home.
  • Nursing staff will discuss your discharge arrangements to ensure everything is in place for a safe return home.

Before you can go home we need to make sure:

  • You can get in and out of bed independently. You can walk unsupervised with a walking aid.
  • You can walk up and down stairs safely if applicable.
  • You can perform your exercise programme independently. Your pain is well managed with tablets.
  • There is support in place at home.
  • You are given a prescription for pain medication.
  • You will be issued with any additional equipment that you will require at home.

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Last updated: October 3, 2017