Initial appointment

When it is decided that you are suitable for a hip replacement you will be provided with both verbal and printed information.  And you can also access further information through this website.  You will then be consented for your procedure and then be given a date for this, which is convenient to you.

Cardiology

A tracing of the heart is routinely done, again for anaesthetic safety. Further cardiology tests and a consultation with your Cardiologist may be required if you have a heart condition.

Anaesthetic

Mr Anderson uses either Dr Magda Rhodes, Dr Clinton Paine or Dr Rob Storer as his anaesthetist, depending on the day of your procedure.

The anaesthetist will contact you by phone before the surgery, to discuss the anaesthetic. Sometimes they will arrange to see you if there are particular concerns.

Pre-assessment

Within the week before the surgery, you will be asked to attend a pre-assessment appointment or have a telephone interview. Here, the final details of admission and preparation will be addressed. You will be provided with information about the administration of the admission, and the pre-surgery work up. You will be given a pre-surgery wash.

Radiology

Up-to-date X-rays of the hip, which we will use to template for the correct size and type of implant

Blood tests

Routine blood tests will be taken. These tests are usually done within a week of the surgery. Further blood tests may be requested depending on the presence of other medical problems. Your urine will be tested for infection, and if this is positive, then further investigations or treatment may be necessary.

Before admission you will need to arrange someone to collect you after your surgery, and to have someone at home with you at least you the first day. If you require special help at home, then this needs to be fully arranged before you come into hospital. Please ask if you have any questions regarding this.

The day of surgery

The majority of patients are admitted on the day of surgery. The nursing staff will prepare you for theatre.  Mr Anderson will usually see you in the holding bay, where all the documentation will be double checked, and you operative side will be marked.

You will next be taken through to the operating room, given your anaesthetic. Antibiotics will be given in order to reduce the risk of infection. The skin is usually closed with skin clips, with a thick dressing that remains on for up to 72hrs.

We will usually fill the knee with local anaesthetic and other medication, to reduce pain, and minimise blood loss. A tiny catheter is usually left in the knee, which can be used to inject local anaesthetic in to the knee over the first two days. A pain patch is placed in theatre, and special ice packs on the knee.

Ice post operative for TKR

Ice for pain is very useful to help postoperative swelling and control pain. You can apply this as many times as you like during the day for a maximum of 20 minutes at a time. Synthetic ice packs can be re frozen and placed on the skin, but if using real ice, always have a cloth or plastic material between your skin and the ice.

Post op

After the surgery is finished, you will be taken through to the recovery room, where you will be monitored until it is safe to return you to the ward. A pain control regime will be in place, and anti sickness medication will be available if required.

If your power in your legs recovers in time, the physiotherapists will stand you up and walk you on the day of surgery.
The physiotherapists will see you twice a day, and teach you your exercises and how to move safely. They may arrange outpatient physiotherapy, depending on your needs and circumstances.

Most of our knee replacement patients will be independently mobile with crutches and able to return home within five days.

Discharge

When you are ready for discharge, you will be given medications to take home, including pain relief, anti inflammatory tablets.  You will be given spare dressings for your wound, and the nurses will instruct you about care of this before you leave. If you live within the greater Perth area, a nurse will come to your home to remove your clips on the 14th day. They may also come to check your wound before this.

If you have problems at home, then your first port of call is ring the ward in the early period.

Otherwise, Mr Anderson’s rooms can be contacted during the day on 9366 1843.

Follow up

A the time of booking your procedure you will also be given a post operative follow up appointment, which is usually six weeks after your procedure.  You will usually be able to drive after Mr Anderson has seen you.

What you can do to optimise yourself

Mr Anderson will assess if any changes need to be made to your medications before admission. If you are on a single anticoagulant such as aspirin, for a medical condition, then I will usually continue with this. If you are on two anticoagulants, or warfarin, then they need to be stopped five to ten days before surgery. Sometimes an alternative medication will need to be used in this period.

Stopping smoking will greatly reduce your risks of chest complications, infection, and poor wound healing, as well as benefit your long-term health.

Exercise, weight loss and healthy eating will all improve your outcome.
Problems with your skin, teeth and nails need to be brought to our attention, as they can be a serious infection risk.

What to bring

Toiletries, all relevant X-rays and other investigations, daytime clothes, non-slip flat shoes, all medications.