Preparation for Surgery
Once the decision has been made to proceed with surgery, preparation and your role in that is important to achieve a successful result.
Routine tests, such as blood tests and X-rays, are performed a minimum of week before any major surgery. You should discuss any medications you are currently taking with your surgeon at the time of your consultation. Some medications can be taken with a ‘sip of water’ on the day of your surgery yet some medications may need to be ceased altogether. Your surgeon and medical specialists may need to be consulted to ensure it is safe to discontinue such medications or switch to an alternative. Unless otherwise advised, aspirin (and other blood thinning agents) and non steroidal anti-inflammatory should be discontinued one week prior to surgery to minimise bleeding.
General well being
Patients should inform the surgeon or his personal assistant if they become ill shortly before the day of surgery. The presence of cold symptoms with a persistent, productive cough make it inadvisable to proceed with surgery. Likewise, any tooth, gum, bladder or bowel problems that are current and ongoing could increase the risk of infection later. Any infections should be reported to the surgeon as surgery cannot be performed until all infections have cleared up.
Pre operative fasting
Patients are advised not to eat or drink from midnight on the day prior to surgery or from the time when advised by the surgeon’s personal assistant. There is not only a risk of nausea and vomiting postoperatively but other conditions with more serious consequences can arise. Please note what you have been advised and adhere to it.
Try and quit smoking a minimum of 2 weeks before surgery as smoking not only slows down the healing process but increase the risk of infection and blood clot formation.
Patients who are overweight have an increased risk of infection let alone the obvious additional stress on the affected joint. Eating a balanced, healthy diet with light exercises (as tolerated) may help reduce weight before surgery.
Daily use of an exercise bike prior to surgery is the most effective way of improving knee muscle strength and increasing speed of recovery. It is recommended for all patients undergoing knee surgery. Seeing a physiotherapist prior to surgery to work on weak muscle groups is also of benefit.
Patients coming into hospital on the day of their surgery are advised to shower beforehand. We recommend using an antiseptic/antimicrobial body wash such as chlorhexidine surgical wash that can bought from your local pharmacy. Body lotions, powders amd perfumes should not be applied on day of surgery. Do not use a razor to remove any body hair as superficial grazes to the skin may cause infections and potentially result in the procedure being postponed. Any hair that does need to be removed will be done so just prior to the procedure by one of our medically trained staff.
It is advised that valuables should be left at home but electronic personal devices or better still a good book can help pass the time waiting for surgery. Jewellery should be removed or in some cases where this is not possible should be taped prior to surgery. Contact lenses cannot be worn in the operating room so patients should remember to bring their glasses or the appropriate storage/solutions required to remove and store contact lenses before surgery.
It is essential that you have someone available to transport you home. You will not be able to drive for at least 24 hours post surgery for arthroscopic surgery and longer for major surgery. Do not drink or eat anything in the car on the trip home. The combination of anaesthesia, food, and car motion can often cause nausea or vomiting. After arriving home, wait until you are hungry before trying to eat. Begin with a light meal and try to avoid greasy food for the first 24 hours. Once home keep the operative leg (knee) elevated and use ice as directed. This will help decrease swelling and pain. Take your pain medicine as directed. Begin the pain medicine as you start getting uncomfortable, but before you are in severe pain. If you wait to take your pain medication until the pain is severe, you will have more difficulty controlling the pain.
Patient safety and reducing the risk of falls is paramount in a speedy recovery. There are a few things you can do around the home to help facilitate this. Place items that you use often within easy reach before surgery so you won’t have to bend or stretch as often. Remove all loose carpets and tape down electrical cords to avoid falls. Make sure you have a stable chair with a firm seat cushion, a firm back and two arms.