Preparing for orthopedic surgery

Preparing for Orthopedic Surgery

The preparation for major orthopaedic surgery (such as hip and knee replacement or foot and ankle surgery) may require careful thought and planning around any home modifications needed for the postoperative period. Even though major trauma also will require many of the following, in view of it being an emergency procedure, we will have to make do with only whats possible.

The following is a guide to some of the preparations patients may wish to make prior to surgery.

In the days leading up to surgery you may consider the following:

  • Carry all the necessary reports and the notes of your first consultation.

  • Improve your general fitness, may be attached to physio to start and practice the exercises to be done after surgery. This will help the patient to familiarise themselves and at the same time it is easier to do the exercises after surgery due to muscle memory.

  • Good joint and muscle control leading into an operation improves postoperative strength and outcomes.

  • Practice with crutches or walker under physiotherapy supervision may make the transition to discharge postoperatively much quicker.

  • Stop smoking for at least two weeks.

  • Do not consume alcohol at least 24 hours prior to an anaesthetic.

  • Blood thinning medications should be ceased a week prior to surgery unless you have been instructed to continue for medical reasons. These include:

    • Aspirin
    • Warfarin
    • Plavix / Clopidogrel
    • Pradaxa
    • Xarelto
    • Fish Oil
  • If you develop any illnesses, before the scheduled date you must contact the doctor to determine if elective surgery should be postponed.

Prepare your home environment

  • Look for hazards around your house that may result in tripping or may restrict your mobility. Clean path between bed and bath.
  • Loose rugs or cords can be moved.
  • Set up extra lights or lamps in dimly lit areas.
  • Need to have a western style toilet if already not there.
  • Adviced to have grab bars and rails in the bath room for support..
  • Non slip mats in the bathing area. A shower stool or seat is commonly required if having major joint replacements.
  • Prepare books, reading material, DVDs etc. to keep you occupied during recovery.
  • Consider whether a temporary bedroom should be set-up in a more accessible room.

Pre admission preparation

  • Get major surgical profile done, as per the requirement and suggestion
  • Review the reports with the doctor.
  • Correction of any abnormalities if found.
  • Most patients would require a fitness from the physician and cardiologist to undergo surgery.
  • Once medical fitness has been given, get a preanaesthetic check up done. Here you will receive instructions on when to and how long to fast, what are the medications to be taken and when the previous night and the day of surgery.
  • Most patients are asked to fast from midnight for morning operations or 06:00am for afternoon operations.
  • After this the date of procedure can be finalised with the consultant.
  • Apply for insurance if you have any and get pre authorisation.
  • You may take your regular medications (other than blood thinners and anti diabetic medications.

Day of admission

  • Bring all of your hospital paperwork.
  • Bring your X-Rays and other scans.
  • If having major joint replacement surgery you are adviced to have an antiseptic wash to shower with prior to coming to hospital.
  • Remove jewellery, watches, false nails, contact lenses.
  • You may wear dentures or glasses to the operating theatre and they will be returned to you in the recovery room.
  • Don't bring valuables into the hospital.
  • Wear loose and comfortable clothing.
  • Arrive at the time instructed or earlier if possible.

Finally, once you are in the hospital, report to the admission desk in the hospital.

Once you are in the room, will be readied for surgery A review check up with the anaesthetist will be done. One of the orthopaedic surgeons will visit you and mark the relevant limb after verification. You will be shifted to the operating room on call. The order of operating lists is determined by patient medical factors and then by planning processes for use of equipment. Some patients have to wait until later in the operating session for their surgery.

After surgery you may be spoken to within the recovery room, but many patients have little recall of such discussions due to anaesthetic effects. Day-care surgery patients will be provided with postoperative instructions by nursing staff and provided with paperwork to assist in postoperative care and review consultation planning and discharged. The details of your operation will be discussed at the postoperative visit in the OPD. If you are staying overnight then the details will be discussed during rounds the next day morning.