FAQ

The usual fasting time is 6 hours before surgery. This includes all liquids as well as solids (though prescribed medications should be taken with a sip of water at their usual time).

Diabetic medications should be specifically discussed with your doctor as they may need to be adjusted at the time of surgery.

Usually if your surgery is in the morning then you will need to fast from midnight the previous night. If your surgery is definitely in the afternoon then you may be allowed an early light breakfast, though check first as operating list ordering may change at short notice.

This will depend on what type of surgery you have had done and what type of work you are involved in.

If you have an office type job then you may get back to work faster than if you are involved in heavy lifting activities requiring a high level of mobility. It is always a good idea to discuss this with your surgeon pre operatively so you can make plans.

This will depend on what joint you have had replaced and on how quickly you are progressing with your post operative mobility.

You need to be able to comfortably get in and out of a car and sit comfortably in the driver’s seat to consider driving. The best plan is to have a few trials at home before venturing out onto the open roads to ensure you are adequately mobile and comfortable to take the next step.

The time frame is usually between 6 and 12 weeks after joint replacement surgery.

Certainly you should mention that you have had joint replacement surgery to any health professional planning to perform a surgical procedure (eg dental, bowel, prostate, bladder, cardiac procedures).

Guidelines recommend that within the first 2 years after surgery you should definitely take oral antibiotics to prevent the risks of infection to a pre-existing joint replacement when undergoing future surgery. Many orthopaedic surgeons would prefer their patients to take preventative antibiotics whenever having medical procedures in future for the rest of their lives if there is any potential risk of infection to the joint replacement.

This usually requires taking an oral dose of antibiotics before and after the procedure.

There are a number of potential complications that may occur after surgery.

These may be grouped together as general complications that may occur after surgery and specific complications related to certain procedures.

General Complications
Drug reactions – Very occasionally medications and anaesthetic drugs may cause a reaction at the time of surgery – hence the need to let your doctors know about any allergies you may be aware of (even if the problem occurred many years ago).

DVT (deep venous thrombosis, blood clots) – These occur most commonly in the lower leg though occasionally can arise in the thigh or lungs. We usually take specific precautions to minimise this risk for all major surgery by using compression stockings (TED stockings), mechanical foot pumps, blood thinning medications and early mobilisation.

Operative Site Infections – We take specific precautions for every operation to prevent any infections occurring. This is especially important in joint replacement surgery. We routinely use antibiotics for 24 hours around the time of joint replacement surgery along with careful aseptic (sterile) techniques to minimise any risk. Risk of infection is usually under 2%.

Risk of other infections around the time of surgery
Urinary/bladder infections
Chest infections
These may occur after surgery and, in men, prostate problems should be identified and treated before major joint replacement surgery if possible.

Deep breathing exercises are important after surgery to help re-expand the lungs and minimise the risk of chest infections.

Heart/Lung/Kidney problems – If pre-existing problems exist then anaesthesia and surgery may act as a stress on the system. It is important to discuss any such problems before surgery so that preventative measures, if necessary, may be taken to minimise the risk.

Specific Surgery related problems
Hip Replacement Surgery
Infections are discussed above and if severe may require the hip replacement to be removed and re-inserted at a later date though this is a rare occurrence.
Dislocations occur rarely . Specific precautions are taken after hip replacement surgery to prevent this.
Leg length differences may occur infrequently but are usually very slight or not noticeable.
Nerve and blood vessel damage may occur but this is rare.

Knee Replacement Surgery
Infections are discussed above and if severe may require the knee replacement to be removed and re-inserted at a later date though this is a rare occurrence.
Knee stiffness may occur and physiotherapy is an important way to avoid the problem arising.
Nerve and blood vessel damage may occur but this is rare.

There is a slight risk of infection after any operation and joint replacement surgery is no exception. We take all precautions to prevent any chance of this complication occurring though unfortunately occasionally it does occur (less than 2% of the time).

If there is any sign of infection it is important to contact your doctor immediately so that we can diagnose and treat it quickly. If diagnosed quickly there is a better chance that the infection may be treated without involving surgery. Superficial (or minor) infections may be successfully treated with antibiotics alone. Deep (or major) joint replacement infections may need surgery to remove the infected joint replacement and replace the joint at a later time when the infection has been successfully treated.

This problem occurs infrequently. After a hip replacement it is important to comply with the specific instructions of your doctor to minimise the risks of a dislocation occurring.

If it does occur it can frequently be successfully treated by manipulating the hip replacement back into the joint with some medication given to relax the muscles or a quick general anaesthetic.

Occasionally if dislocations become recurrent then surgery may be recommended to fix the problem.

After cruciate ligament knee surgery physiotherapy rehabilitation is very important to help get you back to sport as soon as possible. This involves specific exercises (including stationery cycling, jogging in a straight line and ‘sport specific’ training) to get the knee strength and stability back to normal before full competitive sports are allowed.

The time frame for getting you back on the sporting field varies slightly from individual to individual and depends on how quickly your knee has fully recovered from the surgery and back to full strength and stability. Most orthopaedic surgeons, however, would not allow full contact sports before a minimum of 6 months after surgery.

It is safest to check with your doctor if plaster treatment will be required before surgery. Unless you have a fiberglass type plaster cast with water impervious ‘goretex’ underlay dressings then you can’t get the plaster wet.

1. If there has been any surgery performed under the plaster then you  can’t get it wet. This is because wet areas under plaster increases the risk of infection and may interfere with healing skin.

2. If swelling is likely to occur after a surgical procedure then a waterproof cast may not be advisable because the edges can dig into the skin and cause problems.

Treatment of certain conditions that require plaster where no skin areas underneath the plaster need to heal and where swelling is not a concern may be treated with water proof plasters and underlay. The waterproof underlay ‘goretex’ dressings, however, are expensive and not all hospitals keep them in stock. You may need to go to a private facility to be able to get this type of treatment if you desire a waterproof plaster.

This will depend on what joint you have had replaced and on how quickly you are progressing with your post operative mobility.

You need to be able to comfortably walk, be able stand in the golf swinging position and swing through comfortably without any strain. The best plan is to have a few trials at home before venturing out onto the golf course or driving range to ensure you are adequately mobile and comfortable. Use of a golf buggy to decrease the length of walking involved may also help initially.  You may be limited to putting and working on your short game for a time.

The time frame is usually around 12 weeks.