PATHWAY TO SURGERY

Home / Pathway to Surgery

Paul Stevenson 72, English Channel Swim,
7 months post HIP REPLACEMENT SURGERY

It's important to understand what may be involved in your upcoming surgery.
Here's our step-by-step guide.

When you make an appointment, you’ll get to meet with one of our orthopaedic specialists who will
discuss your specific injury. Following your appointment, the team will discuss possible complications,
risks, and surgical approaches specific to your case, drawing on their collective expertise,
to decide on the best treatment option for you.

1. FIRST CONSULTATION

What’s involved with a hip or knee surgery? Do you really need a total hip replacement? Will having a knee replacement enable you to enjoy a pain free active lifestyle again?

Answering these and other questions will be part of your consultation with our team of orthopaedic surgeons at Vincent Pallotti Hospital.

Please bring x-rays, referral letters and medical aid details to your appointment.

We discuss each case, combining our collective experience and knowledge to get to the correct diagnosis for each patient.

Not all injuries require joint replacements. In fact, we prioritise joint preservation over joint replacement. As specialists in joint preservation, we discuss this important decision with you.

Do you require surgery for your injury? If so, what type of surgery is required and what do you need to know? All the necessary details are discussed in your first consultation.

Our collaborative team approach provides assurance that we consider only the most optimal surgical approach for you. We also discuss the associated benefits and risks of the recommended surgical approach to ensure that you have a clear understanding of the procedure.

This is an important discussion as your choice of prosthetics will have a direct impact on your quality of life following the procedure. Rest assured, our team of orthopaedic specialists will assist you with all the information and recommendations so that you can make the right choice.

2. PREPARATION FOR SURGERY

Preparing for surgery needn’t be stressful. We will help you with everything you need to know before your procedure. All patients should not eat nor drink 6 hours prior to their operation.

These important steps are what you need to know leading up to surgery:

Surgery does have an impact on your body, so it’s important to be sufficiently fit and healthy beforehand. If you are unsure about this, talk to us and we will assist in making the call.

We will provide you with the necessary codes and information you need to get an authorisation number for your surgery from your medical aid. Please provide us with these details as soon as you received them from your medical aid.

A member of our nursing team will visit you at home prior to your surgery to check your vitals and gather any information needed from you before the procedure. This personalised service is one of the patient care benefits that sets us apart.

This is a critical consideration as any source of infection can impact the success of a hip replacement or the placement of any prosthesis. The importance of this cannot be stressed enough, as the presence of any infection in the body can rapidly result in an infection of the prosthesis and impact the success of the surgery. Any indication of infection or inflammation will therefore result in the postponement of your operation.

Check for these signs of possible infection:

  • Dental

    It is important to see your dentist for a dental evaluation to reduce infection risk. Common infection sources include irritation from an orthodontic appliance, or any type of mouth infection.

  • Feet and Hands

    Make sure to check your feet for any type of fungal infection, ingrown nails, corns, or unhealed wounds. Also check your hands and fingers for cuts or infections.

  • Skin preparation

    Start washing your body with a medicated or antiseptic soap at least two days before surgery to reduce the presence of bacteria on your skin. Check your body for any kind of pimples. If you are unsure about anything, please contact us so that we can advise.

3. DAY OF SURGERY

All our surgeries are performed in a dedicated orthopaedic theatre at Life Orthopaedic Hospital, Cape Town.

Here is what you need to know to prepare:

ADMISSION - Please take note of your admission time so that you can arrive relaxed and on time.

NO EATING - As mentioned, all our patients should not eat nor drink 6 hours prior to their operation.

SHOWER - Take one last pre-operative medicated soap shower prior to admission to reduce the risk of infection.

SPECIAL REQUIREMENTS - The Anaesthetist will see you in the ward preceding the operation. If you have any special requirements, allergies or previous anaesthetic problems, please be sure to tell the medical staff.

THE PROCEDURE – This takes approximately 2 hours in the theatre. Once the Anaesthetist has checked you and is satisfied, you will be transferred to the recovery ward.

4. POST-OP

RECOVERY WARD - You will be transferred to the recovery ward the next morning if your vitals are stable and your recovery is progressing satisfactorily.

MOBILISATION - The physio will assist with your initial mobilisation. This is an important step to get you moving as soon as possible.

HOSPITAL STAY - You can expect your hospital stay to be between 2-5 days before you are discharged and can go home.

PHYSIO - The physio will provide you with the necessary information and exercises, so you can continue your mobilisation exercises at home.

5. HOME CARE

As an added service to you, Cape Hip and Knee Practice provides you with free home care and 24-hour emergency assistance from our team of experienced clinical nurses.

The initial few weeks after surgery are vital for your recovery and it is important that you know what you need to do to get mobile again and make the best recovery possible.

The wound is covered with a sterile dressing in theatre once the procedure has been completed. This dressing will be replaced in the ward before your discharge. The new dressing will be a waterproof dressing. For infection control, it is important that this dressing does not come loose, but just in case, you will be provided with a spare dressing. We will remove the dressing and inspect the wound at the routine three week follow-up visit.

Following surgery, you need to use 2 crutches for at least 3 weeks’. We encourage you to keep mobile and enjoy the outdoors as far as you are comfortable. However, remember to take it easy – you are still in recovery. Don’t over-stride and stick to level ground when walking. Also, avoid carrying anything that is heavy for a while. Lastly, don’t do anything that creates an impact on your joints – e.g. jumping up and down or stomping your feet.

Our recommendation is that you start driving when you can walk comfortably with a single crutch. However, we advise that you press your legs tightly together and pivot them to get in and out of your car.  

Preferably lie flat on your back with a pillow under the operated leg. Do not lie on your side for the first two weeks. To get out of bed, pivot your buttocks to the operated side with your legs straight and your knees tight. Sit on the edge of the bed and get up with the help of your arms. When you get dressed, begin dressing with your operated leg and put your weight on your stronger leg. Always avoid crossing your operating leg over your midline. Never reach for your foot around the outside of your knee. Always reach down between your knees. This will prevent your leg crossing the midline.

It is important to be very careful in the bathroom as any slips or falls can cause serious injury and hamper recovery. If you can, have a support railing installed to help you get up from the toilet and near the bath or shower to provide support. If you prefer to shower, use a non-slip mat in the shower.

It is important that you stick to the routine provided to you by your physio as this speeds up the recovery process.

Try to only sit on high seats with armrests which can assist you to get up again. Avoid low, soft armchairs as you will struggle to get up and can injure yourself in doing so. Ask for help to pick up an object to avoid bending down. If not, use the safety position shifting your operated leg behind you and placing your weight on your stronger leg. If you have to use the stairs, hold a crutch on the operated side and the banister on the other side. Place your good leg on the first step, whether you go up or down stairs.

If you have to travel, either by car or airplane, it is important to exercise caution so as not to hinder your recovery. Pivot your legs to get in and out of the car. Try to take regular stops so that you can walk around and keep mobile. In the airplane, use the seat armrests and headrest of the seat in front of you to get in and out of your seat. Also try to walk around on the airplane when it is safe to do so.