Mr. Sudheer L Karlakki
MBBS, FRCS(Ed&Gl), FRCS(Orth), Msc(Orth Eng), LLM (Med Law)
GMC membership number: 4340252
Consultant Hip & Knee
Replacement & Revision Specialist
Honorary Senior Lecturer
Robert Jones & Agnes Hunt Orthopaedic Hospital, Gobowen, Oswestry
01691 404344 & 07384 277867
Frequently Asked Questions:
Quit smoking and reduce alcohol intake.
Take any medications that you are regularly.
Consult your GP for a check and your underlying medical conditions are optimised.
Ensure your bowel movements are regular.
Stay as active as you can unless told otherwise.
You will be seen for pre-surgical assessment usually a couple weeks or so before surgery, earlier when the time permits.
The process can take up to couple of hours.
You will be seen by a pre-operative nurse practioner and undergo a thorough examination to ensure your fitness for surgery.
You may also see an anaesthetist as necessary.
You will be given instructions on:
- what to do before surgery
- when and what to bring to hospital
- who to contact before arrival
- and what arrangement you need to make to prepare for your discharge from hospital.
Depending on where your surgery takes place, you may have an opportunity to visit the 'Joint School', where you receive further information on how to cope with your surgery, which is also well laid out in the booklet and will be provided at the time of listing for surgery or at pre-operative assessment.
Shower well before surgery.
Loose fitting clothing for the hospital stay and physical therapy.
List of medications.
A copy of the preoperative history and physical exam form (if available).
Personal care items, such as a hair brush and toothbrush.
On the day of surgery, do not wear makeup, hair products, perfume or jewelry. Leave all valuables at home.
Upon arriving at the hospital, patients will be escorted to the pre-surgical area where they will change into a hospital gown. After changing, the nursing staff will take vital signs, start intravenous (IV) fluids, and administer any required medications.
An anesthetist and nurse will meet with the patient and discuss the type of anesthesia that will be used during and/or after surgery (i.e. general anesthesia, spinal anesthesia, femoral nerve block/catheter). Patients will then be transported to the operating room for surgery.
Recovery after joint replacement is typically 3-6 months.
Initial 2-4 weeks is where you see a rapid improvement.
It is recommended that you prepare your home by:
- removing objects from areas that could increase the risk of falling
- facilities for seating, sleeping and toiletory care downnstairs where possible
- place frequently used items in easy to reach places
- bathroom aids such as a shower chair or shower bar
- it is recommended that you have someone to help with activities of daily living (transferring from bed to chairs, bathroom assistance, dressing changes, etc) for the initial week or 2 depending on your previous mobility and physical ability
You may be required to make provisions for increasing the height of chairs and toilets if you are receiving hip replacement. Instructions for this will be given to you at pre-operaive clinic visit.
You will go home once all your therapy stages are complete and when you are safe, confident in using your crutches, medically well and wound is dry. This can be on the day of surgery or the following day or 2. This can however vary depending on the complexity and recovery after your surgery.
All your routine medication that you brought in with you will be returned. If we have started you on any new tablets / injections, you will be supplied with sufficient to complete the course at home. A nurse will talk you through your medication prior to you leaving the ward.
You will be placed on injections to minimise the risks of blood clots for 2 - 4 weeks. This could be longer or diffrent if you have had a blood clot in the past. You or your partner is required to learn admistering these injections and the nursing staff wil teach you this. This is subject to review, you may be sent home on tablets.
The hospital staff will discuss your individual requirements and will provide information and some equipment as necessary. plan ahead as it may be necessary for you to hire or buy some of the equipment that you will need when you go home after your operation.
By the time you leave hospital, you will have seen our advisory DVD and will have been shown how to get in and out of bed, how to use the bathroom and kitchen safely as well as how to cope with basic activities.
If you have had a knee replacement, outpatient physiotherapy will be arranged for you by our team. This will be at a department that’s closer to your home, unless you prefer to return to this hospital. For hip replacement patients, the best form of exercise is walking. Gradually increase the distance you walk as your general health allows.
Pain Management - Please rember you will have pain from surgery for a few days to weeks. Please ensure you stick to the pain killers as advised, you can taper it down if necessary.
Swelling in the leg - Not uncommon, elevate in bed with leg higher than heart by foot end of matress. May be necessary to do this during day time oce or twice up to an hour depending on the sweiing. Stay active in between.
Leaking wound- Ring hospital for advise, if more than 48 with new dressing, ring my seretary and insist on seeing me.
Redness along the wound - Not uncommon, paticularly in knee rpelaceemnt, does not mean you have an infection, rest and high eleavetion in bed often improves this. If not contact.
Not opened bowels- Ideally you should have done this before discharge. Try lactulose and senna , if no improvemnt seek help locally from surgery.
Persistent swelling of leg- If swelling does not go down after elevation or having been in bed in the night, this may indicate DVT. Contact hospital.
Also look in 'Following surgery' under 'General Info'