FOR PATIENTS
Patient admission forms
Please refer to your confirmation letter for instructions relating to your admission forms.
Pre-admission clinic
Please contact the Hospital at your earliest convenience to make an appointment to attend the pre-admission clinic TWO WEEKS PRIOR to surgery. Take the completed admission forms along with your medical history (from your GP) and medications list to this appointment.
X-Rays
If you have been issued with x-ray films for the area of the body that is being operated on, please take these to the hospital with you (including any MRI, Ultrasound and/or CT scans).
Blood tests
If you have been asked by the doctor to have bloods done prior to surgery, these will need to be done no earlier than 1–2 days prior to your surgery date.
Medications
We recommend that you contact your GP to discuss any medication you are currently taking. You may need to cease taking some medication for a period of time prior to your surgery.
Pre-payment
Pre-payment of your total surgery fee, as per your quote, is required by no later than 7 days prior to your surgery to confirm your booking. Please contact our office to arrange payment.
Surgery preparation
It is a requirement that you wash on the morning of your surgery with a medicated soap. This can be purchased from a chemist or supermarket. Also please ensure that all nail polish is removed prior to admission to the hospital or day surgery.
Fasting
Refer to the Preoperative Fasting handout from for fasting instructions.
Post-surgery aides
If you require any post-surgery aides, please ensure that these are organised prior to your surgery date as you will need to take these with you to the hospital or day surgery. Please speak to our staff regarding what you will need.
Preparing for surgery
Below is some information to help you understand the process that leads to the surgery and help you prepare yourself.
A different level of care
We will provide an individually tailored, patient-centred model of care and work with you and your referring doctor, to give you the seamless care you deserve.
If you have an acute injury, we can facilitate an in-house referral from one of the GPs in our team who will personally liaise with your usual doctor to make sure they are fully aware of the care you have received.
With in-house GPs available, we can see patients urgently without a referral. We will always complete a thorough summary of patient care to be returned to the patient’s usual doctor. This means you can see a surgeon quickly, without a referral but maintain the important relationship you have with your own doctor. So, if it is a Saturday morning soccer injury or a weekend warrior that is struggling with knee pain, give us a call and we will fit you in for an assessment and get you on the road to recovery.
FAQs
These are some of the frequently asked questions from patients undergoing total knee or total hip replacements.
Your anaesthetist will write up a number of pain relieving drugs to keep you comfortable post op. This usually includes a combination of regular paracetamol, slow release medication, immediate release medication and often an anti-inflammatory. Some of these drugs will be ordered as regular doses for the nursing staff to administer and some will be written up to take as required. If you experience pain let the nursing staff know – don’t wait until the pain is severe as it is then more difficult to manage. Ask staff what all the drugs are as when you get home you will be in charge and it helps to know what works for you.
Some of the drugs you will be given for pain have side effects in some patients. They may cause dizziness, nausea or constipation. Make sure you tell nursing staff if you experience any side effects. Constipation is no fun and can be easily managed. Let nursing staff know if you are not going to the toilet normally.
You will also find that ice and elevating your limb can help manage pain and swelling. We encourage you to ask the nursing staff to help you get into a position of comfort.
When you arrive on the ward the nursing staff will check your Vital Signs often. This is routine care and aimed at monitoring your condition in order to quickly determine any issues. Expect to have your blood pressure, oxygen saturation, temperature, pulse and respiration taken frequently during the first 24 hours. You will have an intravenous line for fluids and antibiotics which is generally removed the day after surgery. You will also have foot pumps in place to help your circulation. Although these are distracting they lower your risk of developing blood clots and will be removed when you are up and about. Ice will be applied to your joint either by ice packs or an iceman machine. This helps to reduce swelling. The nursing staff will provide you with a triflow to assist you with deep breathing exercises that are important after having an anaesthetic.
The physiotherapy team will be an important part of your recovery and you will see them every day you are in hospital. A hospital physiotherapist will assist you to get out of bed soon after surgery (either the afternoon of surgery or the next morning). Early mobilisation is very important in preventing possible postoperative complications. Spend time sitting out of bed each day and once you feel confident short walks around the ward are helpful to increase your independence.
Your room will have an ensuite bathroom and the nursing staff will assist you to shower until you become independent. You will probably need to sit down at first and it is important to do this especially if you experience any light headedness.
A hospital physiotherapist will assist you to get out of bed soon after surgery (either the afternoon of surgery or the next morning). It is important to your recovery to do this and helps to prevent post operative complications. Once you feel confident you can get out of bed on your own. Use the control on the bed to raise the back of the bed and lower the bed, if required, to make getting in and out easier. Be sure to use your mobility aid even when transferring from bed to chair and back.
You will be offered refreshments soon after you are settled in the ward and you will have water at the bedside. A menu for the following day will be provided on your breakfast tray each morning for you to make your selections. Some patients experience nausea after anaesthetic. If this happens let the nursing staff know so they can help you to manage it. Don’t be surprised if your appetite takes a while to return to normal.
You will see your surgeon regularly during your hospital stay and the nursing staff are able to contact him with any concerns. If you need medical care during your stay you may also see the Hospital Medical Officer. The hospital has an experienced doctor on site 24/7 in case of emergencies.
As soon as you are settled on the ward you can choose to see your family. Remember you will be drowsy and probably won’t feel much like talking. Visitors are welcomed while you are an inpatient but remember there will be times when you don’t feel like talking or you need to see your physio or be away from the ward for X-rays or rehab. Best time for visitors is late morning or early evening. You will find in the early post op days you will be napping often and tire quickly.
Your surgeon will provide an X-ray request soon after your surgery. You will be transported to the X-ray department, usually on your bed, on the day after your surgery. This is routine and provides a reference on file.
The day after your surgery the nursing staff will reduce the bulky padding over your wound and leave a waterproof post op dressing in place. This dressing will ideally be left in place until 2 weeks post op and would only be changed if it starts to lift or becomes heavily blood soaked. Your surgeon uses staples to close knee wounds and stitches under the skin and glue to close hip wounds. Staples are removed at 14 days post op. This will be attended by the nursing staff if you are still in hospital or at your first post op appointment if you have been discharged.
In the hospital setting all medications you receive need to be charted before the nursing staff can administer them. Provide an accurate list of any medications you take to the pre- admission staff or bring the list with you to give to admission staff. Bring enough supply of your regular meds packaged in the boxes or bottles they were supplied in and clearly marked with a pharmacist label. Remember some medications may need to be temporarily stopped after surgery. If unsure ask your doctor.
The nursing staff and physiotherapists will encourage you you use your triflow and do simple coughing and deep breathing exercises. This is to help fully inflate your lungs after anaesthetic and avoid any respiratory issues. You will be also encouraged to move your feet and legs to aid circulation and to sit out of bed for meals. Drink plenty of fluids (you will always have water at the bedside) to maintain your hydration and tell the nursing staff if you are not going to the toilet as you usually do.
Post-Operative
You can expect to be in hospital for between 5-14 days. If you elect to be discharged without doing any inpatient rehabilitation you will go home about 5 days post op. If you decide to do rehab your stay will be longer and, together with the rehab team, you will decide when you are ready for discharge
The OSSEM reception staff will contact you the day before your surgery is scheduled to tell you when to start fasting and what time to admit to hospital.
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Your regular medication
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Toiletries
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Pyjamas/nightdresses
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Book/magazines/tablet/phone
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If you have already arranged crutches or a walking frame arrange for your family to bring this in prior to your discharge
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Smoking can impact on your recovery so if you can stop, or at least cut back the amount you smoke, it would be beneficial. Do not smoke, vape, use chewing tobacco or use any other tobacco products up to 24 hours before your scheduled admission time.
Alcohol can interact with the drugs you will be given post op so if you can stop or cut back your alcohol intake in the week before surgery it would be beneficial. If you drink alcohol daily please let the nursing staff know as this can impact your recovery after surgery. Do not drink any alcohol 24 hours before your scheduled admission time.
Good nutrition helps with recovery and healing after surgery. In the weeks prior to surgery try to eat a healthy diet that includes a variety of fruit and vegetables and good sources of protein. If you are overweight, losing weight makes recovery easier, even just a couple of kilograms can make a difference. If you need a special diet please let the ward staff know. Some patients with very specific needs are able to take in their own food if they wish.
Prehab involves working on a series of exercises to optimise your function prior to surgery. Review by a physiotherapist can help to provide an exercise plan for you to work with. There are also a number of programs available online that are specific for patients about to have joint replacement surgery.
MyMobility is a digital interactive care plan offered to our total knee replacement patients. The program is in the form of a mobile app made by Zimmer Biomet, the company who manufactures the knee prosthesis. Patients need to have either a supporting iPhone or Android mobile device to utilise it. The app prompts and encourages patients to complete tasks such as prehab, education and rehab exercises as part of a care plan.
Please take supplies of your normal medication to hospital with you. Some medications need to be ceased prior to surgery. Please discuss the following medications with your doctor:
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Anti-inflammatories (Mobic, Celebrex, Nurofen, Voltaren)
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Blood thinning medications (Placid, Pradaxa, Eliquis or Aspirin)
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Diabetes (blood sugar) medications
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Herbal medication (fish oils, garlic, echinacea, kava, glucosamine)
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Pain, anxiety and depression medications
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Nicotine, alcohol, marijuana, or other cannabidiol (CBD) products
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Vitamins B, C, E and K
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You need to shower with an anti-bacterial solution in the days before surgery. This solution will be provided at the hospital pre-admission clinic. There is no need to shave around the surgical site. Remove fingernail polish prior to admission.
Physiotherapy is important in recovery after joint replacement surgery. A hospital physiotherapist will assist you to get out of bed soon after surgery (either the afternoon of surgery or the next morning). Early mobilisation is very important in preventing possible postoperative complications.
You will see the physio regularly during your hospital stay and they will provide you with an ongoing plan of exercises to continue with on discharge.
Some patients elect to remain in hospital for a longer period to undertake an inpatient rehabilitation program. This provides a very good start to your recovery and is especially useful if you will have limited support on discharge. Most patients who stay for rehab are independent or require very little assistance on discharge. RamsayHealth also offer outpatient rehabilitation programs. Discuss this with the hospital staff if you are interested. If you decide to do your own rehab at home, checking in with a physiotherapist at regular intervals will ensure your program continues to suit your needs.
Many patients are concerned about the level of pain they will experience after a total joint replacement. Your anaesthetist will order a schedule of drugs to manage your post operative pain. This usually includes a combination of regular paracetamol, slow release medication, immediate release medication and often an anti-inflammatory. Some of these drugs will be ordered as regular doses for the nursing staff to administer and some will be written up to take as required. If you experience pain let the nursing staff know-don’t wait until the pain is severe as it is then more difficult to manage. Ask staff what all the drugs are as when you get home you will be in charge and it helps to know what works for you.
Some of the drugs you will be given for pain have side effects in some patients. They may cause dizziness, nausea or constipation. Make sure you tell nursing staff if you experience any side effects. Constipation is no fun and can be easily managed. Let nursing staff know if you are not going to the toilet normally.
Visitors are welcomed while you are an inpatient but remember there will be times when you don’t feel like talking or you need to see your physio or be away from the ward for X- rays or rehab. Best time for visitors is late morning or early evening. You will find in the early post op days you will be napping often and tire quickly.
It is best to organise your rehabilitation equipment prior to admission or at least have a look at what is available. Most patients will benefit from the following equipment which can be hired or purchased (do your sums-it is sometimes cheaper to buy than to hire). You will need these items for 2–4 weeks after discharge.
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Toilet raiser (a must have for patients having a hip replacement but also helpful for knee patients)
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A chair to sit down on in the shower
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A long-handled reacher (again a must have for hip patients as you will not be able to bend forward to pick things up- also useful for dressing)
All joint replacement patients will need some sort of walking aid. Have a look at the options available and consider how they might work in your home before admission but don’t arrange until you are advised by physio in hospital what is right for you. The options include crutches, wheeled walker and walking stick. Some patients use a combination of all three so discuss this with the physio.
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It’s good to think about this prior to admission, especially if you live alone. Loose mats can be a tripping hazard so are better removed until you have recovered your normal mobility. Move furniture to create easy access around your home if required. Remember you will have a walking aid and will need a bit more space. A nightlight or bedside light to light your way if you need to get up to the bathroom at night is also useful. Think about rails beside your toilet and in your shower. If you have stairs at home talk to the physio in hospital who can advise you how to manage these safely. If you will be spending time alone after discharge keep your phone close. Patients who have hip replacement surgery will not be able to sit in low chairs and if your bed is very low it may be difficult to get in and out of bed.
A letter will be sent to your nominated GP by the OSSEM team soon after your surgery. As it can sometimes be difficult to get a GP appointment at short notice we advise you to make an appointment for a week or so after you expect to be discharged from hospital. The hospital pharmacy can only dispense a limited amount of pain medications and you may need more scripts from your GP to ensure ongoing supply. Your GP can also help you wean off these medications when you are ready.