About your Robot Assisted Total Knee Replacement

Before your operation

After being admitted through the admissions desk of the Wesley Hospital you will be taken by one of our volunteers upstairs to the surgical waiting area where one of our perioperative nursing staff will check the details of your operation.

In one of our consultation rooms you will change into a surgical gown and a preoperative surgical checklist will be performed. After your first preoperative check has been performed, you will be escorted to a recliner in our preoperative waiting room. Your belongings will be locked up securely during and whilst you are waiting for your operation.

Prior to your surgery you will be introduced to your anaesthetic team (consisting of anaesthetist and anaesthetic nurse). You will have an intravenous cannula inserted in your arm by your anaesthetist which will be used to administer your anaesthetic once you enter the operating theatre.

You will be reviewed by Dr Smith and at this time you will have the opportunity to ask any last-minute questions you may have.

When the operating theatre has been properly prepared for your operation, you will be wheeled into theatre on a trolley and transferred to the operating table. Prior to the administration of an anaesthetic, the surgical team will confirm your personal details, the operation that you will be undertaking and the status of any drug allergies you may have. Your anaesthetist will administer a general anaesthetic from which you will wake up in the recovery room.

Once you are under general anaesthetic a urinary catheter will be placed into your bladder. This is routinely removed on the first morning after your operation.

Your operation

During your operation you will be given intravenous antibiotics to help prevent infection. A tourniquet will be applied to your thigh which is typically inflated for 15-20 minutes during implantation of the knee prosthesis. You will also be given a medication (tranexamic acid) to reduce bleeding during your operation.

A robot assists in preparing your knee and precisely orienting your knee replacement. Once your knee has been implanted, the robot is used to ensure that the alignment, orientation and soft tissue balance of the knee has been adequately restored. Your knee wound is then closed with invisible dissolving sutures, which need not be removed.

The wound is then sealed with a (fibrin) tissue sealant. A waterproof, second-skin dressing (Comfeel) is then applied over the wound. It is of paramount importance that this dressing is not disturbed for the next four weeks.

A stretchy, brown bandage (Coban) is then applied on top of the waterproof dressing from your foot up to your thigh and this remains until just prior to discharge from hospital. The nursing team on the ward will remove this dressing on the second or third post-operative day.

A powerful local anaesthetic block will be administered during the course of your operation, which will eliminate need for post-operative pain buttons or infusions. It will also allow you to get out of bed and take a short walk in the afternoon or evening a few hours following your operation. The local anaesthetic typically wears off by lunchtime on the first post-operative day.

After your operation you will be prescribed a variety of different pain-killing medications as well as medication to reduce post-operative nausea and vomiting.

From the minute that you wake up from your operation your knee is stable and you can move into whichever position is comfortable for you. There are no specific post-operative restrictions or precautions, but it is preferable that your knee is kept straight when you are resting in bed.

Resist the temptation to place a pillow under your knee! You may sleep in whichever position is comfortable for you. Patients are encouraged to sit out of bed as much as possible and perform multiple short walks regularly throughout the day under the supervision of the ward physiotherapy and nursing staff.

Whilst in bed patients are recommended to wear thromboembolic deterrent stockings (TED stockings), wear pneumatic sequential compression devices on their lower legs. These assist with improving circulation and blood flow back to the heart and are important in the prevention of blood clots (deep vein thrombosis-DVT, and pulmonary embolism-PE).

You will also be administered either Aspirin or Rivaroxaban, which are medications to thin the blood and further reduce your risk of blood clots.

On the first post-operative day

  • the catheter in your bladder will be removed (in the morning)
  • an x-ray will be performed to assess the overall alignment of your hip replacement
  • a blood test is usually performed

Mobilising after surgery

You will commence ward rehabilitation on the day of surgery shortly after your operation. Initially you will use a Rollator for mobility which will allow you to take your body weight predominantly through your arms.

As your mobility improves, your physiotherapist will upgrade your walking aids to either crutches or a walking frame as appropriate. You can use these for as long as you feel it is necessary and should you require them at discharge this will be arranged for you.

Discharge

You can discharge from hospital when you and your physiotherapist feel that your mobility is sufficiently safe and comfortable for you to cope at home. Typically this is between the third and seventh post-operative day.

You will be provided with a supply of all of the medications that you have been prescribed during your admission including blood thinners and painkillers. You can choose to have your prescription filled through the on-site Wesley Pharmacy (EPIC pharmacy) or at your local pharmacy on your way home.

The Wesley Hospital recommended discharge time is 10am, as it allows your bed to be made available for post-surgical patients in the afternoon.

After discharge

You need not follow any special precautions or restrictions on your mobility after you leave hospital.

You may sleep in any position that is comfortable for you. You should undertake physiotherapy rehabilitation to improve your recovery. This can be performed through the Wesley Day Rehabilitation Unit or alternatively through your local physiotherapy practice.

Please discuss this with your treating inpatient physiotherapist who will be able to liaise with the team who will continue your rehabilitation after your discharge from hospital.

Your wound dressing

The waterproof dressing on your wound should be left intact until the four-week mark following your surgery. At this point you may remove the dressing and wash the skin underlying it. There is often a residue under the dressing after it has been on for a month. This is normal and is no cause for concern.

If, after cleaning your wound you have any concerns regarding its healing or appearance please contact our rooms immediately and we will organise to have your wound reviewed and treated as necessary. It is not necessary to have the wound reviewed by your local GP.

Please make an appointment to be seen in Dr Smith’s rooms at approximately the six week and three month mark following your surgery. We will organise for you to undergo a standing x-ray of your legs prior to your three month appointment.

Questions or Concerns

Throughout your admission should you have any questions or concerns please speak to your ward nurse. Dr Smith is happy to be contacted at any time by the nursing staff should they be unable to answer your questions or address your concerns.

You will be seen on each day of your admission by Dr Smith on his daily ward round where your progress will be reviewed and any specific questions can be answered.

About your Hip Arthroscopy

Before your operation

After being admitted through the admissions desk of the Wesley Hospital you will be taken by one of our volunteers upstairs to the surgical waiting area where one of our perioperative nursing staff will check the details of your operation.

In one of our consultation rooms you will change into a surgical gown and a preoperative surgical checklist will be performed.

After your first preoperative check has been performed, you will be escorted to a recliner in our preoperative waiting room. Your belongings will be locked up securely during and whilst you are waiting for your operation.

Prior to your surgery you will be introduced to your anaesthetic team (consisting of anaesthetist and anaesthetic nurse). You will have an intravenous cannula inserted in your arm by your anaesthetist which will be used to administer your anaesthetic once you enter the operating theatre.

You will be reviewed by Dr Smith and at this time you will have the opportunity to ask any last-minute questions you may have.

When the operating theatre has been properly prepared for your operation, you will be wheeled into theatre on a trolley and transferred to the operating table.

Prior to the administration of an anaesthetic, the surgical team will confirm your personal details, the operation that you will be undertaking and the status of any drug allergies you may have. Your anaesthetist will administer a general anaesthetic from which you will wake up in the recovery room.

During your operation

During your operation you will be given intravenous antibiotics to help prevent infection. Your foot on your operated leg will be placed in a “ski boot” and then you will be rolled onto your non operative side. Traction will be applied to your operative leg by an instrument pulling on the ski boot. This will cause your hip joint to open up sufficiently to allow our surgical instruments to be inserted without damage to your hip joint surfaces.

An x-ray machine is used to confirm that the instruments are placed safely into your hip joint.

Hip arthroscopy involves using very fine instruments and a camera to perform keyhole surgery on the hip joint and surrounding structures. This usually requires 2 to 3 very small (15 mm) skin incisions (portals) to allow passage of these instruments into the hip joint.

Once the camera has been placed in your hip joint, photographs will be taken of all of the relevant structures in the hip as well as any pathology seen. Pathology such as labral tears, cam and pincer lesions, ligamentum teres tears and cartilage defects are then treated. X-rays are taken throughout the procedure and a selection of these are printed and given to you at the completion of your operation.

A final series of photographs is taken at the completion of your hip arthroscopy. A copy of all photographs taken throughout your operation is printed and provided to you after your operation. Your arthroscopy portals will be closed with nylon sutures and covered with small adhesive dressings (Primapore).

A large, bulky, white dressing is then placed over your hip at the completion of your operation.

A powerful local anaesthetic block will be administered during the course of your operation, which will eliminate need for post-operative pain buttons or infusions. It will also allow you to get out of bed and take a short walk in the afternoon or evening a few hours following your operation.

The local anaesthetic typically wears off by lunchtime on the first post-operative day. After your operation you will be prescribed a variety of different pain-killing medications as well as medication to reduce post-operative nausea and vomiting.

From the minute that you wake up from your operation your hip will be stable and you can move into whichever position is comfortable for you. There are no specific post-operative restrictions or precautions.

During the first six weeks of your recovery it is important to avoid moving your hip into positions which feel particularly painful or uncomfortable. You may sleep in whichever position is comfortable for you. Patients are encouraged to sit out of bed as much as possible and perform multiple short walks under the supervision of the ward physiotherapy and nursing staff.

Whilst in bed patients are recommended to wear thromboembolic deterrent stockings (TED stockings), wear pneumatic sequential compression devices on their lower legs. These assist with improving circulation and blood flow back to the heart and are important in the prevention of blood clots (deep vein thrombosis-DVT, and pulmonary embolism-PE). You will also be administered Rivaroxaban, which is a medication to thin the blood and further reduce your risk of blood clots.

Mobilising after surgery

You will commence ward rehabilitation on the day of surgery shortly after your operation. Initially you will use a Rollator for mobility which will allow you to take your body weight predominantly through your arms. As your mobility improves, your physiotherapist will upgrade your walking aids to crutches as appropriate. You can use these for as long as you feel it is necessary.

Patients usually require the use of crutches for 4 to 7 days post operatively. It is safe for patients to return to driving when they no longer need to use crutches and are able to perform an emergency stop without hesitation or pain.

Discharge

You can discharge from hospital when you and your physiotherapist feel that your mobility is sufficiently safe and comfortable for you to cope at home. Typically this is on the morning after surgery.

You will be provided with a supply of all of the medications that you have been prescribed during your admission including blood thinners and painkillers. You can choose to have your prescription filled through the on-site Wesley Pharmacy (EPIC pharmacy) or at your local pharmacy on your way home.

The Wesley Hospital recommended discharge time is 10am, as it allows your bed to be made available for post-surgical patients in the afternoon.

After discharge

You need not follow any special precautions or restrictions on your mobility after you leave hospital. You may sleep in any position that is comfortable for you.

You should undertake physiotherapy rehabilitation to improve your recovery. This can be performed through the Wesley Day Rehabilitation Unit or alternatively through your local physiotherapy practice.

Please discuss this with your treating inpatient physiotherapist who will be able to liaise with the team who will continue your rehabilitation after your discharge from hospital.

Your wound dressing

The bulky, white dressing on your hip can be removed at any time from the first post-operative day. You may wish to have this removed by the ward nursing staff before you leave hospital as it is not waterproof and can make showering more difficult.

The adhesive dressings underneath should be kept clean and dry until your two week review. Dr Smith will remove these dressings and remove your sutures at that stage.

Questions or Concerns

Throughout your admission should you have any questions or concerns please speak to your ward nurse. Dr Smith is happy to be contacted at any time by the nursing staff should they be unable to answer your questions or address your concerns.

You will be seen on each day of your admission by Dr Smith on his daily ward round where your progress will be reviewed and any specific questions can be answered.

About your Anterior Total Hip Replacement

Before your operation

After being admitted through the admissions desk of the Wesley Hospital you will be taken by one of our volunteers upstairs to the surgical waiting area where one of our perioperative nursing staff will check the details of your operation. In one of our consultation rooms you will change into a surgical gown and a preoperative surgical checklist will be performed. After your first preoperative check has been performed, you will be escorted to a recliner in our preoperative waiting room. Your belongings will be locked up securely during and whilst you are waiting for your operation.

Prior to your surgery you will be introduced to your anaesthetic team (consisting of anaesthetist and anaesthetic nurse). You will have an intravenous cannula inserted in your arm by your anaesthetist which will be used to administer your anaesthetic once you enter the operating theatre. You will be reviewed by Dr Smith and at this time you will have the opportunity to ask any last-minute questions you may have.

When the operating theatre has been properly prepared for your operation, you will be wheeled into theatre on a trolley and transferred to the operating table. Prior to the administration of an anaesthetic, the surgical team will confirm your personal details, the operation that you will be undertaking and the status of any drug allergies you may have.

Your anaesthetist will administer a general anaesthetic from which you will wake up in the recovery room. Once you are under general anaesthetic a urinary catheter will be placed into your bladder. This is routinely removed on the first morning after your operation.

Your operation

During your operation you will be given intravenous antibiotics to help prevent infection. You will also be given a medication (tranexamic acid) to reduce bleeding during your operation. Once your hip has been implanted, intraoperative x-rays are taken to ensure that the alignment, orientation and soft tissue balance of the hip has been adequately restored. Your hip wound is then closed with invisible dissolving sutures, which need not be removed. The wound is then sealed with a (fibrin) tissue sealant. A waterproof, second-skin dressing (Comfeel) is then applied over the wound. It is of paramount importance that this dressing is not disturbed for the next four weeks. A bulky, white, padded dressing is then applied on top of the waterproof dressing and this remains until just prior to discharge from hospital. The nursing team on the ward will remove this white dressing on the second or third post-operative day.

A powerful local anaesthetic block will be administered during the course of your operation, which will eliminate need for post-operative pain buttons or infusions. It will also allow you to get out of bed and take a short walk in the afternoon or evening a few hours following your operation. The local anaesthetic typically wears off by lunchtime on the first post-operative day. After your operation you will be prescribed a variety of different pain-killing medications as well as medication to reduce post-operative nausea and vomiting.

From the minute that you wake up from your operation your hip is stable and you can move into whichever position is comfortable for you. There are no post-operative restrictions or precautions. You do not need to adhere to hip precautions. You may sleep in whichever position is comfortable for you. Patients are encouraged to sit out of bed as much as possible and perform multiple short walks regularly throughout the day under the supervision of the ward physiotherapy and nursing staff. Whilst in bed patients are recommended to wear thromboembolic deterrent stockings (TED stockings), wear pneumatic sequential compression devices on their lower legs. These assist with improving circulation and blood flow back to the heart and are important in the prevention of blood clots (deep vein thrombosis-DVT, and pulmonary embolism-PE). You will also be administered either Aspirin or Rivaroxaban, which are medications to thin the blood and further reduce your risk of blood clots.

On the first post-operative day

  • the catheter in your bladder will be removed (in the morning)
  • an x-ray will be performed to assess the overall alignment of your hip replacement
  • a blood test is usually performed

Mobilising after surgery

You will commence ward rehabilitation on the day of surgery shortly after your operation. Initially you will use a Rollator for mobility which will allow you to take your body weight predominantly through your arms.

As your mobility improves, your physiotherapist will upgrade your walking aids to either crutches or a walking frame as appropriate. You can use these for as long as you feel it is necessary and should you require them at discharge this will be arranged for you.

Discharge

You can discharge from hospital when you and your physiotherapist feel that your mobility is sufficiently safe and comfortable for you to cope at home. Typically this is between the third and seventh post-operative day. You will be provided with a supply of all of the medications that you have been prescribed during your admission including blood thinners and painkillers.

You can choose to have your prescription filled through the on-site Wesley Pharmacy (EPIC pharmacy) or at your local pharmacy on your way home. The Wesley Hospital recommended discharge time is 10am, as it allows your bed to be made available for post-surgical patients in the afternoon.

After discharge

You need not follow any special precautions or restrictions on your mobility after you leave hospital. You may sleep in any position that is comfortable for you. You should undertake physiotherapy rehabilitation to improve your recovery. This can be performed through the Wesley Day Rehabilitation Unit or alternatively through your local physiotherapy practice.

Please discuss this with your treating inpatient physiotherapist who will be able to liaise with the team who will continue your rehabilitation after your discharge from hospital.

Make an appointment

Please contact our clinic based at The Wesley Medical Centre in Brisbane.