Patient Information

You will be assessed by one of our expert surgeons. The diagnosis is made by a combination of a detailed history of your problem and any other medical issues, clinical examination, and tests.

We may be able to arrange for these tests to be done on the same day of your consultation. If you have had some tests performed elsewhere, please let our administrative team know and they can request the results of these tests prior to your consultation.

During your consultation with us, we will discuss how the pain you are experiencing is affecting your life. We will make every attempt to explain what the cause of your pain is and sometimes we will need to arrange further investigations to help with this.

We understand that the key thing you will want to know is what can be done to help. We will start by explaining what is likely to happen to your pain, quality of life and independence if nothing is done. We will discuss with you the role of painkillers, physio and other therapies and lifestyle modifications. Unfortunately, however, a proportion of patients with arthritis will require surgery to gain good pain relief and to start enjoying life again. We will never advise you to have surgery but will always work through a process with you help you make the right decision for you. This is called Shared Decision Making and will involve a discussion of what any operation might involve and what the benefits and risks are. We will also provide you with further information which you can access from home which will help remind you of our discussions and for you to show to/discuss with family members and friends.

If you make the decision to go ahead with surgery, we will do everything we can to perform an excellent operation in a timely manner, with the best chance of returning you to the life you aspire to. We are lucky that in hip and knee replacement we have two of the most successful operations ever invented and whilst there may be some early discomfort, the rehabilitation is usually swift and predictable.

Your Consultant will arrange the surgery at a hospital that you are happy with at a time that suits. Our team of secretaries will help co-ordinate this both with the hospital and, if necessary, your insurance company. You will need to visit the hospital before surgery for a pre-assessment visit where your health will be checked to be sure you are ready for your operation. At your pre-assessment visit, advice will be given to you about your medications, nil by mouth timings on the day, what aids you might need after surgery, how long you are likely to be in hospital and your discharge. For the foreseeable future there will be COVID19 related issues to discuss as well.

The surgeon will explain to you the diagnosis and treatment options. These may include non-operative treatment such as physiotherapy, injection and analgesia. If the surgical treatment is required, our surgeons will explain the details of the operation including the benefits and risks.

Our administrative team can help explain the costs of the treatment and liaise with the relevant insurers. For self-paid patients, the hospital can provide a fixed price treatment package. Please ask our team for more details.

One of the biggest advances in planned, elective surgery in the last 5 years has been the adoption of Prehabilitation (prehab). We now know that a period of training prior to surgery enables patients to recover better, faster and with less complications.

For 2 years we have been routinely offering this service to our patients. Prehab has revolutionised the recovery of our patients. This involves a telephone call, ZOOM call or home visit from one of our prehab therapists and the planning of an exercise programme which will get you fit for your operation. You may think you have too much pain/stiffness for exercise, but we start with chair-based exercises, core stability and balance work which will make a huge difference to how you come through and recover from your operation.

One of the other benefits of having a home visit from the prehab therapist is to look at your home surroundings and make adjustments around your mobility and safety following discharge. We do make a charge for this service, which is not covered by your insurance, but patients generally find this offers extremely good value.

Once you are listed for surgery, you will be reviewed by the pre-op assessment team. Their role is to review any medical conditions and medication you take to ensure our anaesthetists are ready for your surgery and your stay in hospital is smooth.

A planned discharge date will normally have been agreed as part of the pre-assessment process. You would normally be in hospital for between two and four days, with your progress monitored by the team. By the time you go home you will be confident walking and be able to do stairs. Don’t worry – we won’t send you home until everybody is happy that you are ready to go home.

There will be a dry dressing on the wound, which is left intact for between 10 and 14 days. You will be able to shower, but not soak the dressing.

You will be sent home with blood thinners. This will normally be injections for hip replacements (we will teach you how to do this) and a mini aspirin for knees; some patients require a different approach, depending on their history, and this will be discussed with you.

You will be sent home with pain killers; we recommend paracetamol and an anti-inflammatory (e.g. ibuprofen if you can tolerate these drugs) to be taken on a regular basis; we will also give you stronger (opioid) pain killers to take as necessary.

In the early stages after you go home you will feel tired and want to rest frequently – this is normal. Patients will normally take regular pain killers for the first couple of weeks and then wean them off the subsequent weeks as the post-surgical pain reduces. You will continue with your blood thinners, but do not need to wear surgical stockings after you go home.

There will be a waterproof dressing over the wound. There will be a second dressing if you are having robotic assisted surgery. These can be left intact unless they get wet in the shower. We will give you a spare dressing in case it needs to be changed. You can take the dressing off yourself after 10 to 14 days and then leave the wounds exposed.

The physiotherapist will send you home with an exercise programme to follow. It is important to do light exercise little and often. Patients often feel very stiff and sore when they first get up, but feel better as they get going, so short frequent walks are a good idea. It is best to rest and exercise at home for the first week or so, but after that it is often helpful to see a physiotherapist to progress your rehabilitation. You can come to the hospital for that or arrange it with your own physiotherapist closer to home.

You will be using walking supports (crutches or walking sticks) when you first go home. Patients often find they can manage without support very quickly at home and are walking without support outdoors by between 4 and 6 weeks. Essentially you can stop using support when you no longer think you need them.

Patients can get back to driving by between four and six weeks. By three months we would normally expect patients to be getting back to light sporting activities, but full recovery and return to full sporting activities can take at least 6 months. Your surgeon will discuss your return to sport programme on an individual basis.