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- Joint School
Joint School is a programme run by the Mater Private to help prepare patients for joint replacement surgery. The aim is to ensure that they are as fit as possible for surgery and that they are ready to be an active participant in their own care.
Patients meet with members of the entire team who will explain the roles of surgery, anaesthesia, physiotherapy, recovery and pain relief.
Joint School has been hugely successful in encouraging and enabling patients to become active participants in their care. This preparation and involvement also removes many of the fears and anxieties which some experience prior to surgery.
- Enhanced Recovery Programme
The Enhanced Recovery Programme (ERP) is a multidisciplinary and goal based approach which encourages the patient to become an active participant in their recovery process and rehabilitation. The goal is to minimise the physical and mental stress of surgery through a combination of preparation and participation so that patients can return to normal, daily activities as soon as possible.
In practical terms this means that the nursing and physiotherapy teams commence rehabilitation within 24 hours of surgery. The anaesthetic and pain relief protocols have been enhanced – which has the benefit of allowing patients to move earlier and recover faster.
- Pre-Operative Assessment Clinic
Within one month before your operation, patients may be invited to attend the Pre-operative Assessment Clinic. During this visit they will be asked about their medical history and any medications they are taking. Blood tests will be carried out and they may have an ECG and x-ray.
Pain management plays an important part in recovery and rehabilitation and is often of great concern for patients. The Consultant Anaesthetist and Nurse at the Clinic will talk to patients about pain management after surgery.
The Pre-operative Assessment Clinic gives patients the opportunity to see the Physiotherapist and Nurse, ask any questions they may have and plan for their discharge from hospital.
- Preparing for Procedure
Patients and the Healthcare team will work together to carry out several actions before and after surgery to reduce the risks of complications. It is important to be in the best possible overall health and there are a number of things patients can do to prepare for surgery, recovery and rehabilitation.
Diet - In the weeks before your surgery eat a balanced diet as this can help the healing process.
Smoking - If you smoke, stop as far in advance of surgery as possible. Smoking may cause complications with the anaesthetic and nicotine can delay or interfere with healing and bone growth.
Blood Clots - To reduce the risk of developing a blood clot in the legs or lungs, a number of recommendations will be given to you in advance of your surgery.
Infection - If you have any signs or symptoms of an infection, such as a chest or urinary infection in the days prior to your surgery, you will need to inform your surgeon. The surgeon will also need to be advised if you have a rash or flare up of psoriasis or eczema around your hip area or a leg ulcer. If you have a history of MRSA/VRE or have been in contact with someone with MRSA/VRE, you should also inform us.
Exercise - It is important to be as fit as possible before your procedure, as it will make your recovery much faster. You will be given a personal exercise programme to follow in advance of and for a time after your procedure.
- The Procedure
Any damaged cartilage and bone will be removed and the hip joint will be replaced with an implant. A total hip replacement procedure takes a few hours. The Surgeon will select the type of implant that best suits a patient's needs.
Hip replacement surgery is generally carried out under spinal anaesthetic with sedation. A Consultant Anaesthetist will discuss anaesthetic options with patients, as well as the risks and benefits associated with each.
- Following the Procedure
- Patients will be held in the recovery area until they are stable enough to return to the ward where the team will work closely to aid recovery.
- Patients will have a drip for intravenous fluids through a vein into the arm or hand which will continue until they are able to eat and drink again. Patients may eat and drink as required, commencing with sips of water followed by a light meal.
- A drip may be inserted in the hip which is normally removed 1-2 days after surgery.
A patient's discharge date will be determined by all members of the Healthcare team involved in their care, who will work in consultation with their family.
Discharge from hospital normally occurs when patients reach specific goals such as the distance they can walk or how much their wound has healed. The Surgeon will discuss the expected length of stay prior to admission.
Patients generally return to their own homes after discharge from hospital as they typically do better in their own familiar environment. They are given a home exercise programme and rarely require further physiotherapy.
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