(08) 7077 0158 FAX: 7099 0171 liewadmin@orthopaedics360.com.au

Welcome to our pre-operative page. On this page and in the video above will be continually updated information regarding your upcoming total hip replacement.

Congratulations on taking the first step in your hip replacement journey. We are delighted to be able to help you on this pathway, and would like to make things as seamless as possible for you. The video above is to be used in con junction with our consultation that would have already occurred. We expect that viewers would have already been through the rooms for a discussion about your hip and the next step is your hip replacement!

A hip replacement is a fantastic operation, where the results should be phenomenal in restoring quality of life, mobility and removing pain generated from your hip. We perform all of our total hip replacements using the Direct Anterior Approach.

Please revisit this page as it will be continually updated with more information relevant to total hip replacement surgery so you familiarise yourself with the most up to date information. Contact our rooms if you have any queries related to your specific requirements.

Should I be performing physiotherapy before surgery?

In general, we would recommend that it is beneficial for all of our patients to stay as fit and healthy before surgery. For some, this means a physiotherapy program. Whilst physiotherapy is essential in general peri-operatively, it is not useful if you are experiencing a lot of discomfort whilst performing the movements. Remember that with surgery with us, we do not cut or detach any muscles to achieve the total hip replacement, so you will be able to return to gym exercises and rehabilitation after. Pushing yourself to cause pain and inflammation of the joint before surgery is certainly not required.

When do I stop my blood thinners?

We aim to give each patient a custom plan for their blood thinners (if you are on them). It is important that the decision to stop blood thinners is discussed with you to ensure it is safe to do so. In general, the below applies – please ensure you check with us if you are not sure. 

  • Aspirin – Stop 2 weeks before surgery (Unless you have a cardiac stent in which case we continue with Aspirin and accept a slightly higher level of post operative bleeding)
  • Xarelto/Apixaban/Eloquis/Pradaxa – Stop 4 days before surgery if it is used for Atrial Fibrillation. Do not stop if you are on them for an artificial valve. A custom plan would need to be created for you, which usually includes bridging anti-coagulation. 
  • Warfarin – Stop 5 days before surgery. Again, if this is for something more than Atrial Fibrillation, then a custom plan would need to be created for you. 
  • Clopidogrel (Plavix) – Stop 2 weeks before surgery. If this is for a cardiac stent or similar, then we would normally swap this for Aspirin. In general, those on Clopidogrel would need a custom plan created for them based on their risk profile. 
  • Glucosamine, Fish Oil, Ginkgo, Ginger and other supplements – Please stop these 2 weeks before surgery. 
  • Anti-inflammatories (Voltaren, Nurofen, Mobic) – Stop 2 weeks before surgery. If you are unable to cope without these, then they post a small risk of bleeding and can be taken ONLY when absolutely necessary during the 2 weeks before surgery. If you can stop them and cope, then please do so. 

The above covers most anti-coagulants. If you believe you are on something other than the above and need guidance, please contact us. 

When can I drive post op?

Often 2-3 weeks post operatively. We will normally be seeing you at the 2-3 week post op mark after surgery. In general, about 80% of our patients will achieve driving by the 2-3 week mark post total hip replacement surgery.

What happens after my scan?

Once you have booked your surgery, we will organise a 3 dimension scan of your hip. The scan is then processed and Dr Liew will perform a virtual simulation of your surgery, checking the position of the implants selected, the size, shape and small details associated with your particular hip. It is important for a thorough knowledge of any morphological or shape differences that may be there BEFORE the surgery takes place. During surgery, an intra-operative scan is performed to match with the pre-operative scan, ensuring that accuracy of implantation is optimised. Dr Liew believes that an Xray only performed AFTER surgery is too late, and does not allow for small adjustments to be made during surgery that can improve the end position of the implant, and affect longevity. 

When will I receive paperwork

In general, you should receive paperwork around the 3 week mark before the surgery. 

Can I shower with my wound dressings?

Although the dressing we use are classified as waterproof, it is recommended to keep     them as dry as possible. A simple tip to maintain a dry dressing is to cover the area with glad wrap or something similar, tape the edges and try not to immerse the area in water during your shower. Once finished, remove the wrap and tape and pat dry the surrounding area.

How long do the dressings stay on?

The dressings are to stay on until your 2 week appointment with the Doctor. At this appointment your dressing will be assessed and reviewed. If the dressing comes off during the first two weeks, please contact our rooms for advice and we will point you in the right direction.

How soon after surgery can I travel?

Interstate flights – as soon as you are discharged.

Overseas flights – given the normal increased duration of flights to international destinations, and the higher risk of blood clots after surgery for 28 days, we would recommend not flying overseas for 28 days post op. When flying on long flights after surgery, it is recommended to take a before and after flight aspirin to further reduce the risks of blood clots until 6 weeks post

When can I restart my natural supplements after surgery?

The reason why we stop the natural supplements such as Glucosamine, Fish Oil, Turmeric, Ginkgo, Garlic etc – is that they can cause blood thinning. This would be possibly too much when combined with the medicated blood thinners we give you after the surgery (usually twice daily aspirin). Once you have completed your 4 weeks post op of the medicated blood thinning, you can resume all natural supplements if you wish. 

How soon after surgery can I resume work?

This is highly dependent on the type of working being performed. It is our recommendation that you do not resume until you can drive, which for 80% of our patients is somewhere between 2-3 weeks post op. Whilst you would certainly not be fully recovered, you should be able to accomplish sedentary type work (ie office based duties) then, as long as there was flexibility in having opportunities throughout the day to stretch, exercise gently and ice the knee down. 

For more strenuous or manual roles, 6 weeks minimum is recommended. 

You should be able to do stairs post op when you wish. 

I will need a sick certificate - how do I get one?

If a sick certificate is required at any stage, please contact Jalmin by email advising her of the name (ie you or carer), the dates required and we will send you one via email.

When will I find out when I need to go to hospital on the day of surgery

We will send you an SMS and an email confirming your admission time 3 days prior to your surgery. Please fast 6 hours prior to this time. An admission to hospital can take 1-2 hours, to complete paperwork, and double check all the details, medical details and ensure you are safe to proceed with surgery. You may have 100mLs of water in the hour before your admission time. If you have any queries regarding your admission time, either respond to the email sent, or call us at any time. 

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