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You should bring in with you

• Day clothing - Men, tops and shorts - Ladies, tops and elasticated skirts or shorts

• Nightclothes and a loose fitting dressing gown

• Underwear

• Firm fitting low-heeled slippers and shoes

• Soap, flannels/sponge, make up, hand mirror

• Shaving equipment - please bring adapter if electric razor

• Comb or hairbrush

• Toothpaste and toothbrush, or denture tablets and pot

• Towels, large and small

• Fruit juice, or mineral water

• Any walking or dressing aids

• All medication you are taking including inhalers and anything bought from a Chemist or health food
• shop.

Please leave all cash and valuables at home. If you need to bring valuables into hospital with you, a nurse can lock these away for you at your request. The Trust does not accept responsibility for any items not handed in for safekeeping.

Please bring this booklet into hospital when you are admitted for your surgery.

On the day you are admitted (usually one day before surgery) you will be seen by the various members of the team who will be caring for you before surgery, during the operation and afterwards.

Nursing Staff

On admission, you will be told who your named nurse will be. He or she will be a qualified nurse, who has special responsibility for your care. In the absence of your named nurse, the team of people working with them will be responsible for providing your care. The nursing staff will check that there has been no changes in your circumstances since your pre-admission clinic visit, and discuss with you the support you may need after discharge home. The nursing staff will discuss any fears or concerns you may have about any aspect of your care.

Surgeon

A member of the team who will be performing the surgery will see you. He or she will examine you and arrange for any further blood tests, x-rays etc. to be done to ensure that you are fit for the operation. If you require any medical treatment to get you fit for surgery, this will be arranged. The doctor will also explain to you about the operation, possible complications and what is done to reduce the risks of complications. He or she will also mark your leg for the operation and ask you to sign a consent form.

Anaesthetist

He or she will see you on the ward before surgery to discuss with you the type of anaesthetic and also the types of pain relief available, after your operation. We aim to keep you comfortable at all times.

Physiotherapist

The physiotherapist may visit you to remind you about the leg exercises and teach you breathing exercises. These exercises are very important and will help prevent some of the complications of the operation; clots in the leg and chest infection. The leg exercises will also start to strengthen and relax the muscles of your leg, which have become weak and tight because of the arthritic pain and stiffness in your leg. The physiotherapist will also tell you about how they will help you to get back on your feet and walking safely, ready for home. He or she may teach you some exercises to help strengthen your muscles ready for after the operation.

Occupational Therapist (OT)

The OT will also check that you have enough support at home and offer advice for a safe discharge. He or she will discuss with you and advise you on the necessary precautions following your operation with regard to everyday living activities, e.g. washing/dressing, getting on/off furniture. Please give your furniture measurement form to the OT.

All of these people are here to help you. Others, like the Social Worker and Dietitian, are available if you need them.

The day of your operation

On the morning of your operation, you will be asked to have a bath or shower and then put on a theatre gown and disposable underwear. You will be asked to remove jewellery - plain rings can be worn but they will be taped. Acrylic nails and nail polish will also need to be removed.

If you are on regular medication you will be told to take this if necessary. A bracelet with your personal details will be attached to your wrist. The anaesthetist (who will have previously been to talk to you) may have prescribed a tablet (you may be prescribed a sleeping tablet the night before surgery and a pre-med on the morning of surgery).

One of the actions of the pre-med is to relax you. It may make you drowsy. Once you have had your pre-med you will be asked to stay in bed for your own safety. When the surgeon is ready, a nurse and a porter will take you to theatre on your bed. Your dentures, glasses or hearing aid can stay with your on your journey to the operating theatre. When you arrive in theatre, a theatre nurse will check your details with you. You will then be asked to put on a disposable hat. The ward nurse will then leave you and you will be taken to the anaesthetic room

The operation is performed in a very special ultra clean operating theatre to reduce the chance of infection getting into your new joint. The operation itself takes between 1-2 hours. After this, you may spend at least an hour in a recovery area until the early effects of the anaesthetic wear off and it is safe for you to return to the ward. You should expect to be away from the ward for at least three hours.

Recovery

When you wake up in the recovery area you will have an oxygen mask on your face, a drip in your arm and maybe a drainage tube in your knee. After you have recovered from the anaesthetic a nurse will escort you back to the ward.

A nurse will check your pulse, blood pressure and breathing rate regularly. The nursing staff will also advise you when you can start taking sips of water. Anaesthetics can make some people feel sick. If you feel sick we advise you not to drink until this feeling has passed. The nursing staff may offer an injection to help this feeling go away.

Pain Management

We aim to keep you comfortable at all times. At first, painkillers will be given through an injection. If you are suitable and wish to use patient controlled analgesia (PCA) this will be given by a drip and full explanation of PCA will be given to you on admission to the ward. You may feel a little nauseous as a side effect of the injected painkiller. Please let us know if you are and we shall arrange to give you something to help. Painkillers in tablet form are often sufficient from two to three days after your operation. Please remember it is important that you are comfortable enough to relax, sleep and move freely. Nursing staff will offer you painkillers regularly but please tell them if you are uncomfortable. The use of painkillers will help you to tolerate your postoperative exercises.

Intravenous Infusion (Drips)

Drugs and fluids are given by this route. Occasionally a blood transfusion may be in progress. This may restrict the movement of your arm. The drip will remain in your arm for between 24 and 48 hours. The drip may feel uncomfortable at times but it should not be painful. If it is painful please tell your nurse.

Wound

Your wound will be covered with a dressing, and a tube may be in the wound area to drain any oozing blood. This small drainage tube is normally removed at 24 to 48 hours after the operation. This is not a painful procedure. Your dressing will only be changed or removed if it is loose or heavily bloodstained. Sutures (stitches) or staples are removed 10 to 12 days after surgery. This is not a painful procedure.

Stockings and Foot Pumps

You may have a special stocking on your leg to help keep your blood flowing at a good rate. In addition a foot pump may be used to encourage the return of blood from your leg veins to your heart to reduce the risk of thrombosis (blood clot). This foot pump repeatedly inflates and deflates.