Your consultant will already have discussed your procedure with you in detail and highlighted any potential risks or complications associated with it. We will then send you a pre-operative questionnaire to fill in and bring with you on the day of your procedure.
When you have your pre-operative assessment, either over the phone or during an appointment, we’ll ask you some questions about your health and you’ll also have an opportunity to ask questions or discuss any concerns you may have. You’ll be given a time to arrive on the day of your surgery and some instructions about preparing for surgery.
If, for any reason, you can’t attend your appointment, please contact us as soon as possible.
Your consultant will discuss with you not only the prospective benefits of your treatment but also possible complications and how the risk of such complications occurring can be managed. They consider what is best for each patient on an individual basis. As with all careful and responsible orthopaedic surgeons, they have regard both to national guidelines (such as those produced by the National Institute for Health and Care Excellence in relation to preventing blood clots and local protocols (which will differ, depending on where your treatment is being provided). If they consider, when exercising their clinical judgment in relation to your care, that your interests would be best served by treatment that does not follow a national or local guideline, they will explain to you why your particular circumstances justify a different form of treatment. Our consultants believe that decisions about your treatment and care should be made jointly, and so they will welcome any questions you might want to ask.
It’s a good idea to wear comfortable, loose fitting clothes, cotton underwear and flat shoes. Please don’t bring any valuables such as large amounts of money or jewellery (apart from a wedding ring, which can be covered). Please remove make-up including nail varnish and/or artificial nails before you arrive.
When you arrive at reception you will be asked to sign any outstanding paperwork and confirm your payment details. One of our nurses will meet you and show you to your room. They will ask some more questions about your health and also check your blood pressure, pulse and temperature. They will give you a hospital identity bracelet and ask you to change into a hospital gown.
Your consultant will come and see you and discuss your procedure. He will then go through the consent process with you, highlighting any potential risks or complications associated with the procedure. After this, you’ll be asked to sign a consent form. You will also be seen by the consultant anaesthetist who will explain the different anaesthetic options; together you’ll agree the method that’s best for you (normally a general anaesthetic). You will have an opportunity to discuss any concerns about your anaesthetic with your anaesthetist before the surgery.
You are welcome to bring a friend or relative with you and they can stay with you until it’s time for you to go to the operating theatre.
You will be taken from your room to the operating theatre. Once in the anaesthetic room, you will be given the appropriate anaesthesia. Most patients undergoing knee surgery have a general anaesthetic. However, patients with medical problems such as heart or lung disease may be offered a spinal anaesthetic instead. Sometimes both techniques are used, with the spinal anaesthetic providing post-operative pain relief.
When you wake up in the recovery suite you will be closely monitored until you’re ready to return to your room; you’ll be offered appropriate pain relief as and when you need it. Depending on the type of surgery you’ve had, you may be able to return home once you’ve had something to eat and drink and are feeling steady.
During your hospital stay, your progress will be closely monitored by your consultant, along with a team of ward nurses and physiotherapists. When you wake up, you may have a bulky bandage around your knee (and/or a protective splint/knee brace). Depending on the type of procedure you’ve had, you may also have a thin plastic tube, or drain, to collect and measure any post-operative bleeding. These are used for more complex procedures where there is a risk of bleeding, such as a total knee replacement. If you’ve had keyhole surgery, you’ll be given photos and a DVD of your operation if you would like to have them.
This depends on the type of surgery you have had. All patients are given an injection of local anaesthetic at the end of the procedure which helps to reduce pain for up to 12 hours after surgery. With some operations such as ligament reconstruction and knee realignment (osteotomy) surgery, stronger painkillers may be needed. With major surgery, such as a total knee replacement, an injection into the spine and/or a patient controlled painkiller infusion may be used to make you more comfortable.
This depends on the type of procedure you have had. Keyhole surgery is normally carried out as a day case procedure, although some patients prefer to stay overnight. The same applies to simple ligament reconstruction surgery. However, for more complex operations such as joint replacement you may need to stay in longer. You’ll be able to discuss this during your pre-operative assessment.
All surgery carries risks. However, we are committed to minimising risk to our patients. Your consultant will discuss the risks of surgery with you beforehand and you’ll have an opportunity to discuss any concerns before you decide to go ahead. It’s important that you fully understand both the risk and benefits of any procedure before you decide whether surgery is right for you.
The risks of surgery vary from procedure to procedure, but can include:
This depends on the type of procedure you have had. Keyhole surgery is normally carried out as a day case procedure, although some patients prefer to stay overnight. The same applies to simple ligament reconstruction surgery. However, for more complex operations such as joint replacement you may need to stay in longer. You’ll be able to discuss this during your pre-operative assessment.
Your consultant will be able to give you an indication of costs before your procedure. However, the actual cost of treatment may be higher if further unexpected treatment is required. Please contact us for further information.
During your hospital stay, one of our physiotherapists will advise you about your rehabilitation programme, including any follow-up physiotherapy appointments. Your surgery is likely to be more successful if you understand what your limitations will be after surgery and plan in advance so that you are well supported when you return home. Carrying out your rehabilitation exercises as advised will help you to recover as quickly as possible.
This depends on the type of procedure you have had as well as your general fitness and your circumstances at home, including how much help is available. You will need a responsible adult to accompany you home and stay with you for at least the first 24 hours following a general anaesthetic.
Before you go home, we will arrange any follow-up appointments, including physiotherapy, as well as any medication you may need.
The risk of any major complications after keyhole surgery is less than 1% (one in every 100 procedures). After your operation, you might be comfortable enough to go home the same day, although some patients prefer to stay in hospital overnight. You will be given a DVD and photos taken during your operation to take home with you if you would like to have them. The two small arthroscopy incisions are sealed with sticky plasters, or occasionally, stitches. The nursing staff on the ward will give you instructions about how to look after the dressings and wounds.
This is normally carried out using keyhole surgery, although in some cases you may need to have open surgery. Recovery is usually similar to keyhole surgery although there may be extra incisions with dissolvable stitches. In most cases, you can bear weight straight after surgery and walk without crutches, but this can depend on the type of meniscal surgery you have had. You’ll be offered advice about your rehabilitation, and how to care for your wound before you leave hospital. Most patients are able to go home the day after their operation.
If you have had a microfracture procedure to treat a knee cartilage injury, you’ll need to use crutches for up to six weeks after your operation. If you have had an osteochondral grafting (OATS), or cartilage transplantation (MACI) procedure, your rehabilitation will depend on exactly where in the knee the cartilage surgery was carried out. Following all these procedures, patients normally go home the next day.
This will depend on whether you have had medial patella-femoral ligament (MFPL) reconstruction to stabilise your kneecap, trochleoplasty or bony realignment surgery. In most cases, you’ll stay in hospital for up to two days. Depending on the type of operation you have had, you might need to wear a brace or use crutches after surgery. You will be given a rehabilitation programme by one of our physiotherapists before you go home.
Repair/reconstruction of a single ligament such as the anterior cruciate ligament (ACL) or medial collateral ligament (MCL) takes around an hour of surgery. Although most patients go home the next day, there can be a long rehabilitation process. If you are having multi-ligament surgery, you are likely to have to stay in hospital longer, and have a longer rehabilitation period.
A high tibial knee osteotomy takes around an hour of surgery, with a hospital stay of up to three days. Although the fixation plate is very strong and it is safe for you to walk straight away, you are likely to need crutches for the first two weeks to help with wound healing. Recovery from this type of surgery takes around six weeks. Some patients chose to have the fixation plate removed; however, we recommend you wait for at least a year before you have this procedure.
During your pre-surgery appointment, your consultant will measure your knee joint using specially designed software to calculate which bones need to be cut and how to precisely realign the knee joint.
High tibial knee realignment (osteotomy) surgery is when the tibia, or shinbone, is cut and reshaped to remove pressure from the knee joint. It’s normally used to treat arthritis and to correct a bowlegged deformity that has caused damage to one side of the knee. It can delay – or even avoid the need for – joint replacement surgery.
Distal femoral knee realignment (osteotomy) involves changing the shape of the knee joint in order to take the load off the side of the knee affected by arthritis and increase the load on the other side. In some cases, it can delay – or even avoid – the need for joint replacement surgery. It is similar to having a high tibial osteotomy in terms of planning your operation but the cut in the bone is made in the lower end of the femur (thigh bone) to correct a knock-kneed deformity.
Research carried out by the World Health Organization demonstrated that patients who have the knowledge, skills and confidence to manage their own condition enjoy better outcomes. 1Your experience of having osteotomy surgery is likely to be more positive, and your recovery faster and more successful, if you make sure that you understand the procedure, prepare for surgery, and carry out any exercises you have been given as part of your rehabilitation programme – including strengthening the muscles around the knee joint before surgery.
After you’ve had your pre-operative tests, it’s important to follow the advice you’ve been given. This includes:
You’ll be encouraged to get up and move around within a few hours to help blood flow and reduce your risk of deep vein thrombosis (DVT). Moving your knee joint will also ease stiffness.
During your operation, your consultant will inject local pain relief into your knee joint so that when you wake up you should have little or no pain. After this, you’ll be given pain relief as and when you need it and, once you return home, you can take over-the-counter painkillers as advised by your doctor for the following days. However, it’s important to avoid taking anti-inflammatory painkillers such as ibuprofen after surgery as these can prevent the bone healing.
Although the risks from having knee realignment (osteotomy) surgery are low, complications can include: infection, blood clots, stiffness of the joint, injuries to vessels and nerves and problems with healing.
It’s important to contact your consultant or your own GP as soon as possible if:
82, Sita Sadan, Shivaji Road, Santacruz East,
Mumbai – 400055 (Opposite Hyatt Hotel)
For more information or to make an enquiry
please call +91 9819668669
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