• Keep the post-operative dressings clean and dry. You can remove the bandages 2-3 days after surgery - but leave the Steri-strips in place. Keep the wounds covered with a small sterile dressing until your post-operative appointment. Take care when showering to keep the wounds dry.
  
  
• At first your knee will be swollen and hard to bend. This is normal following an ACL reconstruction. There will also be bruising around your knee and shin.
  
  
• Apply ICE to the knee regularly and keep your leg elevated to help reduce pain and swelling. When elevating the leg ensure the pillow is under the heel/ankle – NOT the knee.
  
  
• Take analgesics for pain relief (do not drive a car while taking prescription pain medication)
  
  
• You are allowed to fully weight bear as tolerated and bend your knee. You may use crutches for assistance.
  
  
• Physiotherapy is a crucial part of successful ACL surgery, with passive exercises beginning immediately after the surgery. Much of the success of ACL reconstructive surgery depends on your dedication to regular prescribed exercise.
  
  
• Getting the knee straight as soon as possible is the main goal in the first few days following the procedure.
  
  
• Your post-operative appointment has been scheduled approx. 12-14 days after your surgery. Your stitches will be removed at this appointment and further physiotherapy instructions given.
  
  
• Remember: You should not drive until you are confident you can control your vehicle. Always check first with your insurance company and your Surgeon.
  
  
• It is normal to have some swelling and discomfort in the knee for the first few days (or weeks, depending on what procedure was done) but fever or chills, nausea, unrelenting pain, redness around incision sites, colour change in foot or toes, or significant swelling or numbness may indicate an infection.
  
  
• If you are concerned, contact our rooms on 08 9301 0101, your GP or the closest Emergency Dept.

• Keep the post-operative dressings clean and dry. You can remove the bandages 2-3 days after surgery - but leave the Steristrips in place. Keep the wounds covered with a small sterile dressing until your post-operative appointment. Take care when showering to keep the wounds dry.
  
  
• Apply ICE to the knee regularly to help reduce pain and swelling. Elevate the leg for the first 24-48 hours.
  
  
• You may walk on the leg as tolerated. Use crutches to minimise discomfort for the first day or two if desired. Normal walking is encouraged after 2 days.
  
  
• Take analgesics for pain relief (do not drive a car while taking prescription pain medication)
  
  
• You will require at least a couple of days off work to recover and then may resume work when the pain and swelling subsides, depending on your type of employment.
  
  
• Avoid sports and rigorous exercise for at least the first few weeks after your procedure.
  
  
• Your post-operative appointment has been scheduled approx. 12-14 days after your surgery. Your stitches will be removed at this appointment.
  
  
• It is normal to have some swelling and discomfort in the knee for the first few days (or weeks, depending on what procedure was done) but fever or chills, nausea, unrelenting pain, redness around incision sites, colour change in foot or toes, or significant swelling or numbness may indicate an infection.
  
  
• If you are concerned, contact our rooms on 9301 0101, your GP or the closest Emergency Dept.

AIMS to:

- Control pain
- Minimise swelling
- Reduce risk of infection of wound

• Your wound has had a long-acting local anaesthetic injected into it. There may be some discomfort when this wears off. Take the analgesia as recommended, at regular intervals as instructed. You may require analgesia for at least 48 hours or longer.
  
  
• After surgery your limb requires rest and elevation to minimise swelling. Elevate your limb in the sling provided when walking so that your hand is elevated at heart level.
  
  
• While sitting you may like to elevate your limb on a pillow, thus reducing swelling and aiding the healing process.
  
  
• Your dressing has been applied in theatre in a sterile environment and must be kept clean and dry. This dressing should not require changing. It is very important you keep it clean and dry for at least five days or as instructed.
  
  
• When showering, wrap the dressing in a taped up plastic bag or plastic cling wrap. Do not direct water over the wound. However should the dressing get wet, remove it, apply an antiseptic then reapply another clean, dry dressing. If a plaster back slab or metal splint has been used by the surgeon as part of the dressing do not remove the dressing.
  
  
  
• Should your wound become excessively swollen, hot, have excessive fluid discharge or become very painful, contact the Surgeon or your local GP as soon as possible.
  
  
• Your upper limb/fingers should remain pink, have minimal swelling and sensation will return. If you have any concerns that your fingers have diminished function once the local anaesthetic wears off, contact the Surgeon. If unable to contact your Surgeon, please ring the hospital where you had the surgery for advice or please attend your local GP clinic or nearest Emergency Department.
  
  
• A post-operative follow-up appointment has been made for you approx. 12-14 days after surgery. The surgeon will discuss your operation findings and review your dressing at this appointment.
  
  
  
• Early passive movement of the operated shoulder is an essential step in the healing process. Comprehensive rehabilitation guidelines will be provided by your surgeon/physiotherapist to ensure that your mobility and strength improve. Follow the instructions provided.

Prior to leaving the hospital you will be given a list of instructions on how to care for your wound and exercises to perform until you see your Surgeon again. A sling will be applied to support and elevate the hand.

Home

• The local anaesthetic starts to wear off within 4-6 hours. A regional block takes up to 12 hours to wear off.
  
  
• It is important that you rest and elevate your hand either in a sling or on a pillow for at least 48 hours. This is to assist in the reduction of swelling and aid in pain relief and healing.
  
  
• The sling may be removed at night.
  
  
• It is best to take pain-relieving medications when you start to feel pain, do not wait until the wound is throbbing. Take the analgesia regularly. You may require analgesia for at least 48 hours or longer.
  
  
• Keep the bandage or plaster splint clean and dry until your follow-up appointment with your Surgeon.
  
  
• Observe the fingers for colour, warmth, movement and feeling.
  
  
• Commence gentle exercises by making a fist with the unaffected fingers and releasing it several times an hour.
  
  
• You may require assistance with activities such as driving and home duties.
  
  
• Do not drive a car until you regain full movement of your hand and fingers (approximately 1 week).
  
  
• If you have any problems contact your Surgeon or General Practitioner or you nearest Emergency Department.

Returning to Work

Your Surgeon will advise you when you can return to work.

• If your work involves heavy labour, this may be up to 3 or 4 weeks.
  
  
• If your work involves minimal use of your hand, up to 2 weeks.

Both Joondalup Health Campus and St John of God Hospitals offer an Enhanced Recovery Programme for patients having Total Hip or Total Knee replacement surgery.

There is a great deal of evidence based research that supports enhanced recovery after surgery. This states the sooner you get out of bed, begin to walk and start eating and drinking the quicker the recovery.

With this new approach, recovery after surgery is more comfortable, easier and happens faster.

This new approach consists of:

• Pre-operative advice and information
  
  
• Pre-operative group education class
  
  
• Reduced fasting times by using special carbohydrate drinks (these will be supplied to you)
  
  
• Tailored post-operative pain relief
  
  
• Early feeding after surgery
  
  
• Early walking after surgery

These elements speed up recovery and reduce the possibility of complications. The Enhanced Recovery Program aims to make sure patients are involved in their own care. You play an active role in your recovery and work in partnership with all of the orthopaedic team to achieve this.

Booklets will be provided by the Hospital to inform and guide you through your total hip replacement surgery and recovery.