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Preparing for Surgery & Procedure

Preparing for Surgery

Once you and your Doctor decide that surgery will help you, you'll need to learn what to expect from the surgery and create a treatment plan for the best results afterward. Preparing mentally and physically for surgery is an important step toward a successful result. Understanding the process and your role in it will help you recover more quickly and have fewer problems.

Working with Your Doctor

Before surgery, your doctor will perform a complete physical examination to make sure you don't have any conditions that could interfere with the surgery or the outcomes. Routine tests, such as blood tests and X-rays, are usually performed a week before any major surgery.

  • Discuss any medications you are taking with your doctor and your family physician to see which ones you should stop taking before surgery
  • Discuss with your doctor options for preparing for potential blood replacement, including donating your own blood, medical interventions and other treatments, prior to surgery
  • If you are overweight, losing weight before surgery will help decrease the stress you place on your new joint. However, you should not diet during the month before your surgery
  • If you are taking aspirin or anti-inflammatory medications or warfarin or any drugs that increase the risk of bleeding you will need to stop taking them one week before surgery to minimise bleeding
  • If you smoke, you should stop or cut down to reduce your surgery risks and improve your recovery
  • Have any tooth, gum, bladder or bowel problems treated before surgery to reduce the risk of infection later
  • Eat a well-balanced diet, supplemented by a daily multivitamin with iron
  • Report any infections to your surgeon. Surgery cannot be performed until all infections have cleared up
  • Arrange for someone to help out with everyday tasks like cooking, shopping and laundry
  • Put items that you use often within easy reach before surgery so you won't have to reach and bend as often
  • Remove all loose carpets and tape down electrical cords to avoid falls
  • Make sure you have a stable chair with a firm seat cushion, a firm back and two arms

Preparing for Procedure

If you are having Day Surgery, remember the following:

  • Have someone available to take you home, you will not be able to drive for at least 24 hours
  • Do Not drink or eat anything in the car on the trip home
  • The combination of anaesthesia, food, and car motion can quite often cause nausea or vomiting. After arriving home, wait until you are hungry before trying to eat. Begin with a light meal and try to avoid greasy food for the first 24 hours
  • If you had surgery on an extremity (leg, knee, hand or elbow), keep that extremity elevated and use ice as directed. This will help decrease swelling and pain
  • Take your pain medicine as directed. Begin the pain medicine as you start getting uncomfortable, but before you are in severe pain. If you wait to take your pain medication until the pain is severe, you will have more difficulty controlling the pain

The stiff-soled post operative shoe ( www.darcointernational.com/medsurg )

Indications include big toe fusions, hammer toe corrections, Morton's neuroma excision & sesamoid excision. Allows a very stiff sole to prevent unwanted post operative foot movements limiting pain & improving mobility post operatively. Frequently used for 6 to 8 weeks. Not required to be worn in bed but usually at all other times when weight bearing.

The heel weight-bearing post-operative shoe ( www.darcointernational.com/orthowedge ) This link includes a video of how to use the show which you should practice pre-operatively.

Indications will include bunion correction surgeries where the alternative is to use a plaster cast but where with current internal fixation techniques & forefoot offloading, this can be avoided allowing the wearer to regain movement in the big toe post op early & so minimise stiffness post op. Also allows wound surveillence and cryotherapy (ice) to be applied to minimise swelling. Used for 6 to 8 weeks post op. Is NOT required to be worn in bed but is at all times when weightbearing. May be used without crutches if able. Please note that a single shoe will make you very lopsided!

The moonboot ( www.darcointernational.com/fx-pro )

Indications post operatively are mainly in step-down immobilisation after a cast has been removed to allow the transition from complete immobility all the time to freedom of movement in a stepwise manner. It allows protection during the early days of mobilisation in the recovery phases post op, whilst being removable to allow rehab physio, cryotherapy (ice) and activities such as washing, showering & dressing to be undertaken more easily. Does NOT have to be worn in bed. Generally it is worn most of the time initally when weightbearing but used progressively less frequently as the patient becomes both more confident & comfortable out of the boot. The suggestion is that it be removed at home & in familiar circumstances & for short walks first before being too adventurous & removing it for longer walks before you are ready. 

The ankle brace www.sportco.co.nz/mcdavid-ultra-light-ankle-brace-p-27.html )

Indications post op include step down immobiliastion after ligament & tendon reconstruction in the ankle, usually after the removal of the moonboot. By this stage in rehabilitation, the patient has regained ankle dorsiflexion & plantarflexion (up & down movement) but remains weak in inversion & eversion stability & proprioception (balance). The brace can be worn inside normal footwear and provide additional support whilst regaining confidence to transition from significant immobilisation to complete freedon - occasionally with the addition of taping techniques such as zinc oxide tape or Kinesio tape. Usually worn for 6 weeks. Does NOT have to be worn in bed & is removed for washing & showering. The plan is to allow the wearer to remove the brace in a stepwise manner as they gain more confidence such that by 6 weeks after they were instructed to first use the brace, they are out of it full time. As with the moonboot, initially the brace should be removed whilst in familiar circumstances such as home and for shorted walks gradually building up exercise tolerance.

Knee Braces (cnxuda.en.alibaba.com/product/481158973-209345575/Range_of_Motion_Knee_Brace_with_FDA_and_CE_Certificate.html )

Indications after knee reconstructive surgery usually where additional limitation of range of motion is required to support the healing & protection of reconstructed structures such as meniscal (cartilage) repairs and patellar stabilisation operations. Not used routinely for ACL reconstruction unless combined with either meniscal repair or additional ligament reconstruction. Will typically be worn for 4 to 6 weeks & be used with crutches to limit weightbearing. May be removed in bed & when not weightbearing to facilitate cryotherapy (ice) but should be used at all times when up and about or weightbearing.

Mr. Peter RM Black - Anglesea Clinic Orthopaedics Mr. Peter RM Black - Anglesea Clinic Orthopaedics
BSc (Hons), MBBCh,
FRCSEd, FRCS (Tr & Orth)
Orthopaedic Surgeon
Mr. Peter RM Black - Anglesea Clinic Orthopaedics
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