FREQUENLTY ASKED QUESTIONS

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. There are numerous programs that have been shown to be beneficial for reducing knee pain associated with arthritis. When you have exhausted this, then you can continue with physiotherapy to prepare yourself for surgery if you wish. It is not essential however, for a good result. 

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.

How soon after surgery can I swim?

While you can shower post operatively (The dressing is water resistant) we recommend not swimming or having a bath until the wound has fully sealed. For Total Knee Replacements, this is 4 weeks post op.

When can I resume my natural supplements after my 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. 

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 designed to remain on, and do not need to be changed. We wait a minimum of 2 weeks, and up to 4 weeks post op to change your dressings. You will not require regular dressings, unless there is some pooling of some bleeding under the dressing in which case we will create a customised plan for you. 

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 op.

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 3-4 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. 

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