• Nuffield Hospital Leeds

    2 Leighton street, Leeds, LS1 3EB
    Main switchboard: 0113 388 2000
    Out-patient bookings: 0113 388 2067

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    BMI The Duchy Hospital Harrogate

    Queens Road, Harrogate, HG2 OHF
    Main switchboard: 01423 567136
    Out-patient bookings: 0808 101 0337

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    Spire Methley Park Hospital

    Methley Lane, Methley, Leeds, LS26 9HG
    Main switchboard: 01977 518518
    Out-patient bookings: 01977 518518

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  • Treatment FAQs

    During treatment there are many questions that immediately come to mind, most of which, especially those regarding the actual surgery that has taken place are very dependent on each individual patient and the circumstances surrounding that patient.

    However over the many years of experience the Yorkshire Knee Clinic has in this area we have been able to compile the following three lists of more generalised, but equally important questions, and their associated answers.

    Knee Arthroscopy

    When will I be admitted to Hospital?

    You will be admitted on the day of surgery. You will be advised prior to admission the time up to when you can eat and drink. This will allow you to arrive fasted and prepared for surgery.

    What sort of anaesthetic will I be given?

    The vast majority of arthroscopies are performed under a general anaesthetic. Occasionally, for medical reasons, a spinal anaesthetic may be given. This is normally decided with the anaesthetist. Local anaesthetic is also injected into the knee at the time of surgery to provide post operative pain relief.

    How long does the surgery take?

    Surgical time varies according to the complexity of the problem. Most procedures are completed within 30 mins.

    Will I have stitches?

    The surgical incisions used are small (5-7mm) and do not normally require stitches.

    When do I go home?

    Arthroscopy of the knee is normally performed as a ‘day-case’ procedure with patients going home the same day. In some circumstances, however, there may be an overnight stay. It is important to have a responsible adult at home for 24 hrs following a general anaesthetic.

    Will I require painkillers?

    These are provided by the hospital and advice will be offered prior to leaving hospital.

    When do I remove my dressings?

    The large wool and crepe bandage is usually removed 24-48 hrs following your operation. The small dressings over each wound should be left on for 5 days and then removed providing all leakage has stopped. Re-apply a fresh dry dressing or plaster if there is still any leakage from the wound.

    Should I do exercises at home?

    Simple exercises will normally be demonstrated by the physiotherapists prior to leaving hospital. These must be performed regularly to be effective. However, it is possible to over-exercise which can cause increased swelling and pain. If in doubt consult your physiotherapist.

    Will I require physiotherapy after leaving hospital?

    Most patients require additional physiotherapy following discharge. Patients will be advised on an individual basis prior to discharge.

    Anterior Cruciate Ligament Reconstruction

    When will I be a Admitted to Hospital?

    You will normally be admitted on the same day as surgery. You will be advised prior to admission the time up to when you can eat and drink. This will allow you to arrive fasted and prepared for surgery.

    What sort of anaesthetic will I be given?

    The vast majority of ACL Reconstructions are performed under a general anaesthetic. Occasionally, for medical reasons, a spinal anaesthetic may be given. This is normally decided with the anaesthetist. Local anaesthetic is also injected into the knee at the time of surgery to provide pain relief in the post-operative period.

    How long does the surgery take?

    Surgical time varies according to the complexity of the problem. There may be associated injuries to the knee such as a meniscal or cartilage tear that was sustained during the initial injury or at a later date as a secondary injury. The majority of ACL reconstructions are completed within 60 mins.

    When do I go home?

    The majority of patients are fit to be discharged home within 24hrs and some patients go home on the day of anterior cruciate ligament reconstruction. Your surgeon will advise a plan for discharge based on the specific surgery and physiotherapist recommendations.

    It is important to have a responsible adult at home for 24 hrs following a general anaesthetic.

    Will I require painkillers?

    Painkillers and/or anti-inflammatory tablets are provided by the hospital for the first few days following ligament reconstruction and advice will be offered prior to leaving hospital. Regular painkillers and/or anti-inflammatory medication are important to allow early mobilisation.

    When do I remove my dressings?

    The large wool and crepe bandage should be removed 24-48 hrs following your ligament reconstruction. The small dressings over each wound should be left on for 5 days and then removed providing all leakage has stopped. Re-apply a fresh dry dressing or plaster if there is still any leakage from the wound.

    What can I do at home after ligament reconstruction?

    For the first few days, try to keep the leg elevated when sitting down and rest as much as possible. Do your exercises frequently. You can put as much weight through the knee as comfortable but the muscles around the knee will be weak and therefore crutches are encouraged for support for a few days. The hospital physiotherapists will give you specific advice prior to discharge from hospital.

    When can I take a shower after ligament reconstruction?

    You may take a shower or bathe from the day after ligament reconstruction providing you keep the wound areas completely dry. Provided the wounds have healed, they can be soaked from day 5.

    When can I drive?

    In order to drive safely you must have regained good muscle control of the operated leg. This is normally at least 2 weeks following surgery. Advice can be sought from your surgeon or physiotherapist. . You should be confident you are in full control of the car and be able to perform an emergency stop with no hesitation.

    When will I start physiotherapy?

    Out-patient physiotherapy will normally start within a week of your ligament reconstruction. This must be with an experienced knee physiotherapist and will follow a structured program in order to get the best results from your ligament reconstruction surgery. There are important activity restrictions over the first few months following ACL reconstruction and these will be explained fully by your physiotherapist. If these restrictions are ignored there is a significant chance that the surgery will fail.

    Related topic: Physiotherapy

    When can I return to work?

    This depends on the recovery from surgery and the type of work. Some patients have more complicated surgery which may require extra restrictions. The majority of office workers can return within 2 weeks, whilst those patients who need to stand for long periods may need 2-3 weeks off work. Heavy manual work or patients whose jobs require carrying or lifting may not return to work until advised by their surgeon or physiotherapist.

    Should I do exercises at home?

    Simple exercises will normally be demonstrated by the physiotherapists prior to leaving hospital. These must be performed regularly as well as frequent ice application to reduce swelling etc.. Further exercises will be explained by your physiotherapist. The success of anterior cruciate ligament (ACL) reconstruction surgery depends upon complying with the rehabilitation programme which must be supervised by your physiotherapist.

    What are the possible complications following ligament reconstruction?

    Serious complications are uncommon following knee ligament reconstruction but can occur. These include infection, blood clots (or DVT – deep vein thrombosis), excessive swelling, bleeding and damage to blood vessels or nerves.

    There is always a small risk that the reconstructed graft can rupture, in a similar way to the original injury to your ligament. This risk is greatest in the first 3 months following surgery. It is therefore important an experienced physiotherapist supervises your recovery.

    Warning signs following surgery you should look out for are:

    • Fever / Chills above 38ºC (100.4ºF).
    • Persistent warmth or redness around the knee.
    • Persistent or increased pain.
    • Significant swelling, tingling or numbness in your knee/leg which is not relieved by elevating the leg for one hour.
    • Increasing pain in your calf muscles.
    • Shortness of breath or chest pain.

    If you experience any of the above please contact the Hospital for advice.

    Knee Replacement

    When will I be admitted to Hospital?

    You will normally be admitted on the same day as surgery. You will be advised prior to admission the time up to when you can eat and drink. This will allow you to arrive fasted and prepared for your operation.

    What sort of anaesthetic will I be given?

    Knee Replacements are performed under either general or spinal anaesthetic. Nerve blocks are sometimes also used. This is normally decided with the anaesthetist.

    How long does the surgery take?

    Surgical time varies according to the complexity of the problem. On average the surgery takes 60 minutes for a first time joint replacement. However you will be away from the hospital ward for longer than this to allow for your anaesthetic and initial recovery.

    When do I go home?

    The majority of patients are discharged home within 2-5 days. Some patients are safe to go home earlier whilst others may need longer.

    Will I require painkillers?

    Painkillers and/or anti-inflammatory tablets are provided by the hospital for the first few days following surgery and advice will be offered prior to leaving hospital. Further pain killers may be required from your doctor.

    When do I remove my dressings?

    Advice on dressings (if still required) will be given before leaving hospital.

    What can I do at home?

    Exercises will need to be done frequently each day to build muscles and recover range of movement. It is important to remain active at home and regular walks are encouraged. When resting it is best to elevate the leg to reduce swelling. Most knees, however, remain swollen and warm for many weeks.

    When can I take a shower?

    You may take a shower or bathe when you get home once you can get safely into and out of the bath/shower and providing wounds have healed.

    When can I drive?

    In order to drive safely you must have regained good muscle control of the operated leg and pain must be controlled. Remember you are not allowed to drive whilst taking some types of pain killers. Driving is normally possible 3-6 weeks after surgery depending on which leg and whether the car is manual or automatic. Advice can be sought from your surgeon or physiotherapist.

    When can I return to work?

    This depends on the recovery from surgery and the type of work. Some patients have more complicated surgery which may require extra restrictions.

    The majority of office workers can return within 3-4 weeks, whilst those patients who need to stand for long periods may need 6-8 weeks off work.

    Should I do exercises at home?

    Simple exercises will normally be demonstrated by the physiotherapists prior to leaving hospital. These must be performed regularly to be effective. However, it is possible to over-exercise which can cause increased swelling and pain. If in doubt consult your physiotherapist.

    Will I require physiotherapy after leaving hospital?

    Most patients require additional physiotherapy following discharge. Patients will be advised on an individual basis prior to discharge.

    What are the possible complications following surgery?

    The majority of patients have an uncomplicated recovery but knee replacement is a major operation which carries risks of complications. The main risks associated with knee replacement are:

    • Infection – the chance of a serious deep infection is approximately 1-2%, although 2-3% may have a treatable infection which settles down over a short period. A serious deep infection is a major complication which may require further (often extensive) surgery to treat it.
    • Deep Venous Thrombosis (DVT) – blood clots affecting the lower leg can occur although precautions are taken to reduce the chance of this. They are often not serious and are treatable.
    • Pulmonary Embolus – a rare but serious complication where a blood clot obstructs some of the blood vessels in the lung.
    • Nerve damage – it is common for patients to be left with a patch of numbness on the outside of the scar on the front of the leg. It is extremely rare to have nerve damage which causes weakness in the leg or foot.
    • Bleeding
    • Stiffness

    Warning signs you should look out for are:

    • Fever / Chills above 38ºC (100.4ºF)
    • Persistent warmth or redness around the knee
    • Leakage from the wound after leaving hospital
    • Persistent or increased pain
    • Significant swelling, tingling or numbness in your knee/leg which is not relieved by elevating the leg for one hour
    • Increasing pain in your calf muscles
    • Shortness of breath or chest pain

    If you experience any of the above please contact the Hospital for advice.