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Orthopaedics (bones and joints)

We provide surgical and non-surgical treatment for conditions relating to the musculoskeletal system (bones, joints and ligaments) in adults and children.

We provide face-to-face clinics in Rockhampton and Gladstone, as well as telehealth consultations in Emerald, Gladstone, Biloela, Blackwater, Blackhall, Longreach and other centres as required. Most surgery is performed in Rockhampton, with a small number of cases in Gladstone.

Services

  • Replacements (primary and revision) – hip, knee, ankle, shoulder, elbow
  • Hand, elbow, shoulder, spine, hip, knee, foot and ankle surgery for arthritis, deformities and soft tissues problems.
  • Management (operative and conservative) of injuries to arms, legs and spine.

How to access this service

To access this service, your GP or medical practitioner will need to send a referral letter to the hospital.

If there is a waiting list, you will receive a confirmation letter and be advised on what to do next. If there is no waiting list, you will receive an appointment booking letter or we will contact you to arrange a suitable time for your appointment.

Knee replacement - patient information

Video transcript

Part 1: Welcome

Welcome! This video will help prepare you for your operation. It will tell you what to do when you come to hospital, what to expect before, during and after your operation and how to prepare for your return home. It is important to have the help of family or friends during this time. You are encouraged to watch this video with them.

Part 2: About your operation

The knee joint is a hinge joint, formed by the femur and the tibia. Usually the surfaces of the bones are covered with a smooth coating called cartilage.

This coating can wear away and the joint surfaces become rough or damaged when arthritis occurs. This causes pain and stiffness.

A total knee replacement operation removes the damaged areas and replaces them with metal and plastic parts. The operation aims to reduce pain and stiffness and allow you to move more easily.

A knee replacement operation takes approximately two hours, and depending on your recovery, you should be able to return home 3-4 days after your operation.

Part 3: Preparing for your operation

This operation has been suggested to you because it is the best choice for dealing with your current condition. It is normal to be anxious about your operation and recovery, so it is important you discuss any questions or concerns with your GP, surgeon and specialist.

To help with a speedy recovery and make the most of your new hip there are a number of steps you can take to be ready for your operation.

Weight and diet

Your weight plays a big role in how well your operation will go, your risk of complications, how long you might need to stay in hospital after your operation, and how long your new knee will last.

Being underweight or overweight can increase your risk of complications during and after your operation.  If you are overweight, losing weight both before and after your operation can be good for your health and your knee.  In the long term, if you are overweight or obese, you may be more likely to dislocate your knee, or wear it out quicker.

If you need to lose weight, aim to lose it slowly as it is more likely to come off and stay off. Losing 1 to 4 kilograms per month is a healthy, realistic goal. This is best achieved through positive lifestyle changes with assistance from your dietitian who will take into account your lifestyle, food choices and your individual goals.

There are a number of ways you can access a dietitian. You may be eligible for Medicare-subsidised appointments with a private-practice dietitian. Your GP can advise you on this and refer you. If you are looking at a meal replacement program your GP can also help you to get started with this.  If you are underweight, it is recommended you talk to your GP or dietitian about ways to help increase your weight.

When you have a date for your operation, aim to keep your weight stable for 1-2 weeks beforehand and for around 2-4 weeks after your operation.  If you try to lose weight after your operation this can make your recovery slower.

General fitness

It is important to stay fit and healthy before your operation.  Regular activity will help prepare your heart, lungs and muscles for your operation. Exercise will also help you feel more confident with everyday activities before and after you receive your new hip. It’s helpful to discuss your plan with a friend and find an exercise partner to keep you motivated. Make sure you don’t overdo it. An activity that allows you to talk without puffing too much is ideal.

Choose an exercise you enjoy. Some good options that are gentle on your sore hip include:

  • Walking (on land or in the pool)
  • Swimming or other pool exercises
  • Exercise bike

Home Environment

Your operation will impact how you do things, so it’s important to start preparing your home now for when you leave hospital.  Your occupational therapist will talk to you about how to make things easier at home following your operation.   When you leave hospital, you will most likely be walking with crutches or a walking frame. You should remove clutter or furniture that blocks doorways or walkways in rooms, including the bathroom and toilet.

You may have difficulty standing up from furniture of a low height due to discomfort and a limited range of motion with your knee after your operation. You should consider raising the height of your bed and armchair. Bed and chair raisers can be bought, or you can use cushions or folded blankets.  Toilets are also low in height and an aid such as an over-the-toilet frame or raised toilet seat can be discussed with your occupational therapist.

It may be more comfortable and safer to sit down to shower and dress following your operation.  The occupational therapist will discuss what aid might be suitable for you to use in your bathroom.  If you have a shower, a shower chair or shower stool may be used. If you have a bath or shower over a bath, you could use a transfer bench or bath board. Other aids such as a long-handled bath sponge or shoe horn may assist you to shower and dress following your operation.  Daily living aids recommended by your occupational therapist can be hired or purchased through providers in Central Queensland.

You should keep items that you use often between hip and shoulder height, so they are easy to access.

Cooking may be more difficult when you return home after your operation.  You should consider preparing some meals in advance and freezing them.

You may also choose to have a thorough clean of your home before coming to hospital. Cleaning will be difficult while you recover, and this can reduce the amount of cleaning needed when you return home.

If you have pets at home, it is important to organise someone to care for your pet while you are in hospital and to potentially assist you in caring for your pet upon discharge. It is important to consider the length of stay in hospital and that this is subject to change.

Social Supports

Before your operation, it is important to start planning what help may be needed from your friends and family. Think about the tasks you may need assistance with after your operation.  Perhaps they can help with cooking and housework. It is also important you have someone to drop by and say hello while you recover. Due to driving restrictions following your operation you may need others to help you with getting around.

This is particularly important for leaving hospital. It is your responsibility to organise a friend or relative with a car to pick you up. Any arrangements for how you go home should be organised well before you come into hospital. You may even want to stay with friends or relatives for a short period after the operation.

For persons aged 65 and older, you can contact the My Aged Care national online and phone service to help you find out about services you may be eligible to access. When you call the My Aged Care contact centre, the staff will ask questions to help understand your needs and help you find out if you are eligible.

Call the My Aged Care contact centre on 1800 200 422 or visit www.myagedcare.gov.au to find out about aged care services that may help you.

Persons under the age of 65 can get help from a Queensland Government Service known as Access Point. To find out about the services available, or to apply, phone your local Community Access Point on 1800 600 300. You do not need a referral.

If you are a carer, you can call 1800 242 636 for information, support, planning and referral advice.

Dealing with the stress of an operation

The overall experience and outcome of your operation can be improved when you take an active role in your healing and recovery.  A knee replacement operation can be quite stressful. From the time a decision is made to have an operation until the recovery is complete, there are major physical and psychological processes that can either help or hinder your recovery. Stress can have a number of harmful physical effects on your body including:

  • Rapid and shallow breathing
  • Increased muscle tension
  • Release of stress hormones, like cortisol
  • Increased heart rate and blood pressure
  • Lowered immune system function.

Physical stress effects can directly affect your ability to heal following your operation.  For example, if you are experiencing pain this can be a major cause of emotional distress.  It is then important to manage stress and pain as effectively as possible.

You can make your operation as stress-free as possible by doing the following:

  • Gather information about the operation and recovery to help you understand exactly what takes place during your operation, and what to expect in the days and weeks following. If you have any questions, please discuss with your doctor.
  • Discuss pain control with your doctor to prepare yourself for the type of pain you may experience and how to best manage it.
  • Investigate mental coping strategies such as cognitive restructuring. This will teach you to think differently so you can positively influence your emotions and behaviours.  This is a well-known technique for reducing fear and anxiety.
  • Learn relaxation techniques which can help with the negative physical changes that occur during times of stress.  Your social worker can provide you with details of resources that can assist with these techniques.

Advanced Care Planning

As with any major operation, you should check the status of your Advance Health Directive, Power of Attorney/Enduring Power of Attorney or Will. It is encouraged that you bring a copy of your Enduring Power of Attorney into hospital with you. It is important that your nominated next of kin is someone you trust as they will be deemed to be your Statutory Health Attorney in the event you do not have an Enduring Power of Attorney. If you need support to discuss these documents, please talk to your GP or contact the hospital on (07) 4920 6211 and ask to speak to the Surgical Ward Social Worker.

Part 4: The day before your operation

Please make sure you’ve packed the following items to make your stay in hospital as comfortable as possible:

* Health care card

* Medicare card

* Pension card

* Contact lenses, glasses or other aids

* Pyjamas

* Personal toiletries such as soap, toothbrush, toothpaste, shampoo, shaving gear, hairbrush or comb

* Closed in shoes with a non-slip sole

* Loose comfortable clothes for leaving hospital

* A small amount of money for personal items

Do not bring valuables: the hospital does not hold responsibility for losses.

Remember to bring your medications with you to hospital, in their original packaging where possible. This helps your doctor to correctly prescribe your medications and make sure you receive your medications without any delays. You will be given advice regarding your medication, especially if you are taking any blood thinning drugs or an anti-inflammatory.

The night before your operation you should have a high carbohydrate meal (such as pasta or rice) and drink plenty of fluids to stay hydrated. You will be asked not to eat solid food for 6 hours before your operation. You should stay hydrated and keep drinking clear fluids (water or clear apple juice with no pulp) up to 2 hours before your operation.

You will be given two carbohydrate-rich drinks to have before your surgery – one the night before, and the other on the morning of your operation. This drink will help with your recovery. A nurse will advise you on when to take this drink. You will also be given another carbohydrate drink after your operation to help with recovery.

Part 5: Going to hospital

The date of your operation and the time you should arrive at the Day Surgery and Admissions Unit will be sent to you by the hospital.

Please phone the day before your operation on 4920 6461 or 4920 6226 between 2.00 pm and 3:30 pm

If you develop an illness or sickness of any sort, including rashes, cuts, boils, pimples or notice any infection on or near the area of your operation, please contact us immediately.

You will need to attend the Day Surgery and Admissions Unit on the morning of your operation. From here you will go to the Day Surgery Unit where nursing staff will prepare you for your operation. You may have to wait for a little while, there could be more than one operation before yours.

Part 6: After Your Operation

The operation takes about two hours, but you will stay in the recovery area until the anaesthetist is happy that you are well enough to return to the ward.  A nurse will collect you and take you to your room in the Surgical Unit. We will let your next of kin know that your operation has finished, if you have told us that you would like this to happen.  If your family or friends phone the Surgical Unit, it may be possible to transfer the call to you via the ward phone. However, if you have a mobile phone, it is easier and faster if your family and friends ring you directly.

An ice pack will be placed over the site of your operation. You will have a drip for extra fluid intake and some oxygen going into prongs in your nose. Nurses will regularly take your pulse, blood pressure, temperature and other observations to make sure you continue to recover safely from your operation. You will also have routine blood tests and an x-ray done. Your pain will be regularly assessed, and pain medications will be available as you need them. You will wear white compression stockings and leg pumps to assist with circulation and prevent blood clots.

You can return to a normal diet as soon as you feel fully awake from the anaesthetic.   You will have a bandage and a waterproof dressing covering the area of the operation, which will come off after 1 – 2 days.

You will most likely have had a spinal anaesthetic that may affect urinary continence for a very short while.  For this reason, you will have a pad in place for the first couple of hours after your operation and the nurses will keep track of when you pass urine. Make sure you tell your nurse if you can’t pass urine.

It is important to drink plenty of fluids after your operation. You will also be given a carbohydrate drink in recovery. It is easy to become constipated after your operation because of the pain medications that we give you and because you will not be moving as much.  Please make sure your bowels are working normally during the week before your operation to avoid constipation in hospital.  A high fibre diet will help.  After your operation you should ask for pear juice and prunes when you order your meals.

There will be many times when we will ask you to tell us your name and date of birth and if you have any allergies. Our aim is to provide excellent care and we need to make sure we are providing you with the correct medications, meals, medical tests and procedures. Your safety is very important to us.

The doctors and pharmacist will talk about what sort of pain relief is best for you before you go home after your operation.

Part 7: After Your Operation – exercises

As soon as you wake up you should start doing your breathing and circulation exercises. These exercises help reduce your risk of complications such as chest infections and blood clots. You should do these every hour that you are awake.

To perform your Deep breathing exercises, take a long slow deep breath in and hold it for 3 seconds. Try to get the air down to the bottom of your lungs. Repeat these 5 times.

Circulation exercises can be done sitting or lying. Gently move your feet:

  1. Up and down
  2. In clockwise circles
  3. In anti-clockwise circles

Do these for 2 minutes in each direction.

Depending on when you arrive back to the ward and get clearance from the medical team, you may be able to start moving again with a physiotherapist on the same day as your operation. This will be guided by your physiotherapist and may include sitting on the edge of the bed, standing with a frame or going for a short walk.  Usually, you can put as much weight on your operated leg as pain will allow.  The physiotherapist will confirm with the doctors how much weight you can put on your leg before your first walk.  Your new knee needs extra support until it is fully healed, and your muscles are stronger. You will start walking with a frame and then crutches when appropriate.

Part 8: First days after your operation

The physiotherapist will assist you into a chair on the first day after your operation. You will sit in a high back chair with armrests.  We recommend you sit out of bed for all meals and throughout the day to practice bending your knee. The physiotherapist will aim to progress your walking ability each day to prepare you for going home.

Stairs

Once you are walking safely, the physiotherapist will teach you how to go up and down stairs. Even if you don’t have stairs at home, it is important you know the safest way to use stairs for when you are out and about. If there is a sturdy handrail you should use it for extra support when going up and down stairs. Your physiotherapist will ensure you are safe on stairs before you go home.

*Demonstration of stairs with crutches*.

Functional Activity

The occupational therapist will help you regain your independence with getting on and off furniture, showering and dressing.  These activities may be more difficult because of the precautions that are in place after your operation. Your occupational therapist will also advise of any other equipment or techniques that will help you to perform tasks more easily or independently following your operation. These may be needed until your walking, strength and operated knee have improved.

Going home

You can expect to be in hospital for three to four days after your operation. Depending on how well you recover your stay may be shorter or longer.  Your team of therapists will guide you on how you are doing and the likely day you will be able to leave hospital. Depending on what your physiotherapist recommends,

you may leave with a four wheeled walker or other aid,

You will need to arrange for someone to pick you up from hospital before your operation, as the ambulance service cannot take you home. Please make sure the person assisting you with transport home is on standby to collect you at any time.

Driving

Under Queensland Legislation, you cannot drive for six weeks after your operation and may only start driving again once you have gained medical clearance from your surgeon or GP.  You may still travel by car as a passenger during this time. You will need to ask family and friends to assist with transport so you can attend appointments and access the community. Always travel in the front seat, make sure the seat is back as far as it will go with the backrest reclined and a firm cushion is in place to raise the height of the seat. Try not to travel in small, low cars for the first six weeks after your operation. Larger cars with more leg room will be more comfortable.

You may be eligible for some taxi subsidy from the Queensland Government. For more information, visit the Department of Transport and Main Roads' NDIS page.

Part 9: Precautions and complications

If you are healthy and fit before your operation and follow medical advice after your operation, your recovery should be straightforward. However, it is important to be aware of how you’re feeling and what is and isn’t normal when recovering. Be on the lookout for:

  • Venous thromboembolism (VTE), which is commonly known as a blood clot and can occur after major general surgery.  Symptoms may include increased pain and swelling in the calf.
  • Wound infection.  Symptoms include increased pain, redness and swelling around the knee.

Preventative treatment for these conditions will be prescribed by your doctor before you go home from hospital.  Treatment is different for everybody and may vary depending on other conditions, allergies and medications.

Part 10: Exercises

Exercising at home is important for your recovery. After your operation, the physiotherapist will provide you with a home exercise program, targeting the muscles around your knee and hip.

However, it is a good idea to start these exercises prior to your operation in order to start strengthening your knee early.

Demonstration of exercises as below

Static quadriceps

Start in a relaxed and comfortable position in bed or on the floor, with your head propped up slightly.

Pull your toes toward your knee, tense the muscles on the front of thigh and simultaneously squeeze your buttocks.

Keep leg and buttock flat on floor. Hold for 5 seconds and repeat 3 sets of 10 reps.

Inner Range Quads

With your operated knee over rolled towels, straighten the knee by tightening muscles on top of thigh.  Keep the back of your knee on the towel.  Hold for 5 seconds. Do this for 3 sets of 10 reps.

Active knee flexion and extension

Bend your operated knee as far as possible, then use your other leg to gently push until a stretch is felt.  Hold for 3-5 seconds and then return to straight knee. Do this for 3 sets of 10 reps.

Straight Leg Raise

Lie on your back with the operated leg straight and your opposite leg bent.  Slightly rotate the straight leg out and lift  to about 12 inches/30cm/1 foot off the bed.

Passive knee extension

Rest with a rolled towel under the ankle of the operated leg to stretch knee into extension.  You can also place an icepack or light weight across the knee.

Hold for 10-15 minutes.

Active Knee Flexion/Extension (Sitting)

Place the operated foot on a smooth surface. Slowly slide your foot back as far as possible. You can also use your opposite foot to help apply over-pressure.

Hold for 3-5 seconds and do this for 3 sets of 10 reps.

Sit to stand

Sit on the edge of a high chair, feet flat on floor with your hands on the chair or thighs as needed.  Stand upright, extending you knees fully.  Repeat 3x10 reps.

You should see your general practitioner or physiotherapist if you are experiencing any difficulties, have a lot of pain or any other concerns with these exercises.

Part 11: Road to recovery

Your muscles will not regain full strength while you are in hospital. It is important to continue your exercise program after you have left hospital to strengthen your muscles.  The physiotherapist will refer you for an outpatient follow-up appointment to continue your strengthening exercises and walking regime.  This will usually be at three to four weeks after your operation.

Two weeks after your operation you will need to see your general practitioner/GP for a review of your wound and removal of any sutures. You will then see your surgeon about six weeks after your operation for a review.

After three months you should be back to most of your usual activities.  You may even find you can return to activities you haven’t been able to do for some time because of your knee pain.  Make the most of these improvements by getting back to activities you enjoy!

We look forward to meeting you in the Surgical Unit. We aim to provide excellent care and we know that you will be pleased with your experience during your stay with us.

We always want to know how we’re doing. You can give feedback at any time by filling out a Have your say’ form, available throughout the hospital or by asking a staff member for one. You can also call or email, or you can do it online at the link below.

We’re here to help.

Hip replacement - patient information

Video transcript

Part 1: Welcome

Welcome! This video will help prepare you for your operation. It will tell you what to do when you come to hospital, what to expect before, during and after your operation and how to prepare for your return home. It is important to have the help of family or friends during this time. You are encouraged to watch this video with them.

Part 2: About your operation

The hip joint is a ball and socket joint. The ball is formed by the head of the thigh bone (femur), and the socket is formed by part of the pelvis (acetabulum).

Usually the surfaces of the bones are covered with a smooth coating called cartilage.

This coating can wear away and the joint surfaces become rough or damaged when arthritis occurs. This causes pain and stiffness.

A total hip joint replacement operation removes and replaces the damaged areas of bone in your hip joint. The head of the femur is replaced with an artificial ball and the socket is replaced with an artificial socket.

A total hip replacement operation removes the damaged areas and replaces them with metal and plastic parts. The operation aims to reduce pain and stiffness, and allow you to move more easily.

It will also help to fix deformities and any differences in your leg length.

A hip replacement operation takes approximately 2 hours, and depending on your recovery, you should be able to return home 3-4 days after your operation.

Part 3: Preparing for your operation

This operation has been suggested to you because it is the best choice for dealing with your current condition. It is normal to be anxious about your operation and recovery, so it is important you discuss any questions or concerns with your GP, surgeon and specialist.

To help with a speedy recovery and make the most of your new hip there are a number of steps you can take to be ready for your operation.

Weight and diet

Your weight plays a big role in how well your operation will go, your risk of complications, how long you might need to stay in hospital after your operation, and how long your new hip will last.

Being underweight or overweight can increase your risk of complications during and after your operation.  If you are overweight, losing weight both before and after your operation can be good for your health and your hip.  In the long term, if you are overweight or obese, you may be more likely to dislocate your hip, or wear it out quicker.

If you need to lose weight, aim to lose it slowly as it is more likely to come off and stay off. Losing 1 to 4 kilograms per month is a healthy, realistic goal. This is best achieved through positive lifestyle changes with assistance from your dietitian who will take into account your lifestyle, food choices and your individual goals.

There are a number of ways you can access a dietitian. You may be eligible for Medicare-subsidised appointments with a private-practice dietitian. Your GP can advise you on this and refer you. If you are considering a meal replacement program your GP can also help you to get started with this.  If you are underweight, it is recommended you talk to your GP or dietitian about ways to help increase your weight.

When you have a date for your operation, aim to keep your weight stable for 1-2 weeks beforehand and for around 2-4 weeks after your operation.  If you try to lose weight after your operation this can make your recovery slower.

General fitness

It is important to stay fit and healthy before your operation.  Regular activity will help prepare your heart, lungs and muscles for your operation.  Exercise will also help you feel more confident with everyday activities before and after you receive your new hip. We recommend discussing your plan with a friend and finding an exercise partner to keep you motivated. Make sure you don’t overdo it. An activity that allows you to talk without puffing too much is ideal.

Choose an exercise you enjoy. Some good options that are gentle on your sore hip include:

  • Walking (on land or in the pool)
  • Swimming or other pool exercises
  • Exercise bike

Home Environment

Your operation will have a physical impact on how you do things, so it’s important to start preparing your home now, for when you leave hospital.  Your occupational therapist will talk to you about how to make things easier at home following your operation.   When you leave hospital, you will most likely be walking with crutches or a walking frame. You should remove clutter or furniture that blocks doorways or walkways in rooms, including the bathroom and toilet.

You may have difficulty standing up from furniture of a low height due to discomfort and a limited range of motion with your hip after your operation. You should consider raising the height of your bed and armchair. Bed and chair raisers can be bought or you can use cushions or folded blankets.  Toilets are also low in height and an aid such as an over-the-toilet frame or raised toilet seat can be discussed with your occupational therapist.

It may be more comfortable and safer to sit down to shower and dress following your operation.  The occupational therapist will discuss what aid might be suitable for you to use in your bathroom.  If you have a shower, a shower chair or shower stool may be used.  If you have a bath or shower over a bath, you could use a transfer bench or bathboard. Other aids such as a long handled bath sponge or shoe horn may assist you to shower and dress  following your operation.  Daily living aids recommended by your occupational therapist can be hired or purchased through providers in Central Queensland.

You should keep items that you use often between hip and shoulder height, so they are easy to access.

Cooking may be more difficult when you return home after your operation.  You should consider preparing some meals in advance and freezing them.

You may also choose to have a thorough clean of your home before coming to hospital. Cleaning will be difficult while you recover, and this can reduce the amount of cleaning needed when you return home.

If you have pets at home, it is important to organise someone to care for your pet while you are in hospital and to potentially assist you in caring for your pet upon discharge. It is important to consider the length of stay in hospital and that this is subject to change.

Social Supports

Before your operation, it is important to start planning what help may be needed from your friends and family. Consider the tasks you may need assistance with after your operation. Perhaps they can help with cooking and housework. It is also important you have someone to drop by and say hello while you recover. Due to driving restrictions following your operation you may need others to help you with getting around.

This is particularly important for leaving hospital - it is your responsibility to organise a friend or relative with a car to pick you up. Any arrangements for how you go home should be organised well before you come into hospital. You may even want to stay with friends or relatives for a short period after the operation.

For persons aged 65 and older, you can contact the My Aged Care national online and phone service to help you find out about services you may be eligible to access. When you call the My Aged Care contact centre, the staff will ask questions to help understand your needs and help you find out if you are eligible.

Call the My Aged Care contact centre on 1800 200 422 or visit www.myagedcare.gov.au to find out about aged care services that may help you.

Persons under the age of 65 can get help from a Queensland Government Service known as Access Point. To find out about the services available, or to apply, phone your local Community Access Point on 1800 600 300. You do not need a referral.

If you are a carer, you can call 1800 242 636 for information, support, planning and referral advice.

Dealing with the stress of an operation

The overall experience and outcome of an operation can be improved when you take an active role in your healing and recovery.  A hip replacement operation can be quite stressful. From the time a decision is made to have an operation until the recovery is complete, there are major physical and psychological processes that can either help or hinder your recovery.  Stress can have a number of harmful physical effects on your body including:

  • Rapid and shallow breathing
  • Increased muscle tension
  • Release of stress hormones, like cortisol
  • Increased heart rate and blood pressure
  • Your body cannot fight illness like normal.

Physical stress effects can directly affect your ability to heal following your operation.  For example, if you are experiencing pain this can be a major cause of emotional distress.  It is then important to manage stress and pain as effectively as possible.

You can make your operation as stress-free as possible by doing the following:

  • Gather information about the operation and recovery to help you understand exactly what takes place during your operation, and what to expect in the days and weeks following. If you have any questions, please discuss with your doctor.
  • Discuss pain control with your doctor to prepare yourself for the type of pain you may experience and how to best manage it.
  • Investigate mental coping strategies such as cognitive restructuring. This will teach you to think differently so you can positively influence your emotions and behaviours.  This is a well-known technique for reducing fear and anxiety.
  • Learn relaxation techniques which can help with the negative physical changes that occur during times of stress.  Your social worker can provide you with details of resources that can assist with these techniques.

Advanced Care Planning

As with any major operation, you should check the status of your Advance Health Directive, Power of Attorney/Enduring Power of Attorney or Will. It is encouraged that you bring a copy of your Enduring Power of Attorney into hospital with you. It is important that your nominated next of kin is someone you trust as they will be deemed to be your Statutory Health Attorney in the event you do not have an Enduring Power of Attorney. If you need support to discuss these documents, please talk to your GP or contact the hospital on (07) 4920 6211 and ask to speak to the Surgical Ward Social Worker.

Part 4: The day before your operation

Please make sure you’ve packed the following items to make your stay in hospital as comfortable as possible:

* Health care card

* Medicare card

* Pension card

* Contact lenses, glasses or other aids

* Pyjamas

* Personal toiletries such as soap, toothbrush, toothpaste, shampoo, shaving gear, hairbrush or comb

* Closed in shoes with a non-slip sole

* Loose comfortable clothes for leaving hospital

* A small amount of money for personal items

Do not bring valuables: the hospital does not hold responsibility for losses

Remember to bring your medications with you to hospital, in their original packaging where possible. This helps your doctor to correctly prescribe your medications and make sure you receive your medications without any delays. You will be given advice regarding your medication, especially if you are taking any blood thinning drugs or an anti-inflammatory.

The night before your operation you should have a high carbohydrate meal (such as pasta or rice) and drink plenty of fluids to stay hydrated. You will be asked not to eat solid food for 6 hours before your operation. You should stay hydrated and keep drinking clear fluids (water or clear apple juice with no pulp) up to 2 hours before your operation.

You will be given two carbohydrate-rich drinks to have before your surgery – one the night before, and the other on the morning of your operation. This drink will help with your recovery. A nurse will advise you on when to take this drink. You will also be given another carbohydrate drink after your operation to help with recovery.

Part 5: Going to hospital

The date of your operation and the time you should arrive at the Day Surgery and Admissions Unit will be sent to you by the hospital.

Please phone the day before your operation on 49206461 or 49206226 between 2.00 pm and 3:30 pm

If you develop an illness or sickness of any sort, including rashes, cuts, boils, pimples or notice any infection on or near the area of your operation, please contact us immediately.

You will need to attend the Day Surgery and Admissions Unit on the morning of your operation. From here you will go to the Day Surgery Unit where nursing staff will prepare you for your operation. You may have to wait for a little while, there could be more than one operation before yours.

Part 6: After Your Operation

The operation takes about two hours, but you will stay in the recovery area until the anaesthetist is happy that you are well enough to return to the ward.  A nurse will collect you and take you to your room in the Surgical Unit. We will let your next of kin know that your operation has finished, if you have told us that you would like this to happen.  If your family or friends phone the Surgical Unit it may be possible to transfer the call to you via the ward phone. However, if you have a mobile phone, it is easier and faster if your family and friends ring you directly.

You may have a wedge shaped pillow between your legs to keep them apart. You will have a drip for extra fluid intake and some oxygen going into prongs in your nose. Nurses will regularly take your pulse, blood pressure, temperature and other observations to make sure you continue to recover safely from your operation. You will also have routine blood tests and an x-ray done. Your pain will be regularly assessed and pain medications will be available as you need them. You will wear white compression stockings and leg pumps to assist with circulation and prevent blood clots. You can return to a normal diet as soon as you feel fully awake from the anaesthetic.

You will most likely have had a spinal anaesthetic that may affect urinary continence for a very short while.  For this reason you will have a pad in place for the first couple of hours after your operation and the nurses will keep track of when you pass urine.  Make sure you tell your nurse if you can’t pass urine.

It is important to drink plenty of fluids after your operation. You will also be given a carbohydrate drink in recovery. It is easy to become constipated after your operation because of the pain medications that we give you and because you will not be moving as much.  Please make sure your bowels are working normally during the week before your operation to avoid constipation in hospital.  A high fibre diet will help.  After your operation you should ask for pear juice and prunes when you order your meals.

There will be many times when we will ask you to tell us your name and date of birth and if you have any allergies. Our aim is to provide excellent care and we need to make sure we are providing you with the correct medications, meals, medical tests and procedures. Your safety is very important to us.

The doctors and pharmacist will talk about what sort of pain relief is best for you before you go home after your operation.

Part 7: After Your Operation – exercises

As soon as you wake up you should start doing your breathing and circulation exercises. These exercises help reduce your risk of complications such as chest infections and blood clots. You should do these every hour that you are awake.

To perform your Deep breathing exercises take a long, slow, deep breath in and hold it for 3 seconds. Try to get the air down to the bottom of your lungs. Repeat this 5 times.

Circulation exercises can be done sitting or lying. Gently move your feet:

  1. Up and down
  2. In clockwise circles
  3. In anti-clockwise circles

Do these for 2 minutes in each direction.

Depending on when you arrive back to the ward and get clearance from the medical team, you may be able to start moving again with a physiotherapist on the same day as your operation. This will be guided by your physiotherapist and may include sitting on the edge of the bed, standing with a frame or going for a short walk.  Usually, you can put as much weight on your operated leg as pain will allow. The physiotherapist will confirm with the doctors how much weight you can put on your leg before your first walk.  Your new hip needs extra support until it is fully healed and your muscles are stronger.  You will start walking with a frame and then crutches when appropriate.

Part 8: First days after your operation

The physiotherapist will assist you into a chair on the first day after your operation. You will sit in a high back chair with armrests.  We recommend you sit out of bed for all meals and throughout the day. The physiotherapist will aim to progress your walking ability each day to prepare you for going home.

Stairs

Once you are walking safely, the physiotherapist will teach you how to go up and down stairs. Even if you don’t have stairs at home, it is important you know the safest way to use stairs for when you are out and about. If there is a sturdy handrail you should use it for extra support when going up and down stairs. Your physiotherapist will ensure you are safe on stairs before you go home.

*Demonstration of stairs with crutches.

Functional Activity

The occupational therapist will help you regain your independence with getting on and off furniture, showering and dressing.  These activities may be more difficult because of the precautions that are in place after your operation. Your occupational therapist will also advise of any other equipment or techniques that will help you to perform tasks more easily or independently following your operation. These may be needed until your walking, strength and operated hip have improved.

Going home

You can expect to be in hospital for three to four days after your operation. Depending on how well you recover your stay may be shorter or longer.  Your team of therapists will guide you on how you are doing and the likely day you will be able to leave hospital. Depending on what your physiotherapist recommends,

you may leave with a four wheeled walker or other aid,

You will need to arrange for someone to pick you up from hospital before your operation, as the ambulance service cannot take you home. Please make sure the person assisting you with transport home is on standby to collect you at any time.

Driving

Under Queensland Legislation, you cannot drive for six weeks after your operation and may only start driving again once you have gained medical clearance from your surgeon or GP.  You may still travel by car as a passenger during this time. You will need to ask family and friends to assist with transport so you can attend appointments and access the community. Always travel in the front seat, make sure the seat is back as far as it will go with the backrest reclined and a firm cushion is in place to raise the height of the seat. Try not to travel in small, low cars for the first six weeks after your operation. Larger cars with more leg room will be more comfortable.

You may be eligible for some taxi subsidy from the Queensland Government. For more information, visit the Department of Transport and Main Roads' NDIS page.

Part 9: Precautions and complications

For the firstthree months after your operation there is a risk that your new hip may dislocate. Dislocation is when the two parts of the joint separate. There are certain things you must not do to prevent this from happening. The following precautions will protect your new hip from damage until the healing is complete.

Do not bend your hip more than 90 degrees. This means you cannot raise your knee higher than your hip. Do not sit in low chairs and sofas and do not lean forward while sitting.

Do not cross your legs when lying or sitting. If it is a hard habit to break, place a pillow between your legs to keep them apart.

Do not lie on the operated side and if lying on the un-operated side place a pillow between your knees.

Do not rotate or twist on the operated leg when turning or reaching for an object. Turn by taking small steps.

These precautions may vary depending on the approach taken by your surgeon. Your physiotherapist will talk to you about any changes to your precautions before getting you out of bed for the first time.

If you are healthy and fit before your operation and follow medical advice after your operation, your recovery should be straightforward. However, it is important to be aware of how you’re feeling and what is and isn’t normal when recovering. Be on the lookout for:

  • Venous thromboembolism (VTE), which is commonly known as a blood clot and can occur after major general surgery.  Symptoms may include increased pain and swelling in the calf.
  • Wound infection.  Symptoms include increased pain, redness and swelling around the hip.

Preventative treatment for these conditions will be prescribed by your doctor before you go home from hospital.  Treatment is different for everybody and may vary depending on other conditions, allergies and medications.

Part 10: Exercises

Exercising at home is important for your recovery. After your operation, the physiotherapist will provide you with a home exercise program, targeting the muscles around your hip.

It is a good idea to start these exercises before your operation in order to start strengthening your hip early.

Demonstration of exercises as below

Static quadriceps

Start in a relaxed and comfortable position in bed or on the floor, with your head propped up slightly.

Pull your toes toward your knee, tense the muscles on the front of thigh and at the same time squeeze your buttocks.

Keep leg and buttock flat on floor.  Hold for 5 second and repeat for 3 sets of 10 reps.

Inner Range Quads

With your operated knee over rolled towels, straighten the knee by tightening muscles on top of thigh.  Keep the back of your knee on the towel.  Hold for 5 seconds.  Repeat 3 sets of 10 reps.

Heel Slide

Bend the knee of the operated leg pulling your heel toward your buttocks.  Hold 2-3 seconds then return leg to flat.  3 sets of 10 reps., 2-3 times per day.

Bridging

Lie on your back with your feet shoulder width apart.  Gently lift your hips toward the ceiling, clearing your bottom off the bed.  Repeat 3 sets of 10 reps., 2-3 times per day.

Hip Abduction

With a pillow between your legs, bring your operated leg out to the side and then return to the pillow (do not cross legs).  Keep knee straight.  Repeat 3 sets of 10 reps., 2-3 times per day.

Hamstring Curl

Stand up straight and place your hands on a rail or bench for balance as needed.  Bend the knee of your operated leg.  Repeat 3 sets of 10 reps., 2-3 times per day.

Standing Hip Flexion

While holding onto a bench or rail, lift the knee of the operated leg, working up to 90 degrees.  As it gets easier you can also do marching on the spot. Repeat for 3 sets of 10 reps., 2-3 times per day.

Standing Hip Abduction

Stand up straight and place your hands on a rail/bench for balance as needed.  Take operated leg out to side.  Repeat for 3 sets of 10reps 2-3 times per day.

Standing Hip Extension

Stand up straight and place your hands on rail/bench for balance as needed.  Place the foot of your operated leg back as far as possible.  Repeat for 3 sets of 10reps 2-3 times per day.

Sit to Stand

Sit on the edge of a high chair, feet flat on floor.  Hands on chair or thighs as needed. Stand upright, extending knees fully.  Repeat for 3 sets of 10reps 2-3 times per day.

You should see your general practitioner or physiotherapist if you are having any difficulties, have a lot of pain or any other concerns with these exercises.

Part 11: Road to recovery

Your muscles will not regain full strength while you are in hospital.  It is important to continue your exercise program after you have left hospital to strengthen your muscles. The physiotherapist will refer you for an outpatient follow-up appointment to continue your strengthening exercises and walking regime.  This will usually be at three to four weeks after your operation.

Two weeks after your operation you will need to see your general practitioner/GP for a review of your wound and removal of any sutures. You will then see your surgeon about six weeks after your operation for a review.

After three months you should be back to most of your usual activities.  You may even find you can return to activities you haven’t been able to do for some time because of your hip pain.  Make the most of these improvements by getting back to activities you enjoy!

We look forward to meeting you in the Surgical Unit. We aim to provide excellent care and we know that you will be pleased with your experience during your stay with us.

We always want to know how we’re doing. You can give feedback at any time by filling out a Have your say’ form, available throughout the hospital or by asking a staff member for one. You can also call or email, or you can do it online at the link below.

We’re here to help.

Last updated: 28 September 2022

Contact

Rockhampton Hospital
Phone: (07) 4920 6300
Fax: (07) 4920 6301

Gladstone Hospital
Phone: (07) 4976 3207
Fax: (07) 4972 5435