Preparing for surgery

Good preparation shortens your hospital stay and makes the first fortnight at home considerably easier. This page covers the general principles. You will also receive instructions specific to your operation — where the two differ, follow the specific instructions.

In the weeks before

Medications. Bring a complete list of everything you take, including over-the-counter medicines, supplements and herbal preparations, to your pre-operative appointment. Some need to be stopped before surgery and some do not. Do not stop any prescribed medication without being told to.

Medicines that commonly need attention include blood thinners, anti-inflammatories, diabetes medications — particularly the newer GLP-1 agonists, which affect anaesthetic safety — and some rheumatological and biologic drugs.

All GLP-1 agonists (Ozempic, Mounjaro etc) must be stopped 3 days prior to surgery, and all patients taking this medication must have only clear fluids for 24 hours prior to surgery. These guidelines are constantly being updated so please check with both Dr Spelman and your anaesthetist well in advance of surgery.

Smoking. Stopping before surgery measurably reduces wound complications, infection and problems with bone healing. Even a few weeks helps. If you would like support, your GP can help.

Dental problems. Have any dental work completed before joint replacement rather than after. Bacteria from dental infection can seed a new joint.

Skin. Tell the rooms about any cuts, ulcers, rashes or infections on the operative limb. Surgery may need to be postponed — this is inconvenient, but far less so than an infected implant.

Fitness. Sometimes called prehabilitation. Building strength before surgery gives you more to work with afterwards. If you have been given exercises, do them consistently.

Getting your home ready

Arrange this before you go in, not after you get home.

•          Someone to drive you home from hospital, and ideally stay the first night

•          Meals prepared or frozen ahead

•          Clear the pathways you walk most — rugs, cords, clutter

•          Frequently used items moved to waist height

•          A chair with arms and a firm seat

•          Consider a shower chair, non-slip mat, raised toilet seat and long-handled shoe horn. The occupational therapist can advise on what you actually need

•          Plan for pets and children in the first fortnight

The day before

•          Fasting — you will be given exact times. Follow them precisely. Eating or drinking outside these times means your surgery will be cancelled on the day

•          Shower as instructed

•          Remove nail polish, jewellery and piercings

•          Pack: current medications in their boxes, referral and imaging, health fund card, Medicare card, comfortable loose clothing, flat supportive shoes, toiletries, phone charger, and any walking aids you already use

On the day

Your admission time is earlier than your surgery time. The hospital requires time to check you in, confirm your health fund status, get you changed and prepped before theatre. While it may seem excessively early, all of these steps are essential to ensure the day runs smoothly for both you and the surgical team.

You will meet the anaesthetist beforehand — this is the moment to raise any previous problems with anaesthesia, including nausea or difficulty waking.

Dr Spelman will see you before you go to theatre, confirm the operation and mark the correct limb.